At times, discrepancy can exist between the complexity of the results and the patient’s ability to comprehend them so the technologist might ask the radiologist to talk to the patient. However, if results are severely abnormal, only 33% of radiologists and 28% of referring physicians think that the radiologist should provide the information. They simply assert that the radiologist and radiology personnel are not the ones who should do it. a survey of radiologists’ and clinicians’ preferences, Disclosure of diagnosis in ambulatory radiology practice: expectations of patients and referring physicians [in German], When cultures clash: physician, patient, and family wishes in truth disclosure for dying patients, Direct disclosure by radiologists of imaging findings to patients: a survey of radiologists and medical staff members, Radiologists’ responses to patients’ inquiries about imaging results: a pilot study on opinions of various groups, Cleveland Clinic Pediatric Radiology Web site. In addition, lay versions of reports might be generated for patients. Images may be obtained with x-rays, (CT scans or radiographs), nuclear medicine (involving radioactive substances, magnetism (MRI), or ultrasound. It may also decrease productivity and adversely affect compensation, inasmuch as radiologists who do a great job of communicating with patients are not compensated more than radiologists who avoid doing so. "Before you go to get a mammogram, make sure you know whether you're there for a screening mammogram or a diagnostic mammogram. For the moment, however, this decision is still largely in the hands of radiology department personnel, and it is important for all radiologists to think through the advantages and disadvantages of communicating more openly with patients. Whether radiologists themselves always provide the results is another question, but the American Medical Association’s Code is clear that radiologists cannot always or even routinely refuse to provide results to patients who request them. What if patients begin asking radiologists questions about their diseases, prognoses, and therapies that radiologists are ill equipped to answer (5,6)? The purpose in doing so is not to suggest that there is any single correct approach, in comparison to which all others are wrong, but simply to lay out the issues for reflection and discussion. While it is possible to make mistakes in conveying results, it is always a mistake simply to withhold the results. Even those who think they could ask for results may be reluctant to do so, yet eagerly accept the invitation when offered it (4). If a physician thought the patient did not need to know, or might be harmed in some way by being informed, the physician would not tell the patient. 104 views View 4 Upvoters After this, your physician follows up with you about the results. Some radiologists may feel uncomfortable interacting with patients (11) and may have chosen careers in radiology in part to avoid such encounters. Should radiologists and/or their designees be the ones to tell patients the results of their imaging examinations? 199, No. If the results are mildly abnormal, 81% of radiologists and 57% of referring physicians opt for the radiologist. It is probable that these results would differ to an even greater degree in other countries, particularly in regions such as the Far East and the former Soviet Union, where the practice of informing patients of their diagnoses has been historically less prevalent (8). If you're there for your annual screening mammogram, you may not meet with the radiologist or get your results the same day. Accurate results . A major cause of litigation against radiologists is failure to effectively communicate results. When patients ask questions to which radiologists do not know the answer, it is best to say, “I don’t know the answer to that, but I think your referring physician (or someone else) will.” When unexpected or alarming findings are encountered, radiologists can always contact referring physicians to find out how they would like to handle the situation (6,12). Communicating results of all radiologic examinations directly to patients: has the time come? Radiologists write up the results of their studies in detailed radiology reports. One is that doing so responds to a direct request from the patient. In the case of a catastrophic finding that requires immediate treatment, the American College of Radiology guideline for communication advises radiologists to contact the referring physician immediately (21). 11, No. Suppose the infant with a history of prenatal hydronephrosis is found to have a renal mass, and the findings in the patient with vaginal bleeding are consistent with fetal demise. After all, in performing and interpreting results of an imaging examination, radiologists enter into a form of physician-patient relationship with their patients. To some, the approach of always telling every patient the results of their radiology examinations may seem to go too far. plan and conduct food service or nutritional programs to assist in the promotion of health and control of disease. Decades ago, when medical practice conformed to a more paternalistic model, it was more common for physicians to tell patients relatively little about their conditions, and the responsibility for determining what patients should know was understood to rest with the physician (1). Whether radiologists themselves always provide the results is another question, but the American Medical Association’s Code is clear that radiologists cannot always or even routinely refuse to provide results to patients who request them. Consider the following scenarios, each drawn from clinical ultrasonography (US). Furthermore, the radiologist may have any one of a number of reasons for not informing patients. 9, No. Berlin (13,14) points out that communication is one of the top five reasons that radiologists are named in malpractice suits, a risk many radiologists may prefer to avoid. Does Direct Radiologist-Patient Verbal Communication Affect Follow-Up Compliance of Probably Benign Assessments? Radiologists need to be organized in their approach to providing timely information (7). 