The Reading Room

Can rounding decrease the commoditization of radiology?

Natalie McGarry, Imaging Performance Partnership

Researchers at the University of California Irvine attempted to address a daunting question: “What matters more: the radiologist or the radiology report?” To show rather than tell their radiological worth, they built a pilot study to embed radiology residents in rounds with internal medicine teams.

Rounding to educate clinicians and patients

According to Dr. Mamlouk, the commoditization of radiology is being driven by a lack of communication and an overemphasis on relative value units (RVU), which manifests as poor service to referring physicians and patients. In the most recent issue of the Journal of American College Radiology (JACR), Dr. Mamlouk and his team tested whether embedding radiology residents in rounds could combat these stereotypes.

The pilot study consisted of radiology residents physically rounding with internal medicine teams during a two-week rotation. During rounds, radiology residents presented each patient’s imaging studies while educating the clinical team on image appropriateness, the importance of patient history in requests, and radiation dose. If an image didn’t have a formal read, the resident entered a preliminary read in PACS.

Radiology residents also interacted with patients to explain what radiologists do, even showing patients their own exams. A significant number of patients were unaware that radiologists are physicians, but after interacting with radiology residents stated that they would willingly consult radiologists in the future.

Rounds increase recognition of radiologists’ work

At the end of the rotation, clinical teams filled out surveys to demonstrate their opinion of the pilot project and radiology service in general.

Survey questions to clinicians post rounding rotation (n=20)

It is hard to know how clinicians outside of the study would normally respond to these questions without a control group, but against anecdotal evidence, the above responses are much more appreciative of radiologists’ role in care.

Clinicians not only enjoyed the assistance of radiology residents, they felt that a radiological presence streamlined patient care, helped avoid unnecessary exams, and increased their knowledge of radiology.

Radiology residents noticed an improvement in consulting skills and felt they were better able to concisely convey information. The experience fostered greater camaraderie between the services, and improved working relationships beyond the study period.

The authors emphasize that although radiology rounding may not be feasible at all institutions, emphasizing a service-oriented mindset among residents is more important than the clinical rotation itself. 

As the risk of commoditizing radiology increases, radiologists are called upon more and more to prove their value. Raising awareness of radiologists’ expertise and contribution to diagnostics requires creativity, as PACS allows more clinicians to interpret images and patients barely recognize radiologists as physicians.

Take the Next Step

To learn more about combating commoditization, read The Changing Radiologist Role. If you’d like to learn more about fostering clinician-radiologist communication, check out our blog post on embedded reading rooms.

Want more from this author? See all of Natalie's blog posts.