Direct Reporting of Results to Patients

Rationale and Objectives

Radiologists have traditionally left relaying exam results to patients in the hands of clinicians. Recent editorials have reexamined radiologists’ traditional position and questioned whether radiologists should continue to remain within the confines of the reading room or increase their contact with patients. The present study addressed this issue by surveying patients directly regarding their preferences.

Materials and Methods

A survey was given to all patients aged ≥ 21 years undergoing outpatient magnetic resonance imaging or computed tomographic examinations at an academic medical center and at an associated outpatient center. Responses were anonymous. Surveys were provided over a 4-week period in February and March 2011; 237 were returned.

Results

The majority of patients (73%–77%) continue to prefer the practice model already established, regardless of whether the results are normal or abnormal. However, the same percentage of patients preferred to hear the results of their exams from the experts interpreting the exams. The discrepancy in these results is likely reflected in the fact that there is persistent confusion as to the role of radiologists. Although most patients correctly defined a radiologist as a physician, 40% believed that a radiologist is a technician or a nurse. A large percentage of patients (64%) responded positively to wanting to meet the radiologists interpreting their exams.

Conclusions

As radiologists, we need to reevaluate the established model of communication for reporting radiology results and consider the positive impact on patient care, and on the vitality of the radiology profession, of directly communicating with patients.

Radiologists have traditionally remained “behind the curtain” when it comes to patient care, the voice without a face. However, there has recently been a surge of editorials reexamining radiologists’ traditional position in the care of patients and questioning whether radiologists should continue to leave the relaying of exam results to patients in the hands of clinicians.

The American College of Radiology (ACR) created a campaign, The Face of Radiology, to publically define radiologists’ role in patient care. However, despite this campaign, many editorials have discussed the need for radiologists to have more direct interaction with patients . Leah Lakins commented that “where patients are educated, informed, and ready to litigate—radiologists can no longer afford to keep their silence.” It has been noted that direct communication to patients by radiologists improves patient care in a time when patients are more informed and educated about their health care . Additionally, there has been speculation that lawsuits are less likely to occur or go to trial if a physician has developed a relationship with a patient . However, do patients really want direct communication with radiologists?

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Materials and methods

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Table 1

Survey Questions

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Results

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Discussion

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References

1. American College of Radiology. The Face of Radiology. Available at: http://www.mypatientconnection.com/Articles/NeimanLetter.aspx . Accessed January 3, 2011.
2. Lakins L.: The right to speak? Experts weigh in on giving imaging results directly to patients. ACR Bull 2011; 66: pp. 11-13.
3. Stelfox H.T., Gandhi T.K., Orav E.J., et. al.: The relation of patient satisfaction with complaints against physicians and malpractice lawsuits. Am J Med 2005; 118: pp. 1126-1133.
4. Forster H.P., Schwartz J., DeRenzo E.: Reducing legal risk by practicing patient-centered medicine. Arch Intern Med 2002; 162: pp. 1217-1219.
5. American College of Radiology. ACR practice guideline for communication of diagnostic imaging findings. Available at: http://www.acr.org/SecondaryMainMenuCategories/quality_safety/guidelines/dx/comm_diag_rad.aspx . Accessed January 2, 2011.
6. Basu P.A., Ruiz-Wibbelsmann J.A., Spielman S.B., et. al.: Creating a patient-centered imaging service: determining what patients want. AJR Am J Roentgenol 2011; 196: pp. 605-607.
7. Gunderman R.B., Davilla J., Shetty S., et. al.: Visibility matters. J Am Coll Radiol 2005; 2: pp. 971-974.
8. Fritzsche P.J.: Communication: the key to improved patient care. Radiology 2005; 234: pp. 13-14.
9. Patti J.A., Berlin J.W., Blumberg A.L., et. al.: ACR white paper: the value added that radiologists provide to the health care enterprise. J Am Coll Radiol 2008; 5: pp. 1041-1053.
10. Berlin L.: Communicating results of all radiologic examinations directly to patients: has the time come?. AJR Am J Roentgenol 2007; 189: pp. 1275-1282.
11. Raskin M.M.: Survival strategies for radiology: some practical tips on how to reduce the risk of being sued and losing. J Am Coll Radiol 2006; 3: pp. 689-693.
12. US Food and Drug Administration, Center for Devices and Radiologic Health. Mammography Quality Standards Act. Available at: http://www.fda.gov/Radiation-EmittingProducts/MammographyQualityStandardsActandProgram/default.htm . Accessed January 2, 2011.
13. Charig M., Wright F.W.: Should radiologist talk to patients?. BMJ 1990; 300: pp. 610.
14. Levitsky D.B., Frank M.B., Richardson M.L., et. al.: How should radiologists reply when patients ask about their diagnoses? A survey of radiologists’ and clinicians’ preferences. AJR Am J Roentgenol 1993; 161: pp. 433-436.
15. Schreiber M.H.: Direct disclosure by radiologists of imaging findings to patients: a survey of radiologists and medical staff members. AJR Am J Roentgenol 1996; 167: pp. 1091-1093.
16. Safdar N., Shet N., Bulas D., et. al.: Handoffs between radiologists and patients: threat or opportunity?. J Am Coll Radiool 2011; 8: pp. 853-857.
17. Kussin S.Z.: Doctor, Your Patient Will See You Now: Gaining the Upper Hand in Your Medical Care.2011.Rowman & LittlefieldNew York

Direct Reporting of Results to Patients

Rationale and Objectives

Materials and Methods

Results

Conclusions

Materials and methods

Results

Discussion

References

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