It is not uncommon for veterinarians to ask for second opinions on teleradiology interpretations. In some cases radiologists miss a lesion and the request is valid. In other cases, the radiologists is on the money and they just want to be sure that you are seeing what they are seeing. In other cases, crafty veterinarians they to trick the radiologist by not giving you a correct history and then they want to give you the real history and re-read the report to see if the report changes (don’t ask –it happens all the time.)
In all cases, radiologists must look at second opinion requests as golden opportunities to build a better client relationship. Your clients are asking you for help and giving you a second chance. Second opinion requests are your time to shine and show that you care.
Unfortunately, too many radiologists do the opposite and react negatively and fly the “I am the radiologist listen to what I say. My reports come down from Mt. Sainai and you must take them as gospel. Do not question me you silly veterinarian” banner and make a bad situation worse. Too many times, radiologists fire off a terse email in response to the request as if they cannot be bothered.
When confronted with a second opinion request, your best bet is to call the veterinarian immediately.
What you will find if you take the time to get on the phone is that many second opinion requests are not really requests for a second opinion. Rather, they are pleas for you to take more time with your reports. If you read between the lines a bit you will find that what they are really trying to say is…”hey radiologist, I really like sending my cases to you but your reports are too short, you do not use full sentences, and you don’t even talk about incidental things that are so friggin obvious I even put them in my patient record. What I am trying to say is that based on your report, it looks like you do not really care abut my business and I need you to show you care or I am going to take my business elsewhere.”
Here is an example of an email that was sent to a radiologist:
“In response to your report on XXXX, we have several follow up questions. Regarding the soft tissue mass opacity in her caudal lung field: could you please elaborate on this area for size and architecture? Also, could you please describe the orthopedic changes?
This situation got even a little more sticky when the radiologist responded:
Hi....I'm not sure what you're looking for....the opacity in the caudal dorsal thorax is confined to a small area....it's an opacity (don't know how else to characterize it) and I feel it represents slight eventration of the diaphragm. What orthopedic changes are you referring to? I typically don't comment unless there is something significant.
For what it is worth: the report was accurate and this was a bulldog with a nasty spine. In a court of law, there was nothing wrong with this report as it is 100% accurate. From a business relationship standpoint, it left something to be desired as did the radiologists response.
Bottom line: love your clients and use second opinion requests to show you care. Even better, make every report count and show your clients you care before you even need a second opinion request.