As the move toward patient-centered care intensifies, more healthcare facilities are realizing the value of cross-departmental collaboration in improving outcomes and engaging patients in their own healthcare. And imaging is occupying a front-row seat as more radiologists are meeting regularly not only with referring physicians, but also one-on-one with the patients in their care.
“Images are very powerful and allow us to enhance how we can
communicate to our patients about their state of health,” said
Garry Choy, M.D., M.B.A., a diagnostic radiologist at Massachusetts
General Hospital (MGH), Boston.
In 2012, Dr. Choy and his colleagues launched a pilot program—
the Radiology Consultation Clinic at MGH—in which
patients who visit a primary care physician also review their
images with a radiologist. While words convey a physician’s
advice to stop smoking or embark on a diet and exercise program,
images emphasize those messages. The hope is to halt or even
reverse progression of diseases such as atherosclerosis and emphysema,
Dr. Choy said.
“I like to tell the patients or joke around in a lighthearted way,
‘This is the ultimate selfie,’ ” he explained. “We’re looking inside
your own body and your heart, and these are the plaques inside
your coronary vessels.”
Since the pilot consultation clinic at MGH began, radiologists
have been serving on the front lines as patient educators who
advocate for better health, Dr. Choy said.
The program originated when patients began asking to see their
own images and speak with radiologists about terminology in
reports. It began as one-on-one consultations based on requests
from patients or referring physicians and mushroomed into a regularly
scheduled clinic on Tuesdays embedded in primary care.
In the program, senior radiologists collaborate with Susan E.
Bennett, M.D., a primary care physician at Internal Medicine
Associates at MGH, to determine which patients on her schedule
have undergone imaging scans revealing pathologic processes that
may improve with lifestyle modification.
Dr. Bennett then offers these patients an opportunity to meet with a radiologist and discuss their results. “Usually, they say, ‘yes,’ they’re interested,”Dr. Bennett said. “We ask them ahead of time, ‘Do you know what a
radiologist does? How would you feel about having a radiologist inform you
about the results of your imaging examination? Afterwards, we ask them how
they experienced the consultation.”
The program has been remarkably well-received. “With rare exception, patients
have really been pleased to view their images with a radiologist,” Dr. Bennett said.
For most patients, it is the first time that a radiologist has shared images with
them as opposed to forwarding the findings to the ordering physician.
Seeing the images enlightens patients in a number of ways. They are able
to visualize findings such as coronary artery calcification, fatty infiltration of
the liver and mild centrilobular emphysema that could develop into a more
severe form. Or they may be reassured that a small nodule is not posing any
To establish benchmarks, the program measures satisfaction on the part of
patients and referring physicians, as well as patient engagement in their own
care. “In this field, there are emerging metrics in value-based care,” Dr. Choy
said. “We, as radiologists, can now also play a role.”
As medicine moves toward patient-centered radiology, programs similar to the
one at MGH are of increasingly significant value, said Judy Yee, M.D., vice-chair
of radiology and biomedical imaging at the University of California San Francisco,
past-chair of the RSNA Public Information Committee (PIC) and a member
of the RSNA Public Information Advisors Network (PIAN).
“It takes the radiologist out of this black box and puts him or her front and
center as a physician who is invested in taking care of patients,” Dr. Yee said. “It’s
a different paradigm, and it’s a bit of a culture change for radiologists.”
Allocating time and funding for these consultations can be challenging, but
in competitive markets, it helps physicians build rapport with patients. Based on
patients’ experiences with mammography and interventional radiology, they tend
to appreciate personalized interaction with radiologists, said Dr. Yee, also chief of
radiology at San Francisco VA Medical Center.
Although Dr. Bennett has convenient access to radiologists at MGH, primary
care physicians located in separate facilities or cities could offer patients virtual
consultations with radiologists via video conferencing, she said.
“It’s key that physicians understand that patients really like this,” Dr. Bennett
said. “At the end of the day, it’s not what we feel comfortable with; it’s what
works best for patients.”
Access RSNA’s full roster of resources to optimize the patient experience, including:
• RadiologyInfo.org, the public information resource developed by RSNA and the American College of Radiology (ACR), offers information on more
than 200 radiologic procedures with easy-to-understand descriptions about what to expect during imaging exams, how to prepare and more. It also
includes information about diseases and conditions, as well as articles about wellness screening.
• Radiology Cares® (RSNA.org/Radiology_Cares) offers resources and educational materials to help radiology professionals take patient-centered
radiology from concept to practice, from scheduling through follow-up communications to better align their practices with their patients’ needs.
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