10 Steps to Better Benefit-Risk Conversations

Alleviating a patient’s anxieties over having an imaging study done can sometimes be difficult. The scans are likely unfamiliar, and he or she has likely heard about the risks associated with radiation.

Consequently, it is largely your responsibility to have a clear benefit-risk conversation with both your adult and pediatric patients.

In a presentation during the 2021 European Congress of Radiology annual meeting, Jonathan L. Portelli, Ph.D., a radiography lecturer at L-Università ta’ Malta, outlined several steps you can take to facilitate these discussions. Above all else, he said, remember that each patient encounter will be different.

For additional ECR 2021 coverage, click here.

“We have to acknowledge that every individual is unique, and they will have their own needs, preferences, perceptions, and expectations,” he said. “Having a one-size communication strategy may not actually work – we must think about different considerations.”

To effectively communicate with your adult and pediatric patients about the benefits and risks of imaging, Portelli offered these 10 tips:

Enhance your knowledge: Be sure you have a thorough understanding of the benefits, dose, and risks associated with an imaging procedure so you are in a good position to explain it all confidently to the patient. Your communications should be clear, consistent, and confident, Portelli said.

Establish standards and guidance: These documents should highlight the roles of the various professionals who will be part of the patient’s imaging experience, especially any benefit-risk discussions. You can provide these standards and guidelines in a communication toolkit, FAQ document, quick-reference dose tables, or infographics. Make sure everyone in your office has this information and has been properly trained – everyone should be able to provide the same answers to a patient’s questions.

Invest time in preparation: Do not walk in to see a patient cold. Familiarize yourself with them and their health history before entering an appointment. Take time to talk with them and show them procedures – videos can be helpful. With children, taking some time to play with them can enhance their cooperation, he said.

Give a good first impression: Always greet the patient by name and give him or her your full attention. Introduce yourself, explain your role in their imaging experience, and maintain eye contact. It is important to get on the same level with the patient, especially when dealing with children, Portelli said, and express empathy to everyone associated with the patient.

“A patient may not remember what you said. They may not remember what you did,” he explained. “But, they will not forget how you made them feel.”

Engage in dialogue: When talking with patients and relatives, use a calm, reassuring tone of voice at all time, and do not rush through a conversation. Offer explanations about exams and their intent without using medical terms or jargon, and walk a patient through what he or she will need to do, as well as what the exam might feel like. Be sure to stop and listen – dialogue is a two-way street, Portelli stressed.

Highlight the exam’s purpose and benefit: Explain the importance of the exam and what information it will provide. Above all else, provide the patient with a level of reassurance.

Explain the risks in context of the benefits: Patients are frequently nervous, so walk them through the risks while spotlighting the benefits of an exam. Assure them that your staff is trained to minimize risks at every turn. Address any concerns about anesthesia or contrast dye, and help put it all in context.

Put risk in perspective: Let the patient know the actual risks of the imaging study are likely to be very small compared to the general population, explaining to parents that the risk of cancer from a CT is extremely small in children. Have graphics on-hand to help explain, but avoid using actual numbers, he advised.

“If you tell a parent there is a one in 2,000 risk of cancer, they are just going to think of the situation as being their child and 1,999 others,” Portelli said.

Encourage patient involvement: Do not monopolize the interaction. Ask the patient if he or she has questions or concerns. Watch them closely during your conversation to be sure he or she is satisfied with your explanations or if they are understanding everything correctly.

Support dialogue: Enhance the conversation by giving the patient or guardians trusted resources, as well as contact information if future questions rise. Be sure to compliment and thank pediatric patients for being brave and cooperative, he said. In addition, walk a patient through his or her next steps – where will they go, what will they need to do, and how long will they wait for their imaging results.

Following these 10 tips can greatly augment your conversation about imaging benefits and risks with patients, Portelli said.

“Remember your aim is to reassure and help your patient have a positive imaging experience,” he concluded.

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