Radiologists need to be better gatekeepers and medical imaging consultants. At least that’s what David C. Levin, MD is saying. Dr. Levin is professor emeritus of radiology and founder of the Center for Research on Utilization of Imaging Services (CRUISE) at Thomas Jefferson University Hospital in Philadelphia. He argues that radiologists need to take a more active role in assessing the appropriateness of medical imaging requests, instead of just automatically going ahead and doing the study.
“If there’s a request for an exam that isn’t the right one for the patient’s clinical condition, a radiologist should call the referring doctor and get it changed.”
Outside the world of radiology, there seems to be a growing perception that medical imaging is nothing more than a commodity.
Responding to a recent New England Journal of Medicine article (Emanuel E et al, N Engl J Med 2012;367:949), that suggested, in order to contain healthcare costs, medical imaging services should be bid on like a commodity, Levin writes, “It’s important for the radiology community to vigorously refute this notion.”
Becoming better consulting physicians is one of the keys for radiologists to accomplish this, Levin believes. As he sees it, medical colleagues, hospital administrators and policymakers tend to view radiologists as “docs in a black box spewing out reports.” It is important to change that image into one where radiologists are perceived as both medical imaging professionals and physicians relating to patients and referring doctors and participating actively in patient care.
Communicating – The Human Connection
You can’t consult well if you are not a good communicator. Echoing the RSNA 2012 theme of “Patients First,” communication is the key to improving patient care. Patients want to know the results of their medical imaging tests as soon as they are available.
Levin writes, “There’s been discussion lately about giving results directly to patients. I believe that’s the wave of the future. Interventional radiologists and mammographers have already been doing it for years, and we need more of it. Naysayers will complain that doing this will take time away from reading cases and thereby hurt productivity and revenues.”
If radiologists and medical imaging professionals want to elevate their status within the medical community, they must embrace quality over quantity, even it means reduced profits.
Levin points to a recent article in the JACR by Paul Ellenbogen, MD, chairman of the board of chancellors of the ACR, who states that constantly striving to read more and more cases, so as to become more productive, is an unsustainable path. Instead, radiologists must devote more time to non-interpretive activities like consulting with patients and referring doctors, even if it results in a somewhat lower income.
Radiologists as true medical imaging consultants. What do you think?