Empowering Patients with Dose Information

April 23, 2013

Zwanger-Pesiri has a unique approach to lowering dose: giving patients a dose information card after studies. Here’s how the program is affecting business and radiation levels.

What difference does it make if patients know how much radiation they’re getting from each imaging study? According to Zwanger-Pesiri Radiology in Long Island, NY, telling patients about radiation dose motivated the staff to lower the levels even further.

“Within our practice we were driven to lower our dose,” said Steven L. Mendelsohn, MD, president and CEO of Zwanger-Pesiri. “The way to really lower the dose was knowledge.”

The shift in radiology over the past five years has been away from obtaining the highest CT image quality at the expense of a higher radiation dose, to balancing the technical image accuracy with a lower radiation dose, Mendelsohn said.

Zwanger-Pesiri is taking a unique approach to informing patients about dose: giving them each a card detailing the radiation dose received. We spoke with Mendelsohn about the program, and how it’s impacted business and radiation levels.

Diagnostic Imaging: Your practice gives patients a wallet-size card after a CT scan showing the actual dose received. Please describe the card.

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How have patients reacted to getting the dose information?

Very positively. They want it. I’ve had friends at other facilities complain to me that patients demand it from them, and they can’t provide it. They say I’m making them look bad.

Do patients get their cumulative dosage or just information for each study you do?

They get a new card [with that study’s dose] with each scan. We’re trying on our end with software, and we’ll eventually give them a continual update with the cumulative dose from our facility.

How did your radiologists respond to the practice sharing radiation information?

My own radiologists were being given the dose information and they weren’t really aware of what it meant, or they ignored it, initially. We [required them] to include it in the actual radiology report. The radiation dose wasn’t automatically populated into the report - they have to put it in themselves.

You mentioned that some of your radiologists felt the dose was too high and blamed the technologists. The technologists then explained that they were following the physician’s protocol.

This made the radiologists realize they had to get engaged with their processes. It became a team effort. The technologists made it a competition among themselves as to who can have the lower dose. The radiologists are on board with every study being dose driven. They want the lowest dose possible for each patient.

For the protocoling, they determine the various technical parameters of the CT scan, how many passes of the CT scanner and the timing of those passes. They also have to determine pitch as well as the scanning details of mAs and kV. There are five to six parameters we design for each type of study. The radiologists realize that when you adjust those parameters, you can lower the dose, and they’ll spend time playing with those parameters for the highest level of study with the lowest possible radiation.

Has this dose information impacted business in terms of additional referrals or repeat business?

I believe it has affected patient return. We’re going counter-current to the industry where CT volume has declined. Our CT volume has increased, especially in the offices where we have the lowest doses, using the Siemens SOMATOM Definition Flash units. I think we have an educated population in Long Island, but you may as well capitalize on the high level of patient education.

What’s been the reaction from referring physicians to this dose information?

There’s been no response. I don’t think they’re aware of radiation dose. The patients are the ones that care about their dose.