Are Radiologists The True Medical Imaging Gatekeepers?


Medical Imaging GatekeepersIn the business world, “gatekeeper” has come to be known as the person who controls access to the decision maker. In medicine, a primary care physician monitors a patient’s health care and serves as gatekeeper for HMO services. If you’re a radiologist reading this, it’s likely that you’ve never considered yourself a gatekeeper of anything.

But, Alan Kaye, MD, recommended utilizing imaging gatekeeping as a means to hinder the increasing commoditization of medical imaging in his session presented at the annual meeting of the Radiological Society of North America (RSNA).

“Gatekeeping” Benefits Patients

A gatekeeper in a healthcare scenario is generally defined as the primary-care doctor who coordinates patient care and provides referrals to specialists, hospitals, labs and medical imaging services.

Kaye explains that the first role of any gatekeeper is keeping out unwanted elements. In radiology, that translates to unwarranted exams and needless costs. These can be controlled with medical imaging guidelines, tools and point-of-care decision support.

The other role of the gatekeeper is allowing in preferred elements, which include performing the right exam on the right patient the first time, as well as screening exams that can improve outcomes, quality and save money.

Enhancing Radiologists Leadership Role

In a time when medical imaging is coming under greater scrutiny, radiologists owe it to themselves to acknowledge the leadership role they may play in health care delivery. First and foremost, patients are consumers; they’re looking to save money but not at the expense of quality.

Dr. Kaye cited his company’s pilot project for screening mammography, which is a universally accepted metric for quality of care. The goal of the “Dropout Project” was to extract information from Radiology Information System (RIS) data about women who were eligible for screening mammography and who had also undergone other medical imaging tests.

The system identified 976 “patient prospects” and emails were sent to those who had established a patient profile; letters were sent to the remaining women. Almost 25% of those patients contacted responded by scheduling a mammogram, which can be viewed a successful outcome by any measure.

By taking a proactive approach and engaging with patients in a meaningful way, radiologists can be perceived as more than some interchangeable cog in a faceless health system. They can actually embrace the role of point-of-care decision support, enhancing their clinical image and practice outside the lab.

If you are a radiologist reading this, do you see yourself as a commodity or a clinician?  I encourage you to share your thoughts, via a comment below.

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