2, Health Care for Women International, Vol. Radiologists and referring physicians also believe that radiologists should generally inform patients. Ultimate responsibility for decision making is now understood to belong to patients, and it is impossible for them to make informed choices without having all the available information. Another is to inform patients, but only if they ask. Two of those years will be spent in the classroom, while the other two will be spent doing clinical rotations. 3, Journal of the American College of Radiology, Vol. Radiologists have the training and education necessary to interpret the complex images provided by the radiologic tech. In general, moving down this list means informing a progressively higher percentage of patients. We did a survey to ask other Radiologists what degree they had when they became a Radiologist. REs can do wonders for radiologists’ workflow, potentially bolstering the bottom line. Our imaging services include: Want to know more about your test and what we are looking for? For one thing, some patients may not even know that finding out the results is an option. 113, No. Sometimes an area of the body is included and can be evaluated using the images, but is not discussed. Once you have graduated from medical school, you will need to complete a four year radiology residency. 12, Journal of the American College of Radiology, Vol. By examining the arguments for and against each of these approaches, radiologists, radiology department personnel, referring physicians, and patients can gain a deeper understanding of the basic issues involved in results disclosure and make more informed judgments. Many patients do not even know that radiologists are physicians (17). The radiologist will explain his or her findings on the results of the imaging procedures. 10, No. If radiologists want to argue that their professional responsibility extends no further than performing radiologic examinations, interpreting the images, and informing referring physicians of the results, then they risk moving themselves out of the category of physicians and becoming instead technicians. It starts with a bachelor’s degree with medical school prerequisite courses, such as physics, biology and chemistry. Please still keep your doctor's appointment they may have additional lab results and would be important in the treatment plan. Enter your email address below and we will send you the reset instructions. 4, 19 March 2012 | La radiologia medica, Vol. However, there are arguments to be made on its behalf. After reading the results of the medical images, the radiologist will consult with the primary care doctors who referred the patient for the testing. What is the need for follow-up examinations (16)? If radiology is to thrive in the future, the field needs to ensure that more radiologists also regard it as an important professional opportunity. It is not acceptable for a cancer patient to have results with critical informations sitting in the radiologist in-tray for weeks before a report is produced. Handoffs Between Radiologists and Patients: Threat or Opportunity? You can expect easy access, convenient scheduling, and timely service. “In an ideal environment, of course, patients would want to know results instantaneously,” Davenport said. A 3-D mammogram may take a little longer. Again, the American Medical Association’s Code of Medical Ethics is clear on this point (15). Of course, the same is also true for many consulting physicians, some of whom may not even see patients before requesting imaging studies. First, if all patients are informed of their imaging results, failures to communicate results are eliminated. Moreover, many studies of patient preferences tend to omit important confounding factors, such as the degree of familiarity between patient and physician, as well as other hurdles such as language and cultural barriers. While most such communication problems represent a simple failure to communicate, in some of these cases, efforts to communicate have gone awry. 12, 10 March 2016 | Emergency Radiology, Vol. Another argument for informing patients who request their results is that no one understands the imaging examination as well as the radiologist. One of the best ways physicians can enhance patient-physician relationships is, at the end of an encounter, to ask patients if they have any questions (20). 46, No. The Declining Radiology Job Market: How Should Radiologists Respond? Even radiologists who have no qualms about interacting with patients may feel uneasy or unqualified when it comes to breaking bad news (5). In others, they may choose to come to the radiology department, and they may request that a colleague, such as an oncologist, join the conversation. Once the radiologists read it, the results are transcribed and sent to your physician. 9, Seminars in Ultrasound, CT and MRI, Vol. The American Medical Association holds that physicians should deal openly and honestly with patients at all times. 2,3 As radiologists, it is time that we look at this issue with renewed diligence. A strong case can be made for routinely asking patients if they would like to know the results of their radiology examinations. In an age that acknowledges patients’ right to inspect their own medical record, and with the growing implementation of electronic medical records, it is essentially futile for physicians to attempt to withhold such information (16). For one thing, radiology reports will likely follow the model of breast imaging and become more structured and standardized. While in many practices only a small minority of patients are likely to have a severe abnormality, this still can be a substantial drain on time. Radiologists know the indications, limitations, risks, and implications of imaging test results better than referring physicians and patients. In general, it is good for radiologists and referring physicians to know one another well enough to know how to handle such situations in advance. Imagine patients whose follow-up imaging or biopsy takes place on a Friday. This is one of the reasons that informed consent forms have become ubiquitous in health care (2). A radiologist is a physician or medical specialist trained in obtaining and interpreting medical images. In the practice of US, Ragavendra et al (4) found that the average period of time necessary to inform patients of normal results was approximately 2 minutes. 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