Everyone Needs A Little More Radiologist In Them Part II
For an audio version of this post, please click on the speaker icon (top left).
In case you missed the previous installments:
So here are more of the concepts I have gleamed from being a radiologist/physician and how I apply them in my everyday/financial world:
Radiology Concept #5
There have been instances where a radiologist has done everything right, correctly identifying pathology, putting it in a report and signing off in a timely fashion and yet still get sued successfully.
Why is that?
Because the radiologist did not communicate the significant finding and document that communication with the ordering service.
There are multiple cases where a significant finding was documented by the radiologist in the report but somehow got lost in the shuffle and the referring physician did not get the necessary information for further workup.
Both the radiologist and referring doctor then get dragged into the ensuing malpractice case and often have judgements against both physicians.
The key is therefore to establish a reliable line of communication between the radiologist and the referring provider so that good continuity of care is provided to the patient.
I cannot stress how important it is to document these communications.
If it is not clearly documented, it is as if it never happened.
It is important to have some means of documentation and communication regarding your investing philosophy and plans.
This is of utmost importance if one spouse is handling all the finances/investments while the other spouse is left in the dark.
If something happens to the financial spouse, the survivor can be put at an extreme disadvantage with absolutely no idea how to continue the finances for the household.
Having an Investment Policy Statement can help ease this difficult financial transition.
Ideally you have prepared ahead with an In Case Of Emergency Binder that conveniently lists all the pertinent information for your spouse to follow.
Radiology Concept #6:
Know your limitations
Even after 4 years of medical school 5 years of radiology residency, and 1 year of interventional radiology fellowship the amount of information on radiology I know is dwarfed by the amount I do not.
The amount of material is too overwhelming for any one individual to be an expert in the entire field of radiology (this holds true for any specialty for that matter).
This is the primary reason why there is advanced subspecialization training available for those who want to continue the education process via fellowships.
But even these subspecialty trained physicians cannot be expected to know everything, especially with the continuing expansion of knowledge through medical advancements.
So when I come across a perplexing case, I have no qualms enlisting the help of others to get their opinion and help me formulate a better interpretation.
Each physician brings his or her own experiences to the table and through collaboration an appropriate differential diagnosis can be obtained.
The vast majority of physicians have had no formal training in tax code, law, or finance.
Although there is bias on personal finance blogs to cut down costs and take a more DIY approach, if these endeavors are outside your wheelhouse, there is no shame seeking professional help to fill in the deficiencies.
Trying to save a few dollars avoiding consulting fees and then make a mistake on your own that costs you thousands more down the road is not a financially sound practice.
Radiology Concept #7:
Choose the right tools
With regards to medical imaging, the most expensive equipment does not necessarily mean that it is the best for evaluating a particular medical problem.
If there is a question of gallbladder disease for example, using ultrasound is preferable to the far more expensive CT study and has an added bonus of no radiation exposure for the patient.
Intravenous contrast is another tool a radiologist has to aid in interpretation of certain studies however it should be used judiciously.
Sometimes studies require IV contrast to get the best information.
Other times, however, IV contrast can actually hide what you are trying to find (such as renal calculi which can be obscured by IV contrast).
When starting on your journey to financial independence there are several tools that can make your progress that much easier.
One of the most important barometers for your financial progress is your net worth.
In the old days calculating your net worth could often be an extremely tedious process, requiring manual input using data from multiple financial institutions.
Fortunately the digital age has provided us with one of the most amazing tools to help you achieve the same results in just a fraction of the time, Personal Capital.
Best of all Personal Capital is completely free to use.
I also take advantage of Microsoft Excel which, in combination with the data I get from Personal Capital, allows me to get a great snapshot of my assets as well as indicating how I need to rebalance my portfolio.
[For those who subscribe to this blog you will receive a link to a hidden password protected page on this site that gives you access to the Net Worth Spreadsheet Excel template I created.
You can use this as a building block for your own spreadsheet or modify it to fit your personal needs.]
Radiology Concept #8
Continued medical education
After 25+ years of formal education you would think that you would never have to pick up another educational book again.
Unfortunately this is not the case.
Rapid advances in medicine can make prior knowledge obsolete in a few years.
In order to provide the best medical care a physician therefore has to keep up with current medical literature.
This can be accomplished by CME (continuing medical education) which is a requirement (typically 25 hours of CME/yr) for both state licensure as well as maintaining board certification.
Just like medicine, it is important to keep up with current financial issues so that you can optimize your money.
This particularly holds true regarding the ever changing tax code.
It is important to be cognizant of current tax laws and how it effect both the accumulation and decumulation phases of your portfolio.
Reading personal finance blogs as well as a financially oriented book or two should round up your yearly financial educational requirements.
Radiology Concept #9
Tincture of time
Despite advances in imaging I still encounter lesions that pose a diagnostic dilemma.
Most patients prefer avoiding invasive procedures to try and get a more definitive answer, especially if the lesion ends up being a benign finding.
One of the best tools a radiologist has is the “tincture of time” as my radiology partner puts it.
If, after a short term repeat study, the lesion is identical to the original study, we are more confident in saying that this is a benign etiology (or if the lesion remains borderline can push it out to an additional 1 year follow up for additional confirmation of its benignity).
If, however, the lesion has grown and developed more worrisome features, subsequent invasive procedures would then be more appropriate.
For those beginning the journey to wealth they have the advantage of time on their side.
Compound interest is indeed the 8th wonder of the world.
In addition, building a portfolio for retirement is a long term play.
Much like not resorting to invasive procedures right away, it would be unwise to have a knee-jerk reaction and have an equity sell-off whenever there is a market downturn.
It is important to tune out the noise of short term volatility that the stock market displays but rather look at the long term picture which has always shown the stock market to have an upward trend throughout history.
That is using the tincture of time to help with a sound investment strategy.
Please stay tuned for subsequent installments in this multi-part series.
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Even a steadfast DIY’er can sometimes gain benefit from the occasional professional input.
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