[Donald Corenman, MD, DC]

#22324

Calling administration sometimes falls on deaf ears. A well written discussion of the events should cause a response. Don’t put your anger and frustration into the letter but calmly discuss the elements we noted here and give them 3 weeks to respond.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

[MissJ]

#22328

Thanks again for your response. Neutralizing my anger with this is the HARD part of drafting the letter.

The more I look at it, the more it looks like the radiologist seeing (there were a number of things to observe/note on) my X rays, wanted to avoid doing so, used template language (instead) to substitute for much actual observation and may have pre selected the conclusion to be ‘mild arthritis’ as to PEG FIT into some kind of pre-existing template.

For example:

a: Some twisting to the lower lumbar region is visible on the AP. Yet “FINDINGS: Thoracic, lumbar and cervical spine vertebral body height and alignment is preserved…” Note the word: ‘alignment’ is used for lumbar. Here an observation to be made was disregarded in favor of using what I call ‘pre fabricated language’ (found on a template) instead. Other examples of things that could be observed on the X rays, such as various connective tissue calcifications, osteophytes along anterior cervical neck (and more) were omitted from mention.

b: The most salient give away of the interpreter wanting to substitute what I call; ‘pre-fabricated language’ (found on a template) for actual observation is the claim she observed patent foramina from an oblique view and the claim of 4 views of the cervical spine in the TECHNIQUE when ONLY 2 views: AP and lateral actually exist on the X-Ray CD.

The strong preference to save time noting actual observations and relying on template instead results in ‘observations’ which would have been impossible to observe, in particular patent foramina from an oblique view which did not exist in the series.

This undermines the validity of all the ‘observations’made and conclusions drawn thereof and calls for a re-read from an observant interpreter.

[Donald Corenman, MD, DC]

#22331

Many radiologists have a certain way that they dictate. It would be the equivalent of a “macro” or template in computer language but it is in their head. Again remember that these individuals don’t really have a good history of your disorder and do their best to discuss the findings in words (but some are much better than others).

I do agree that you deserve a new reading from another radiologist. Try to contact administration as noted above. If they don’t respond, let them know that you might contact local news groups (but only after the non-confrontational letter is delivered to them and you give them plenty of time to respond). Hospitals in these days cannot afford to have this kind of publicity.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

[MissJ]

#22336

Thanks again for your very insightful feedback on this matter. You sure sound like you know your stuff.

I’ve had 2 other X ray reports from doctors working at this hospital. Not to sound trite but the other ones did appear like the doctors did their ‘own observations’. I mean from the language, I could tell they were actually OBSERVING/paying attention and reporting. So, my comparison was 2 radiologists prior of known competence where I could recognize that just by reading the report even before I knew one was the department head and the other on the teaching staff of the hospital.

You know when they mention such things as osteophytes and their location, subchondral cysts and differentiate that from subchondral sclerosis and/or point out other things (incidental) like phleboliths in soft tissue areas etc., it becomes quite clear they are actually observing the X rays.

An erstwhile MIT classmate of mine, who has been a radiologist for the past 30 years mentioned something about (good) radiologists being replaced by machines. Also there is some ‘buzz’ about reports being ‘ghosted’ by teleradiology firms in India. In 2003, there was a scandal about that sort of thing at MGH in a NYT article. However, other advice I got regarding what to say in the letter was not to speculate if the reports came from a teleradiology sweatshop in India of if the interpreter pre-selected the conclusion before she actually came to it for the purpose of ‘fitting’ into the template. But rather to do what you said; dispassionately point out the discrepencies.

I like your idea about contacting local news agencies (contingency back up). My first thoughts of what to do if NO rectification would be to find some academic with interest in writing articles in professional journals (or on ‘Aunt Minnies’ radiology website) with focus on how to write good reports where this bad one would be an example of what not to do.

Meanwhile, I’m trying to track down the e mail addresses of the department head and also the doctor doing the report. Hard to track down given the profession has always been one that REMOVES itself from direct patient communication.

[Donald Corenman, MD, DC]

#22339

I know that at Vail Valley Medical Center, they had use of “Nighthawks”; board-certified radiologists that live in Australia to read on the “off hours” but never would a foreign radiologist read during normal business hours. I think you will gain the administrator’s attention with a well written letter and gain satisfaction with the result.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

[Donald Corenman, MD, DC]

#22340

I know that at Vail Valley Medical Center, they had use of “Nighthawks”; board-certified radiologists that live in Australia to read on the “off hours” but never would a foreign radiologist read during normal business hours. I think you will gain the administrator’s attention with a well written letter and gain satisfaction with the result.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

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