Why Would You Ask Your X-ray Tech Something You Should Have Asked Your Doctor?

Have you ever seen the Christmas cult classic movie "A Christmas Story"? There's a scene where the main character 10 year old Ralphie is visiting a mall Santa at their local department store. When he finally gets to Santa, his mind goes blank and he's almost in a hypnotic state, frozen and unable to speak. Santa makes some suggestions to Ralphie about receiving some generic boy specific toy. Ralphie feebly responds in agreement and is prompty sent down the slide away from Santa. But it's at that point at the pennicle of the slide that Ralphie comes to his senses and blurts out what he really wants, the reason why he waited forever in line to request from Santa in the first place.

That scene is played over and over in my mind almost every day at my Radiology Department. I get questions everyday from patients that should have been asked while in the presence of their doctor, the whole reason for their visit in the first place. I imagine patients, like Ralphie, becoming entranced with what the doctor's opinion is in regards to their problem, illness, injury, etc.

But something happens between the doctor's exam room and my x-ray room. I get questions like,
"How long do you think it will be until I feel better?"
"Will I need surgery?"
"Do you think it's broken?"

Patients seem to think that we're on their side and are willing to give the "true story" while doctors are vague and tell them things they don't want to hear.

Truth is, most techs do know what's going on in an x-ray film, CT, MRI, Nuc Med scan, Ultrasound, Mammogram, Dexa scan, Angio, and Stereotactic Biopsy. But legally we our bound by law not to give out any interpretive results regarding a pathology finding. We have to use our best "poker face" and pretend nothing was seen. Evaluating, interpreting, or consulting is outside of our licensed scope of practice. If I give you the upward nod regarding your fractured wrist, even though you're going to hear it from your doctor in about 20 minutes, I loose my job and license to ever work again in my profession. At the pay rate and benefits I'm currently receiving, there's no way I'm sharing my secret with you, no matter how irrate and bugged you get. Tough, I want to keep my job. I'm not going to risk it just to make you happy or to help you win that bet with your wife.

I mean, how is this fracture information going to help you in the small moments before your doctor tells you? Do you not trust the doctor you're seeing in the first place? If that's the case then that's your issue to pursue, don't involve me in your doctor/patient situation. I'm providing a service to your doctor who then is providing a service to you. I'm the chef, your the customer and your doctor is the waiter. You don't bypass the waiter and ask the chef for more water, right?

Because I have some patients traveling to my clinic from long distances, I usually ask if they are supposed to bring the x-rays back to their doctor today. That opens up a whole bag of worms;
"Uh, do you think I should?"
"Why, did you see something? If you think I should then I will".

And then there's the classic, "Do you see anything on the x-ray?" This is the point where the whole patient and tech relationship has a tendency to get ugly. I once had a patient ask me directly;
Patient: "Did you see anything?"
Tech: "No, I can't read the x-rays".
Then the patient picked up a magazine, shoved it in my face and asked, "Well can you read THIS?"

I've even had patients tell me that they have a RIGHT to know what I saw. That's a good one. You want a scientific observation? Here's one; the louder the patient raises their voice to me is inversely proportional to their intellegence. It's all I can do to keep from laughing in their faces. People who don't really know their rights sure seem to KNOW their rights...in their minds anyway.

I have a more calm approach when it comes to these type of questions. Usually when I tell the patient I don't read the films, I get in response, "Ah, come on. You look at these films everyday." My response, "Hey, just because I look up and see clouds everyday doesn't make me a meteorologist". That comment usually puts a stop to the whole "let's see if I can get the tech to tell me" Q&A session.