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What is a “Shadow Merchant”?

A Jack Merchant Medical Mystery

The emergency room doctor had become a thorn in my side. He was demanding. He was demeaning. He was defensive. It was obvious to me he had suffered a painful experience with radiologists in his past practice. Pleasing the man was almost impossible. Every interpretation I gave him was insufficient. I was taking too long to report his ER cases. I was too vague in my reports. I was wrong with my diagnoses. You name it, he never appreciated my hard work.


As a radiologist, I was used to this kind of treatment. I’ve been in the business for almost 40 years and recall how poorly we were regarded at the beginning of my practice. Times have changed and radiologists are integral partners in patient diagnosis and treatment and we are accepted as equals by our colleagues in other specialities.


But that was not the case years ago with this emergency room physician. He sat in my office while I was going over the findings of a CAT scan of a patient’s abdomen and pelvis. He told me he was leaving our hospital for another practice. I was ecstatic but didn’t show it. In a rare moment of honesty he looked at me and said, “You know, I practiced in a military hospital before I came here. The radiologist there was not that proficient. That’s not a commentary on the military. Just a commentary on the person. Your group has done a good job while I’ve been here and I wanted to thank you before I left.”
I was stunned and he shook my hand. He stood up and before he walked out the door he said, “You’re the best of the shadow merchants in your group.”
“Shadow merchants?” I asked.
“Yeah. That’s what we call radiologists in the military. Shadow merchants. You live in the shadows and make a living by interpreting shadows on your films. Shadow merchants.” He walked out.

There is a suggestion for authors, write what you know.

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