Radiology: If A Picture Is Worth A 1000 Words

Yesterday I had the privilege of participating in the #JACR (The Journal of The American College of Radiology) during RSNA 2013. In total there were close to 70 participants and the main attraction was the inclusion of Casey Quinlan (@MightyCasey) in the conversation. Casey is a writer, speaker, price cost transparency advocate, and an amazing person with great insight. The discussion was lead by Dr. Geraldine McGinty, a radiologist in New York, and a physician leader and chairs the American College of Radiology’s Commission on Economics.

During the mix of the chat there were a few items that came to my attention. Two of them stood out loud and clear.

The first was the definition of value. This is something that I am passionate about and have a few choice comments on, but I will save for a future post.

The second topic that stood out to me was on communication and the role of radiologists. Again, another topic that is important to me. This one I have addressed in a few other posts, but I want to tackle again. ( Posts can be found by clicking one and two)

I am not sure when or how it happened, but when did physicians lost the gift of gab with patients? Granted, I understand that radiologists typically work in dark rooms, filled with multiple computer monitors, trying to read each exam with precision, and then be able to dictate into a microphone with the findings on each patients exam, and ensure that it gets to the ordering physician and patient on a timely basis. Not to mention the number of interruptions from staff as well. A lot to contend with during a day. (I know there is plenty more, but you get the drift)

I thought the advancement of PACS, voice recognition, EMR, RIS, and all of the workflow enhancements of new CT, MR, X-Ray, PET-CT, U/S, and everything else imaging related was supposed to improve the lives of radiologists?

If the technology doesn’t improve the radiologists ability to communicate with the internal stakeholders of physicians, administrators, technologists, and other staff or provide more time to allow radiologists to meet and speak to patients and other external stakeholders, then is there something wrong?

A radiologists, just like other members on a healthcare team, possess a specific type of intellectual property. A radiologists has the expertise to view into a patients body. They have the responsibility to take multiple pieces of information from other physicians about a single patient, combine them with a tool that allows them to see what is going on inside a patients body, and then put those pieces together to formulate a story of what is or may be causing a patient to feel as they do.

However, if a radiologist does not have the time or ability to share and tell their story to other physicians, healthcare providers, administrators, and staff then who is verbalizing your importance? I am willing to bet it is someone else that is not a radiologist. If it isn’t someone with your domain expertise and knowledge, then are is that person able to convey the importance and the impact that you bring to the team? I doubt it.

Radiologists have also moved further and further away from communicating with patients. Again, how do patients with little to no medical background and training understand your role, your job, and the importance of what you do if you are not able to share your story? Again, leaving it to someone else is not in your best interest.

Perhaps as healthcare has evolved and moved to more and more imaging centers there has been a fear that if a radiologist speaks to a referring physicians’ patient and mentions something contradictory that there could be future implications? Perhaps if a test or exam was ordered and a call was made to ensure that the right test was being ordered that it may upset the ordering physician? Maybe it is the simple fact that radiologists are just too busy to be able to have time to speak with patients directly?

I am sure there are thousands of reasons as to why we can’t, why we haven’t, or why we don’t speak to patients.

Whatever the dogma may be, it needs to stop. Now. Not tomorrow. Not next month. Not next year.  Today.

I am not a radiologist, but I do know the important role you play in the care of patients. I know because I am an insider. I have the ability to have the same conversation with physicians, staff, nurses, administrators, and patients and make the same conversation meaningful to everyone at the table.

This is why I urge you as a radiologist and as a member of a larger community of radiology globally. Your voice has been lost. Your stories are missing from the conversations.

Patients know that they go to a place with fancy equipment and have an exam that gleams into their body. I argue that most patients do not ever see those images. Most patients never hear the story being told alongside the images that were obtained. The stories that are being told are through primary care physicians, cardiologists, orthopedists, internal medicine, and other specialists.

Those stories are not being told through your eyes, your point of view, with your images. Patients rarely ever get to see the power and beauty in what it is you do on a daily basis. Patients walk in, wait for a physician, hope to have 5 minutes with them of face to face time, are told what is going on, and then are left to do the next step in the process.

Imagine if you helped to articulate the story to patients and leveraged the power of your images?

If a picture is worth a thousand words, that what is my specific image that is related to how I feel today worth to me? I would argue that most patients would say that it is one of the most valuable pieces of information that someone has taken the time and effort to communicate with them.

We live in a world of people, process, and technology. Most of us in healthcare like to focus on the process and the technology. Yet the single group that produces the most amount of impact, the people, is the one that typically gets overlooked.

We have conversations all the time. At home, at work, with family, friends, coworkers, complete strangers. So why is it so difficult to connect with the ones that need you the most, your patients?

It is time to challenge yourself and your colleagues. Do not live in the dark, do not just fixate on your work-lists or the reads and dictations that you need to complete, do not solely focus on your production of exams completed.

Do not just be a clinician.

Stand up, step into the light, move from being a clinician to becoming a provider.

You possess a vast amount of knowledge. You have the ability to educate other healthcare providers on the right exam for the right information based on the needs and expectations of the patient. You have the power to see inside the body. You are the voice for each patients set of images.

Patients need you to educate them and tell them what their images are trying to say to others on the care team. Patients need to know the importance of radiologists. Patients need you to help be their voice.

I challenge you to go low tech on a daily basis and have a simple conversation with a patient. Their story may impact you.

How will your story impact them?

As always, you can feel free to contact me at: CANCERGEEK@GMAIL.COM or follow me on twitter @cancergeek


#PtExp #PX #cancer #hcldr #hccosts #hcsm #stories #storytelling #lcsm #bcsm #RSNA13 #imaging #radiologists #radiology

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