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Good to hear from you, Ken. So you haven’t retired either! I have a pdf of a slice presentation by Bob Dixon given at the 2012 RSNA. It’s full of Monty Python references, great analogies, and nice graphics that I think she’ll</div>
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<p class="MsoNormal">Good to hear from you, Ken. So you haven’t retired either!<o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal">I have a pdf of a slice presentation by Bob Dixon given at the 2012 RSNA. It’s full of Monty Python references, great analogies, and nice graphics that I think she’ll understand. She can skip the physics-y stuff.<o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
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<p class="MsoNormal"><span style="font-size:11.0pt"> </span><o:p></o:p></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif;color:#A50021">Robert J. Kobistek, MS, FACR, DABR, MRSE(MRSC™)</span><o:p></o:p></p>
<p class="MsoNormal"><span style="font-family:"Arial",sans-serif;color:#A50021">Medical Physicist</span><o:p></o:p></p>
<p class="MsoNormal"><span style="font-size:22.0pt;font-family:"Castellar",serif;color:#A50021">RJK</span><span style="font-size:22.0pt;font-family:"Colonna MT";color:#A50021">
</span><span style="font-size:14.0pt;color:#A50021">Medical Physics, Inc.</span><o:p></o:p></p>
<p class="MsoNormal"><span style="font-size:14.0pt;color:#A50021">440-463-7879</span><o:p></o:p></p>
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<p class="MsoNormal"><span style="font-size:14.0pt;color:#A50021"> </span><o:p></o:p></p>
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<p class="MsoNormal"><b><span style="font-size:11.0pt;font-family:"Calibri",sans-serif">From:</span></b><span style="font-size:11.0pt;font-family:"Calibri",sans-serif"> Kenneth Coleman <KColeman@radser.com>
<br>
<b>Sent:</b> Wednesday, June 3, 2026 10:26 AM<br>
<b>To:</b> Bob Kobistek <bob@rjkmedphys.com>; DxMedPhys List <intl_dxmedphys_wd_osu_list@lists.osu.edu><br>
<b>Subject:</b> Re: How far should we go with advice<o:p></o:p></span></p>
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<p class="MsoNormal"><o:p> </o:p></p>
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<p class="MsoNormal"><span style="color:#212121">Bob,<o:p></o:p></span></p>
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<p class="MsoNormal"><span style="color:#212121"><o:p> </o:p></span></p>
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<p class="MsoNormal"><span style="color:#212121">You have been invited into a dangerous region. This person has processed some bad information and I don't think you'll be able to correct the problem. Any attempt to do so puts you in an uncomfortable position. <o:p></o:p></span></p>
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<p class="MsoNormal"><span style="color:#212121"><o:p> </o:p></span></p>
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<p class="MsoNormal"><span style="color:#212121">Your idea to provide her links to some accurate information is, I think, the better and safer route to take. It will provide her accurate information and keep you out of the line of fire.<o:p></o:p></span></p>
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<p class="MsoNormal"><span style="color:#212121"><o:p> </o:p></span></p>
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<p class="MsoNormal"><span style="color:#212121">Good luck. <o:p></o:p></span></p>
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<p class="MsoNormal"><o:p> </o:p></p>
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<p class="MsoNormal"><span style="color:#212121">Kenneth A. Coleman, ME, DABMP, DABSNM <o:p></o:p></span></p>
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<p class="MsoNormal"><span style="color:#212121">President, Medical Physicist <o:p></o:p></span></p>
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<p class="MsoNormal"><span style="color:#212121">Radiation Services, Inc. <o:p></o:p></span></p>
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<p class="MsoNormal"><span style="color:#212121">9320 McIntosh Road, Dover, Florida 33527<o:p></o:p></span></p>
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<p class="MsoNormal"><span style="color:#212121">Cell: 813-245-2427 <o:p></o:p></span></p>
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<p class="MsoNormal"><span style="color:#212121">Office: 813-685-3796 <o:p></o:p></span></p>
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<p class="MsoNormal"><span style="color:#212121">Fax: 813-685-2448 <o:p></o:p></span></p>
