Radiologist, Meet Patient

August 3, 2015
Junzi Shi, MD

Radiologists need to read images and see patients.

An earlier version of this article stated that the survey examining patient-doctor relationships within the radiology department queried how many patients met with a radiologist after the exam was 76%, the number was actually 24%. The correction has been reflected in the text.

Day-to-day radiology is image-centered, with the goal to read efficiently and accurately while clearing the list. In addition, there are other roles that include answering calls, acting as the consultant, and talking to patients about the procedure and results. However, these tasks, which have traditionally taken up a small portion of our time, may not be minor any longer. Patient-centered care is a center-stage issue progressively linked to more and more payment incentives.

Traditionally, radiology has attracted applicants who are not keen on patient interaction. Often smart but socially awkward students tend to gravitate toward the specialties with less patient interaction, like radiology, anesthesiology, and pathology. However, in the last decade, medical school admission committees have been emphasizing interpersonal communication skills and the ability to work in a team environment.1,2 Can the applicant communicate clearly while demonstrating compassion and empathy for patients? This is a key skill that ties directly to success in medicine, regardless of specialty.

Radiology is not shielded nor isolated from the bigger picture of global patient management and its shifting landscape. A survey examining the patient-doctor relationship within the radiology department queried how many patients met with a radiologist after the exam (24%) compared to how many patients desired to meet with the radiologist (77%). Patients explained that they would like to hear “preliminary results” and that the radiologist is the most qualified person to give imaging results. [[{"type":"media","view_mode":"media_crop","fid":"40050","attributes":{"alt":"","class":"media-image media-image-right","id":"media_crop_5260665795500","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"4048","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"float: right; height: 424px; width: 250px;","title":" ","typeof":"foaf:Image"}}]]

Post-exam discussion of results alleviates anxiety for patients, who may otherwise wait two to three weeks to meet with the referring physician. However, results of imaging may be not always be desirable for the patient, and the 23% of patients who did not want to meet with the radiologist after the exam either preferred to speak to their referring physician or felt that it was not necessary because adequate explanation was given during the exam (ultrasound).3

In particular, delivering bad news places the radiologist in a tough position. It is difficult to deliver critical results without the full clinical picture or prognosis, which is managed by the respective specialist. On the other hand, clinicians also desire involvement from radiologists when patients ask for imaging findings that the referring physician is not able to answer.4 Based on these considerations, it seems that we can optimize relationships with patients to achieve greater satisfaction with the following recommendations:

1. Offer a systematic opportunity for patients to meet with the radiologist after the exam

2. Communicate important findings via phone call to the referring physician

3. Ensure a prompt follow-up appointment with the referring physician

Within the chain of patient care, radiologists are still relatively invisible. However, as gatekeepers of an essential service, radiologists should be considered just as important as any other specialist in the process of screening and treatment of disease, with a role in patient care. Radiologists are privileged to be the stewards of advanced technologies, imaging techniques, and minimally invasive procedures, and we have a duty to make sure they are understood and welcomed by patients through better communication and direct interaction.

 

References

1. Albanese MA, Snow MH, Skochelak SE, Huggett KN, Farrell PM. Assessing personal qualities in medical school admissions. Acad Med. 2003;78:313-321.

2. Lumsden MA, Bore M, Millar K, Jack R, Powis D. Assessment of personal qualities in relation to admission to medical school. Med Educ. 2005;39:258-265.

3. Ollivier L, Apiou F, Leclere J, et al. Patient experiences and preferences: Development of practice guidelines in a cancer imaging department. Cancer Imaging. 2009;9 Spec No A:S92-7.

4. Kolata, Gina. "Radiologists Are Reducing the Pain of Uncertainty." The New York Times, November 24, 2014. Web. Accessed July 27, 2015.

 

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