Reversing Radiology’s Culture

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imagePop quiz: How far back does radiology’s disconnect from patient care go? I’ll give you a minute to think it over; the answer’s after the jump . . .

And here’s your answer. In 1916 – that’s right, 94 long years ago – the American Roentgen Ray Society published the results of its annual meeting, at which time those roentgenologists of yore decided that the radiologist should be a consulting diagnostician who does not interact with patients unless invited by the referring physician to do so. Or, as Gary Glazer, MD, chair of the department of radiology at Stanford, put it, “These are deeply ingrained cultural patterns.”

Today, of course, we know that imaging is on the verge of being – if not already – commoditized. As Michael Brant-Zawadzki, MD, noted during this afternoon’s presentation on patient-centered radiology, “We have to understand that something other than the read is our value.”

That something, of course, is the radiologist’s role as a member of the patient’s care spectrum – a role radiologists are finding tough to fill, for cultural as well as other reasons. Yes, radiologists are unaccustomed to dealing with patients day in and day out, but they’re also under pressure to maintain incredible productivity, which often precludes patient interaction.

imageOne way to successfully launch the cultural change, Glazer argued, is through design. Yes, design. Stanford’s new Palo Alto imaging center, designed from the ground-up to put patients literally at the center of radiology operations, experienced both strong business and high satisfaction marks in its first year. The physical walls separating radiologists from their patients were literally eliminated, and radiologists at minimum took the time to introduce themselves to patients – at maximum they spent time with them going over their images. “We strongly agree with the ACR that direct communication of results to patients should be the overall, long-term goal of our profession,” he said.

Brant-Zawadzki suggested an easier first step for those who lack the funding or buy-in from their partners to build a brand-new imaging center: a letter. Imaging centers could offer patients a letter asking whether they’d like to hear their results directly from the radiologist; the letter could double as a marketing tool, taking a moment to wax poetic about the technology the center offers and the qualifications of its medical staff. He even added that many centers could have reports available to patients by the time they leave, thanks to today’s voice recognition and self-editing technology.

“Keep the end in mind,” he concluded. “An accurate, standardized, understandable report provided by you is your own final product.”