Celebrated Physician: Brooke M. Wolvin, MD

Brooke Wolvin, MD, an attending physician for MedStar Medical Group Radiology, also serves as assistant director of MedStar Washington Hospital Center’s Breast Imaging Center, and director of Breast MRI.

That may seem like a long title, but it’s illustrative of imaging technology’s critical role in breast health. And it’s a field well-suited to Dr. Wolvin’s personal and professional interests. The Potomac, Md., native earned her medical degree at New York Medical College, followed by a radiology residency at New York Presbyterian Hospital-Weil Cornell campus. She then completed a breast imaging fellowship at Memorial Sloan Kettering Cancer Center before returning “home” to the Hospital Center in 2008.

Why Radiology?

“I chose radiology because you get to deal with a wide variety of patients,” Dr. Wolvin says. “Breast imaging is a particularly interesting niche, as it also involves a lot of patient interaction. It starts with the mammogram—still the best way to initially detect a potential breast health issue—and continues across a variety of tools to treat patients who need extra care.”

Among those valuable technologies is 3D imaging, also called tomography, which Dr. Wolvin calls “the greatest innovation in past 20 years.” She likens tomography to a CAT scan of the breast, allowing physicians to scroll through each layer of a scan to spot even the tiniest hint of a tumor or other condition.

“Along with increasing the cancer detection rate, tomography also lowers the number of patients who need to be called back for additional tests,” adds Dr. Wolvin, who has been instrumental in implementing tomography across MedStar. “It’s wonderful that we’ve been able to bring this capability to so many of our breast imaging centers.

Yet another of Dr. Wolvin’s responsibilities is serving as assistant medical director of Radiology at the new MedStar Health at Lafayette Centre in downtown Washington, D.C. There, she says, “we work with a different set of patients and issues, which enhances both our experience and the quality of our services.”

Outside the Hospital

What gives Dr. Wolvin the greatest sense of pride is setting a positive example for her two children, ages 4 and 18 months.

“My mother was a full-time professor, and proved to me that a working Mom can successfully balance work and family,” she explains. “I want my kids to have the same sense of possibility I did.”

Celebrated Physician: Erin O’Neill, MD

The title on Erin O’Neill, MD’s business card reads “Attending Radiologist.” But it could just as accurately say “Puzzle Solver.”

That’s because Dr. O’Neill uses MedStar Washington Hospital Center’s array of state-of-the-art imaging technologies to help other physicians diagnose and treat a variety of illnesses, from the routine to more complex, medically challenging conditions.

“We see all the best cases,” Dr. O’Neill says. “That’s a privilege not all other specialties have, but it also keeps us on our toes.”

Why Radiology?

Originally from Minnesota, Dr. O’Neill considered training in surgery until she became fascinated with radiology’s procedural and analytical aspects. After medical school and internship at Creighton University Medical Center, it was on to Chicago where she completed a radiology residency at Rush University Medical Center, where she served as chief resident. Dr. O’Neill remained in the Windy City for an MRI Predominant Body Imaging and Musculoskeletal fellowship at Northwestern Memorial Hospital.

Training at some of the country’s leading research centers for radiology helped prepare Dr. O’Neill for keeping up with a technologically fast-paced field.

“It does require a lot of reading, and a lot of collaboration with my colleagues here at the Hospital Center and at MedStar Georgetown University Hospital,” she says, “but the strides that have been made in both the quality of imaging and patient safety are amazing.”

Body MRI, for which Dr. O’Neill serves as the Hospital Center’s associate director, is one of the fields most widely used tools, as it can provide extremely clear, detailed scans without the use of radiation. Still, not all patients are comfortable with the procedure, which often involves spending long periods in an enclosed tube.

“We do what we can to make them comfortable and feel at ease during the procedure,” Dr. O’Neill says. “We also look for the best alternative to evaluate a particular condition, such as using ultrasound for younger patients to limit their cumulative radiation doses.”

Outside the Hospital

Dr. O’Neill could easily add another business card title, “Mom.” She and her husband, who works in finance and real estate for a national accounting firm, love spending time with their 2-year old son and the family dog. But while they enjoy the attractions of the Nation’s Capital, they’ve also gotten to know the area’s airports quite well.

“We’re both from the Midwest, so we travel back often to see family and friends,” Dr. O’Neill explains. “There are a lot of places that we get to call ‘home.’”

Overnight Radiologists: Providing Patient Care Around the Clock

Tina Rosenbaum, MD, has been an emergency room physician at MedStar Washington Hospital Center for 12 years – and for much of that time, there was a gap in medical imaging as part of patient care in the middle of the night. “[But] now, we get our answers immediately,” Dr. Rosenbaum says.

The reason? Our overnight radiologists who provide immediate coverage at the Hospital Center, as well as several other MedStar facilities.

Radiology chairman James Jelinek, MD, says the program was the idea of Arnold Raizon, MD. Prior to instituting dedicated teams to cover the overnight hours, radiologists would generally work their normal daytime schedules and then trade off night-time shifts. In addition, MedStar hospitals were previously covered by five different groups, all using different computer systems.

This approach didn’t make for the best patient care experience.

The Rising Need for Overnight Radiology Coverage

Laurie Abrams, MD, notes, however, that the need for dedicated overnight coverage wasn’t always necessary. Smaller radiology practices – which were the norm 20 years ago – didn’t lend themselves to dedicated teams to work the overnight hours. But as practices consolidated and grew larger, small teams of overnight radiologists became a more practical solution.

Also, the technology changed. “Reliance on imaging technology is much greater than it used be,” Dr. Abrams says.

Imaging tests can be used to diagnose an ever-increasing number of conditions. For example, head scans were previously considered to be a rare event, but now a busy hospital might find it necessary to conduct four or five head scans in a single hour. So having an overnight radiologist on-hand to offer advice, and interpret scans and films, can make a huge difference.

Bridging Gaps, Provide Better Patient Care

Thanks to the institutionalizing of the overnight radiologists at MedStar Washington Hospital Center and other facilities, many patients can be sent home quickly and safely. And when they need to be sent to the operating room, that too happens more efficiently.

That’s not to say there aren’t challenges to working overnight.

From the moment they log into the Radiology platform, they have a worklist that generally keeps them busy for the entire shift – and that’s on a normal night. On nights when there are multiple trauma cases, the need for both speed and accuracy becomes enormous.

“Your brain is always on. There is no downtime,” Gabe Schneider, MD, points out.

But that is one of the very reasons why this group takes such pleasure in their work. All radiologists are integral to patient care, says Dr. Taner, but overnight, “you are often the decision point. You can make the most difference.”

For instance, Dr. Rosenbaum says it’s not uncommon for the radiologist to take the initiative and inform the surgical teams when it is apparent that surgery will be necessary: “They will link together all the different teams and keep the lines of communication open. That helps everyone.”

For Dr. Raizon, that type of teamwork is the entire key to what they do. “The technical staff has always had dedicated people who work at night. It makes sense that the physicians do, too. This way, we all get to know each other, which leads to better patient care.”

It’s About People

Even with spending their evenings and late nights intimately involved with some of the technologically sophisticated aspects of medicine, all four overnight radiologists stress that the personal relationships they have developed are the single best part of the job.

Dr. Raizon, who has been there from the beginning, intends to work in this capacity for the remainder of his career. “I really like the people I work with at night,” he says. “It’s not just about reading X-rays. So much of medicine is about the people."

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