Clear communication with referring providers and patients is critical. Following these steps can help.
The days of relying on the radiology report to be your main communication with patients are gone. As the push for radiologists to become more active members of the patient care team continues to gain strength, its incumbent upon you and your trainees to learn how to effectively communicate with your referring providers, as well as patients.
In an article published April 10 in Academic Radiology, a five-member team of experts laid out several tips for improving your communication skills – techniques that can benefit you as the healthcare climate tips further to value-based care.
“Communication requires the formulation of a message which is then shared with, and ultimately interpreted by, the receiving party. Importantly, absent or ineffective communication can lead to wasted time, increased healthcare expenditures, increased patient anxiety, and patient harm,” said the team led by Judah Burns, M.D., director of the diagnostic residency program at Montefiore Medical Center. “Effective communication, on the other hand, has been shown to improve health outcomes.”
But, despite efforts from the American Board of Radiology, the American College of Radiology (ACR), and the Accreditation Council for Graduate Medical Education, radiology residents are not getting the communication guidance they need, the team said.
To help trainees – and practicing providers – communicate better with patients, the team offered several suggestions:
Radiology reports: Keep your reports clear and concise, using clinically relevant information. For example, if you don’t see anything alarming, say the results are “normal” rather than “unremarkable.” Structured reports, disease-specific reports, and templates can help clarify any uncertainty.
“From a patient’s perspective, conclusions and summary recommendations are the most impactful and notable sections of the written report,” they said. “These portions of the report should be most carefully considered to avoid simple repetition of findings, and to make reports actionable and understandable.”
Be patient-specific: Radiologists are often thought of as being removed from or not as invested in a patient’s care. To dispel that thought, include patient-specific information that shows you are an integrated member of the healthcare team. Remember to be respectful and non-judgmental in your tone when discussing sensitive topics, such as alcohol use or body habitus.
Structured reporting: Using these templates can help trainees better learn how to organize their patient communications, giving patients easily understandable, organ-specific information that can help guide their future healthcare decisions. It can also help them develop greater clarity in their communications.
“Communicating uncertainty in radiological imaging is a critical reporting element,” the team said. “Clarifying the nature and extent of potential uncertainty allows physicians and patients to understand the degree of confidence and conveys diagnostic certainty in clinical decision-making.”
Enhanced reports: When possible, use pictures, tables, graphs, and images with hyperlinks to help illustrate findings.
“From the patient’s perspective, enhanced reporting is akin to story-telling. In many cases, a picture is more visually descriptive or impactful than a detailed or nuanced narrative,” they said. “The radiologist must aim to communicate important findings using written and illustrative tools in a manner that is precise, impactful, and relatable, maintaining focus on using those tools that help to best convey and contextualize imaging results.”
Patient portal: Patient portals are growing in popularity with the number of patients using them rising from 35 percent in 2006 to 51 percent in 2016. But, giving patients direct access to images is still somewhat controversial as it can lead to confusion. It could be possible to mitigate this problem by including a summary statement in the report that provide context, such as letting a patient know that while images are available immediately, the care team needs time to interpret the results and will contact them for a discussion. If you choose, you can also include your contact information, as well as information for web consultations.
Be present: Participating in clinical imaging rounds or embedding reading rooms in clinical areas are two good ways to bolster the amount of face-to-face time radiologist trainees have to perfect their oral communication skills. In addition, attending multi-disciplinary meetings or participating in virtual consults can also be helpful. It would also be a good idea to increase training in telehealth consultations.
Non-verbal cues: Encourage your trainees to make eye contact, nod their heads, and gesture – it’s a way to deepen the discussion and show patients that their radiologist is actively engaged.
“Particularly in brief interactions, such as those commonly occurring during radiologist consultations, the opportunity to establish and maintain relationships is limited,” the team said. “Effective non-verbal communication can decrease patient anxiety, reinforce patient discussions, and improve patient accordance with medication and follow-up recommendations.”
Breaking bad news: Approach these situations carefully. Don’t use jargon – instead, focus on using simple terms. Be sure to be an active listener, and choose a supporting environment and atmosphere for relaying bad news.
By actively engaging in more patient interactions, the team said, radiology residents have more opportunities to identify barriers to care and existing health disparities. It provides them with the knowledge needed to combat any potential internal biases. Mastering these skills is critical, the team said, for trainees to be able to offer the highest level of care possible.
“Radiology trainees must gain skills in all forms of communication to fully engage with their patients,” they concluded. “Residency and fellowship programs and teaching faculty must model effective, professional communication in all forms and seek constant improvements in the work and clinical learning environments.”
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