The Reading Room

Should radiologists talk to patients?

by Ben Lauing

Last week, I came across an article in The New York Times, in which author Gina Kolata adds another voice to the ongoing conversation about whether or not radiologists should be directly consulting patients.

While opinions on this question run the spectrum, experts seem to agree that, at the very least, radiologists need to become more accessible.

What do you think: Should patient consultations be part of radiologists' accessibility strategy?

For every pro, a potential con

Radiologist accessibility is something we discussed at length in our study The Changing Radiologist Role, and I looked specifically at radiologist-delivered results as part of The New Radiology Quality Mandate.

For this research, I examined a 2012 study that evaluated the impact of radiologist consultations with patients following their CT or ultrasound exams. 99% of patients agreed that radiologist delivery was helpful, and 90% of patients indicated that being able to speak with a radiologist would make them more likely to return to that program.

Patients see benefit in radiologist consults, but there are certainly drawbacks—many of which are mentioned in the Times article. This 2012 study actually measured the average length of the consultations, and calculated the costs associated with each one. Beyond time and cost, there are issues surrounding radiologist liability, discomfort, and lack of patients’ contextual information.

Probably the greatest drawback is conflict with referring physicians. Many referrers strongly oppose radiologist-driven results delivery, often because they want to analyze the results first, and share them in the context of patients’ comprehensive care.

Creating conflict with referring providers ultimately counterproductive

One radiologist I quoted in my research study claimed that "the time has come for patients to say, 'this is what my radiologist said.'" But one radiologist I spoke with said that she once explained results to a concerned patient, and the referring physician vowed never to send her another patient.

Interestingly, one system imaging director told me that she doesn’t see value in making radiologists visible to patients, because "no one cares who their radiologist is, as long as their doctors are talking to each other."

Ironically, that sentiment points to what I think is the real heart of this article. While it begins as a lesson to patients, that they should take advantage of radiologists for faster results delivery, it becomes a sort of radiologist rallying cry—that they need to be accessible, and communicate with referring providers on behalf of their patients. “Most radiologists certainly should be available,” says Dr. McGinty of the ACR’s Imaging 3.0 initiative. To her, that includes "getting on the phone and talking to physicians."

The point is that the priority is patient care, even if the resulting action steps do not directly involve the patient. Increasing communication between radiologist and referrer, rather than radiologist and patient, may ultimately be the best way to improve radiology’s value to patients. That strategy avoids the risk of straining important care partner relationships—in fact, it seeks to improve them.

Programs taking steps to improve access and satisfaction

One member I spoke with takes the middle road by offering, but not promoting, radiologist consultations. Patient registration forms contain a question asking patients if they would like to speak with a radiologist. The leaders of this program have observed that very few patients opt for a consult anyway—a sentiment seconded in the Times article—but they do appreciate having the option available.

Another member works hard to solicit and document the preferences of all referring providers. That way, radiologists can check to see whether or not referrers are okay with them delivering results to patients. And, if they aren’t, the staff can tell patients exactly when and how their referrer will receive the results.

This article only confirms the trends we’ve been following. In this new, patient-centered health care world, communicating with referrers and patients is simply part of the radiologist job description. Even if radiologists aren’t speaking to patients directly, they need to be getting out of the reading room and working collaboratively to improve patient care.

Do your radiologists offer consultations with patients? Let me know in the comments section below.

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