Introduction
Picture archiving and communication systems (PACS) technology has enabled the physical separation of radiologists from many important members of the health-care team, including technologists, radiology trainees, fellow radiologists, and ordering physicians, not to mention patients. The remarkable irony is that although PACS as a workflow tool has improved efficiency and allowed groups to grow, it has also degraded radiologists’ interpersonal relationships with many such colleagues .
The erosion of these relationships threatens the value-added model of radiology and may over time diminish the magnitude and quality of radiologists’ contributions to health care . In an effort to better understand both the nature of the toll that PACS is taking and the steps that radiologists might take to rectify the situation, we examine each of the major groups of caregivers with whom radiologists’ relationships have been disrupted.
Technologists
In the days before PACS, radiologists enjoyed close personal relationships with technologists, largely because technologists literally held in their hands the images radiologists interpreted, often delivering them to the reading room. The images provided tangible a link between the technologist and the radiologist. If questions arose regarding positioning or technique, technologists often consulted personally with the radiologist, who was necessarily stationed in close proximity to the technologist and patients.
Technologists and radiologists often worked together to evaluate studies and devise plans for improvement before releasing patients from the department. These improvements might include additional views or modifications in positioning or exposure. In some cases, the radiologist might simply offer words of praise in recognition of a job well done. Regardless the outcome, the way workflow was configured fostered a strong interpersonal relationship between technologists who dealt face to face with the patient and radiologists who interpreted the images.
In many cases, technologists are among the most knowledgeable caregivers of patients. They double check orders, call ordering physicians to clarify indications, and consult the medical record to verify important patient safety indicators, such as renal function or coagulation status. Perhaps most importantly, they actually talk with patients at the time of their study. They see the patient, touch the patient, and monitor the patient’s well-being. In most cases, no one in radiology knows as much about the patient as a person or does so much to influence the patient’s experience as the technologist.
Unfortunately, in today’s digital era, radiologists often do not see or even know the technologists who produce most radiological images. PACS technology allows radiologists to sit in quiet rooms far away from busy patient care areas. Indeed, it is quite common today for radiologists to be stationed in a remote location and read exams that were acquired from multiple hospitals and imaging centers scattered around the city, state, or country.
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Trainees
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Fellow Radiologists
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Referring Physicians
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Strategies for Radiologists
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Conclusion
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