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<p class="MsoNormal"><span style="color:#212121">WATS: 800-505-6828 <o:p></o:p></span></p>
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<p class="MsoNormal"><span style="color:#212121"><o:p> </o:p></span></p>
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<p class="MsoNormal"><span style="color:#212121">Sent from my T-Mobile 4G LTE Device<br>
Get <a href="https://urldefense.com/v3/__https://aka.ms/AAb9ysg__;!!KGKeukY!2p5FjIUxkr-iBIZY-JiytEKwCdN2pgcXClW8OdqDC059t3ekfKsVpN8UEwHJsBotKVs9pZJo1bL4xGpQYcG5Y9-xn1SubsW8noZdnQ$">Outlook for Android</a><o:p></o:p></span></p>
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<p class="MsoNormal"><b><span style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:black">From:</span></b><span style="font-size:11.0pt;font-family:"Calibri",sans-serif;color:black"> Intl_dxmedphys_wd_osu_list <<a href="mailto:intl_dxmedphys_wd_osu_list-bounces@lists.osu.edu">intl_dxmedphys_wd_osu_list-bounces@lists.osu.edu</a>>
on behalf of Bob Kobistek via Intl_dxmedphys_wd_osu_list <<a href="mailto:intl_dxmedphys_wd_osu_list@lists.osu.edu">intl_dxmedphys_wd_osu_list@lists.osu.edu</a>><br>
<b>Sent:</b> Wednesday, June 3, 2026 8:51:44 AM<br>
<b>To:</b> DxMedPhys List <<a href="mailto:intl_dxmedphys_wd_osu_list@lists.osu.edu">intl_dxmedphys_wd_osu_list@lists.osu.edu</a>><br>
<b>Subject:</b> [Intl_DxMedPhys] How far should we go with advice</span> <o:p></o:p></p>
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<p class="MsoNormal"> <o:p></o:p></p>
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<p class="MsoNormal" style="mso-line-height-alt:.75pt"><span style="font-size:1.0pt;color:white">Hi list. I got a call from a lady who was looking for a hospital to do her calcium score scan. Her local hospital closed. She was asking what would be her effective
dose from the scan and explained that she had reached her “lifetime limit”<o:p></o:p></span></p>
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<p class="xmsonormal">Hi list.<o:p></o:p></p>
<p class="xmsonormal"> <o:p></o:p></p>
<p class="xmsonormal">I got a call from a lady who was looking for a hospital to do her calcium score scan. Her local hospital closed. She was asking what would be her effective dose from the scan and explained that she had reached her “lifetime limit” so essentially,
she was shopping for the lowest dose. I asked her to explain the lifetime limit. She said that she had received “an enormous amount of ct rads due to errors at the hospital.” Subsequently a radiologist refused to do a Ba swallow because of it. He told her
to not have any more CT scans and only get ultrasound or MRI in the future. <o:p>
</o:p></p>
<p class="xmsonormal"> <o:p></o:p></p>
<p class="xmsonormal">I started typing a response telling her to get a second opinion about the “lifetime limit,” explaining how stochastic effects work, how the decision to go forward with a scan should be based on risk vs benefits of the current scan, not
the past scans, and so on. Then I deleted that part out of fear of liability. I’m not a physician, and that lady isn’t even a patient at the hospital where I consult. But on the other hand, I feel that I’m doing her a disservice to not say something about
the fool of a radiologist who told her to stop betting CT scans.<o:p></o:p></p>
<p class="xmsonormal"> <o:p></o:p></p>
<p class="xmsonormal">I’m thinking pointing her to some lay-language reading material might be a good step.<o:p></o:p></p>
<p class="xmsonormal"> <o:p></o:p></p>
<p class="xmsonormal">Thoughts?<o:p></o:p></p>
<p class="xmsonormal"> <o:p></o:p></p>
<p class="xmsonormal"> <o:p></o:p></p>
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<p class="xmsonormal"><span style="font-size:11.0pt"> </span><o:p></o:p></p>
<p class="xmsonormal"><span style="font-family:"Arial",sans-serif;color:#A50021">Robert J. Kobistek, MS, FACR, DABR, MRSE(MRSC™)</span><o:p></o:p></p>
<p class="xmsonormal"><span style="font-family:"Arial",sans-serif;color:#A50021">Medical Physicist</span><o:p></o:p></p>
<p class="xmsonormal"><span style="font-size:22.0pt;font-family:"Castellar",serif;color:#A50021">RJK</span><span style="font-size:22.0pt;font-family:"Colonna MT";color:#A50021">
</span><span style="font-size:14.0pt;color:#A50021">Medical Physics, Inc.</span><o:p></o:p></p>
<p class="xmsonormal"><span style="font-size:14.0pt;color:#A50021">440-463-7879</span><o:p></o:p></p>
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<p class="xmsonormal"><span style="font-size:14.0pt;color:#A50021"> </span><o:p></o:p></p>
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