Radiologist-Patient Communication Skills in the Digital Age

Technology is transforming how and when patients can view their health information, creating new opportunities for communication with radiologists

Amy Kotsenas, MD
Christoph D. Becker, MD, EBIR
Jonathan L. Mezrich, MD, JD, MBBA

Patients can now use online portals to view their radiology reports and other test results faster than ever before. In response, radiologists need to adapt the ways in which they communicate with patients, according to Amy Kotsenas, MD.

“The 21st Century Cures Act requires immediate release of information like radiology reports to patients unless that immediate release is likely to cause harm to the patients,” said Dr. Kotsenas, a professor of radiology at Mayo Clinic in Rochester, MN and the lead author of an article in the Journal of the American College of Radiology on patient consent in the era of artificial intelligence and big data.

As a result, patients may read their reports before speaking with the physician who requested their radiology exam.

“Given the wide range of people reading our reports—including patients, family members, primary care providers and specialists—I have begun to simplify the language used in my reports so that it is more understandable by all,” she said.

Christoph D. Becker, MD, EBIR, agrees that many patients have difficulties understanding the meaning and implications of radiological reports. Dr. Becker, who coauthored a recent Insights into Imaging article on communicating with patients in the age of online portals, noted that radiologists should be trained in how to relate to patients and their families with respect, empathy, honesty and confidentiality.

“Depending on individual situations, some patients viewing their results online may wish to discuss specific questions regarding complex findings directly with the imaging expert who is responsible for the diagnosis,” said Dr. Becker, a professor emeritus and former chair of the Department of Radiology and Medical Information Sciences at University Hospitals of Geneva in Geneva, Switzerland. 

“It may be useful to provide solutions that help patients understand their diagnostic imaging findings,” Dr. Becker said. “This may be accomplished through automatic translations of original reports into consumer health vocabulary using language processing tools powered by AI and by providing hyperlinks that refer to appropriate multimedia platforms that explain anatomical or pathological terms.”

Making these adjustments will likely not be easy, according to Jonathan L. Mezrich, MD, JD, MBA, associate professor of radiology and biomedical imaging and emergency radiologist at the Yale School of Medicine in New Haven, CT. Dr. Mezrich is the lead author of a special report in Radiology that focused on patient electronic access to final radiology reports.

“Previously, we have generated reports with other physicians as our expected audience, but now we need to deliver jargon-free information that is more easily digestible to non-physicians,” Dr. Mezrich said. “Reports will improve over time based on questions, feedback and trial and error.”

“Patients are going to continue being more involved in decision-making regarding their health care and patient portals, where imaging reports are posted, are part of that process. Radiologists should actively embrace the opportunities and challenges associated with increased communication with patients.” 

Christoph D. Becker,MD, EBIR

Addressing Obstacles to Effective Communication

Simply finding time to speak directly with patients may be the most significant communication-related challenge radiologists face, according to Dr. Kotsenas.

“While it does add time to our day, I have found that speaking with patients gives me a sense of purpose in my work that can help to overcome the inconvenience,” Dr. Kotsenas said.

Radiologists may also be concerned that patients will ask about treatment, she said.

“While that can occur, we can and should be clear about our area of expertise and our limitations,” Dr. Kotsenas said. “We should refer them to the most appropriate member of the health care team to address treatment options.”

Dr. Kotsenas emphasized the importance of coordinating patient communication carefully with other physicians.    

“There are circumstances in which it is beneficial to communicate with patients after talking with the referring physician or as part of a team effort with that physician—for example, if a major unexpected finding or diagnosis is made,” she said.

Dr. Mezrich noted that it’s important to be aware of the emotional consequences of patients receiving serious health news via online portals.

“The best approach for emotionally sensitive information is to give a heads-up call to the patient’s provider that a negative report is about to be released, so they can follow up promptly,” he said.

Raising Radiology’s Profile

Direct communication with patients, Dr. Kotsenas said, “gives a face to radiologists.”

“Patients often believe the physician who requested the exam is the one who interpreted it and made the diagnosis,” she said. “Direct communication provides an opportunity to correct that misperception, and to provide more detailed or precise information than other providers.”

Dr. Becker agrees that speaking directly with patients can contribute to patient-centered care and enhance the visibility of radiologists.

“Patients are going to continue being more involved in decision-making regarding their health care and patient portals, where imaging reports are posted, are part of that process,” Dr. Becker said. “Radiologists should actively embrace the opportunities and challenges associated with increased communication with patients.” 

Fewer things may fall through the cracks when patients are more directly engaged in their care, noted Dr. Mezrich

“In addition,” he added, “the increased interaction may even result in improved work satisfaction for radiologists and decrease the risk of burnout.”

For More Information

Access the Radiology special report, “Patient Electronic Access to Final Radiology Reports: What Is the Current Standard of Practice, and Is an Embargo Period Appropriate?

Access the Journal of the American College of Radiology at

Access Insights into Imaging at

Access RSNA's Professionalism Self-Assessments, which address patient-radiologist communication. 

Read previous RSNA News articles on communication: