Radiologists, Meet Your Patients … Or Else

CHICAGO - Radiologists are emulating the Invisible Man: overlooked, unknown, and, occasionally, seeming like monsters.

That was the message from the opening session of RSNA 2012, a stirring call to arms urging radiologists to leave the shadows and meet their patients. RSNA president George Bisset III, MD, kicked off the annual meeting by urging his fellow radiologists to focus on patients - because if they don't, the practice of radiology itself could be in danger.

"Our future depends on our capacity to develop a new kind of shared ownership of our patients’ needs and expectations along with our primary care and specialty colleagues," Bisset said.

The Affordable Care Act, accountable care organizations, and other economic factors are all conspiring to change radiology as we know it. But that may be a good thing.

"The changing environment of consumer-oriented, value-driven health care gives us an opportunity to address one of our greatest challenges - our tendency toward invisibility," Bisset said. "By addressing the patient experience in our own facilities and ensuring that our patients are treated with compassion and respect we will raise the profile and value of the services that we offer."

That invisibility loomed large over the session. Statistics show that 80 percent to 90 percent of radiologists have never met their patients, Bisset said, and that's a huge stumbling block to radiology being viewed as anything but an ancillary service.

The solution? It could be as simple as wandering out of your office once in a while.

“Spend just a little time in one of your own waiting rooms, and talk to your patients about how you can improve their experience,” Bisset said. “I've done it, and what you learn will surprise you.”

But if Bisset gently encouraged radiologists to break out of their shells, the other speakers were there to provide some tough love. Karen E. Arscott , DO, MSc, described her experiences with radiologists in the seven years since she was diagnosed with lung cancer. Spoiler alert: They weren’t good.

Arscott actually saw the malignant nodule on her CT scan, but waited a week for confirmation. That confirmation came in the form of a written notification. Nobody bothered to speak with her in person or over the phone. That set the tone for her entire treatment.

“I’ve had close to 30 CAT scans and PET scans,” Arscott said. “I never spoke with a radiologist. Not once.”

Even when she specifically asked to talk with her radiologist - when a technologist insisted on running a study without contrast even though her surgeon and the radiologist has specified contrast should be used - she was shot down.

“I was told that the radiologist would not speak with me,” Arscott said. “I don't believe that the radiologist was ever even contacted. But somewhere that technologist was under the impression that the radiologist would not speak with me as a patient, even though I'm a physician.”

Her last radiology encounter may have been the worst: “The radiologist who conducted my biopsy was efficient and not nice to me,” Arscott said. “He yelled at me. He talked down to me. The whole time that I was laying on the table scared to death.”

“I know that he didn't mean anything by it,” she continued. “I know that he was trying to be efficient, trying to do his job, trying to get a good result. He never came to talk to me afterwards while I was in the recovery area. I never had a chance to talk to him and tell him how he made me feel.”

In the end, Arscott joined Bisset in the call for radiologists to remember they’re dealing with patients, not images. “My advice as a patient and as a colleague is: Face your fears. Meet your patients. Your patients want to meet you.”

And, she said, never forget how those patients are feeling: “Your patients are laying there. They're scared, they're vulnerable, and you can do so much to help them. Remember that you are a physician first. You are a physician first, you are a physician always.”