Hey, Radiologist: Call Me Maybe

This post was contributed by Zeeshaan Bhatti, MD, a radiology resident from the University of Michigan Health System.

 Radiology, Vanessa AllenAbout half of the radiology residents at our institution felt that we call our referring providers too often.

This may be due to internal and external pressures to avoid direct contact. These include the disruptive nature of phone calls, growing workload, the ambiguity regarding which test results warrant a call and the expectation that providers should follow up on studies they order. Furthermore, we may think colleagues don’t like the interruption.

However, the majority of referring resident providers we surveyed said they welcome phone calls.

  • 83 percent (125/151) hoped to get a phone call about abnormal radiology findings
  • 24 percent wanted more frequent communication
  • 66 percent felt that radiologists’ calls often or always add value beyond a radiology report
  • 3 percent felt the frequency of calls is excessive (compared to 49 percent of radiology residents)

Is there value in radiologists making these phone calls? There is if the phone calls are truly warranted and if we prioritize patient safety and our referring providers’ preferences — even when it’s not convenient.

Some considerations:

  • Making a diagnosis is part of our job. Adequately communicating it is equally significant.
  • Phone calls can be considered a normal part of our workflow (like reviewing patient charts or looking at prior studies) — not an interruption.
  • Talking to clinicians facilitates timely receipt of test results. It also allows confirmation of understanding.
  • Calls can provide information not found in the medical record. They can also convey a degree of certainty not evident in a radiology report.
  • Talking has been shown to alter clinical management compared to written radiology reports alone.

Our study, presented at ACR 2017, involved residents at an academic center. How do you think attending physicians or those in private practices would respond?

 Please share your thoughts in the comments section below and join the discussion on Engage (login required).

Do Radiologists Have an Image Problem?

RawsonHeadshotThis post was contributed by American College of Radiology Commission on Patient- and Family-Centered Care Chair James Rawson, MD, FACR.

A recent KevinMD Blog post stated that radiologists have an image problem. The post highlights a small study presented at ACR 2017 by doctors from a practice that found that less than half their patients knew radiologists are doctors. The practice made educational materials available in their waiting room and found this helped more of their patients know that they were physicians.

Years ago, ACR did a test measurement and education campaign in select areas called “The Face of Radiology.” Many Americans did not know that radiologists are doctors. Radio commercials, print advertisements and waiting room education materials increased the number of people who knew what radiologists are and do.

We found that the root of the problem then was that patients rarely interacted with diagnostic radiologists However, the most obvious finding was that we can’t “advertise our way” to better patient knowledge of who we are and what we do.

Sustained patient acceptance that you are one of their doctors has to be reinforced by patient experience.

We have to be creative and willing to enhance our patient-engagement skills and offer more patient- and family-centered care. Maybe you just make yourself available for patients? Maybe there is another option that would work better in your practice? I invite you to look at what can be done.

The Imaging 3.0 initiative, along with Commission on Patient- and Family-Centered Care resources, can help you improve the patient experience.  I encourage you to use these resources, along with the new Radiologist’s Toolkit for Patient- and Family-Centered Care, to become more visible to patients and referring physicians.

Another great resource is the JACR special issue on Patient- and Family- Centered Care.

The more we engage with patients and providers, the more input we will have on shaping the future of medicine.

How have you enhanced your patient-engagement skills to offer more patient-centered care?

Please share your thoughts in the comments section below and join the discussion on Engage (login required).

Lung Cancer Screening: Small Victories and Saved Lives

Ella KazerooniThis post contributed by Ella Kazerooni, MD, FACR, chair of the ACR Lung Cancer Screening Committee.

As you read in this week’s Advocacy in Action e-news, Medicare announced that it will pay for low-dose CT lung cancer screening exams performed for eligible patients in independent diagnostic testing facilities (IDTFs).

You may also have seen that more than 45 bipartisan members of the House of Representatives signed a letter to the Secretary of the Department Health and Human Services and HHS Administrator warning against any cuts to Medicare lung cancer screening reimbursement.

With the speed at which LCS was approved for Medicare coverage, many of the coverage details are still being figured out as we go. These small victories are intermingled with the struggle for fair payment, building infrastructure and educating referring providers about which patients benefit most from these exams and why.

There is still much left to do to fulfill lung cancer screening’s promise to save more lives than any cancer screening test in history.

The ACR is working with others to make sure that the work gets done. We are working to reduce false positives, educate lawmakers and regulators, and promote use of Lung-RADS® and the Lung Cancer Screening Registry. All of these are necessary to support the ongoing launch of screening programs nationwide.

We are also working to make sure you have the tools to perform these exams in the safest, most effective manner possible.

Please visit the Lung Cancer Screening Resources section on the ACR site for resources to help you inform referring physicians and patients about lung cancer screening and improve the screening you may already be providing.

I would like to know:

  • Would additional cuts in reimbursement for LDCTs keep your practice from starting a lung cancer screening program?
  • Would additional cuts in reimbursement for LDCTs in the outpatient setting cause your hospital to no longer offer this service?
  • How is your practice saving lives by implementing a lung cancer screening program? Have you learned anything that you think may help others get theirs off the ground?

Please share your thoughts in the comments section below and join the discussion on Engage (login required).