You went to medical school to help, to be of assistance to your fellow human. Well, here’s your chance. Stay a moment and listen to Mrs. Smith’s response to your next questions: “What’s bothering you? Can I help?”
“Dear Dr. Klein,” the letter of complaint began, “it’s difficult for me to write this letter because I have always thought of you as my radiologist.” Mrs. B’s letter went on to excoriate our office for keeping her waiting during her most recent visit for a sonogram and bone density study.
She was completely correct; we messed up that day.
But Mrs. B’s harangue was significant for another reason. How often do patients think of a radiologist as their doctor? We know from surveys that it is far more common for patients to have no idea who interpreted their study, and in fact most Americans don’t know that radiologists are highly-trained physicians.
For the 60 years our practice has served patients in the Washington, DC, community, just about every physician in our radiology practice has had daily face time with patients, sometimes up to 30 or more per day. You may be thinking: “You guys are crazy. It’s incredibly inefficient. No way we could do that in our practice.” We have heard this refrain repetitively from other radiologists who rarely interact with patients.
Let’s start with the “you guys are crazy” part. Hardly. Sixty years later we are still thriving in a competitive imaging environment, with a few of our offices within a stone’s throw of major medical centers. When a referring physician sends us a patient for certain studies, he or she knows that one of us is likely to speak directly with that patient. Sometimes the referring physician has not yet seen the patient, and appreciates the fact that a physician can at least grossly evaluate the patient’s status and perhaps uncover some additional important clinical information.
Patients will reveal only a limited amount to a technologist but often far more to a physician in a white coat. That extra information can often target the most appropriate imaging examination, or lead the radiologist more rapidly to the correct diagnosis. That helps the referring physician immensely more than a report generated by someone in a distant reading room. While making the correct diagnosis seems like the target of a radiologist’s efforts, it’s not the only one, maybe not even the most important one. A patient is of course far more than an illness or imaging finding.
I walk into the exam room to examine Mrs. Smith, who I instantly notice is clearly sad. “Hi, Mrs. Smith,” I begin, reaching out to shake her hand. “I’m Dr. Klein. First of all your study looks great so far. I can’t help but notice that you seem upset.”
Maybe Mrs. Smith is in pain, or maybe she is worried about the potential catastrophic diagnosis she was sure she was about to receive, or perhaps she’s concerned about her husband or her child. You went to medical school to help, to be of assistance to your fellow human. Well, here’s your chance. Stay a moment and listen to Mrs. Smith’s response to your next questions: “What’s bothering you? Can I help?”
Suddenly a door flies open, and Mrs. Smith’s life is now yours to share. Maybe you can’t solve her specific problem, but the act of listening and the sense of caring that you are in a unique position to provide very often are more than enough to comfort her. Mrs. Smith will enthusiastically embrace you as one of her “real” doctors if she believes you care about her well-being. You don’t have to manage her diabetes or hypertension. You don’t have to arrange home IV therapy or schedule her for surgery. You just have to listen and care, and then offer some words that prove that she has been heard and that you are in fact interested.
Radiology is at a crossroads. We will be judged by government, insurers, and the public by the value we bring to the overall care of patients. Our future depends on demonstrating that we add substantially more than we cost to the healthcare equation. In my next column I’ll discuss another reason to become one of your patient’s “real” doctors, although lending a compassionate ear and potentially saving our specialty seem reason enough.
Dr. Klein is a radiologist at Washington Radiology Associates in Washington, DC.