Neuroradiology- The view from the other side. (A survey of Neurologists and Neurosurgeons in India – November 2018) —- Dr. Ravi Ramakantan
In November 2018, I ran this survey amongst 2600 Neurologists, neurosurgeons and a few residents in training from all over India. The survey ran for about 10 days and levelled off at 160 responses.
My main purpose in conducting this survey was to ascertain the relevance and importance of reports related to neuroradiological studies generated by radiologists in today’s practice environment and to ‘crystal-ball’ how the inevitable introduction Artificial Intelligence in image interpretation will impact this.
As and when possible, I will repeat such a study in other major specialities. Be warned!!
When I am asked such a question, I wonder “Why not?” such a survey.
We are here to ‘service’ the needs of patients through their physicians. It is very logical that they are the best people to tell us if we are doing our job right and helping in patient care.
We will never know this unless we ask the difficult question.
Conversations with referring colleagues seldom reveal the harsh truth, much of criticism goes on beyond our earshot in hushed voices and cupped hands. I had written about this long ago – and it is still true.
Hence an anonymous survey is the only way forward, Warts, moles and all. I feel that such survey conveys the broad truth and I am happy to work and learn from such overarching responses.
For long in my career, I have worked closely with neurologists and neurosurgeons and I understand how they work with patients, neuroradiological studies and radiologists.
In our country, neurosurgeons have in the past, taken the lead in performing radiological investigations and have themselves performed many of the older invasive investigations.
It is not surprising therefore, that I have learnt a whole lot of Neuroradiology from Neurosurgeons.
Dr. Sunil K. Pandya has taught me the most. Dr. Pandya for long, was the the Chief of Neurosurgery at the KEM Hospital.
In one such discussion Dr. Pandya mentioned an obvious truth when he said:
“Ravi, we have the advantage of seeing and examining the patient, then do and see the radiology and we know from the operations we perform what it was. In addition we ask for post mortem examinations on almost all our patients. Unfortunately, radiologists rarely have such opportunities”.
For more than a decade, Dr. Pandya had encouraged me to attend the ‘Brain Cutting Session’- – so ably conducted by the Neuropathologist Dr. Anand Desai. Living in the hospital quarters enabled me to attend ‘live’ postmortems as and when required.
My teacher in Radiology, the late Dr. Jimmy Sidhwa who trained in Neuroradiology in the UK in the 60s, can easily be called the first ‘Board Certified” Neuroradiologist in our country. In the UK, he had trained with the doyens in Neuroradiology. His astuteness in picking up findings and interpreting them was inspiring.
A dear neurologist friend, the late Dr. Sorab Bhabha, would drag me each Friday evening to “Ward 10” to take the post-admission evening rounds with him. This went on for a decade or so. I did learn a bit of clinical neurology from this exercise.
For decades, Friday mornings saw neuroradiology meetings with neurologists and sometimes, neurosurgeons. These interactions left me thinking how important it is for the radiologist to understand the implications of what is said in radiology reports.
The learning I have had in these three-way sessions is incomparable to any other source of learning.
More than anything else, this website devoted to the “Patient behind the Image” owes its origins to experiences such as these.