Q&A: Garry Choy on patient engagement and how to make rad resident training more valuable

ACR 2016, the annual meeting of the American College of Radiology, begins May 15 in Washington, D.C. In the weeks leading up to ACR 2016, Radiology Business is previewing the conference by putting a spotlight on various sessions.

This week, we examine “Radiology Practice Improvement: Advances in Optimizing the Patient Experience,” a session organized by Garry Choy, MBA, MD, of Massachusetts General Hospital in Boston.

Choy spoke with Radiology Business about the fastest way to define your workplace’s “culture” and the importance of training radiology residents about the power of their own words.

Radiology Business: Can you touch on how radiologists’ view of patient experience has changed over the years? I would imagine that perspective has changed compared to, say, 15 years ago.

[[{"fid":"21658","view_mode":"140xauto","type":"media","attributes":{"height":185,"width":140,"style":"width: 140px; height: 185px; border-width: 0px; border-style: solid; float: left; margin-right: 15px;","alt":" - Garry Choy, MBA, MD","class":"media-element file-140xauto"}}]]Garry Choy, MBA, MD: Now, there’s definitely more awareness about how important it is to really emphasize and improve the patient experience in all radiology practices. Of course, there are political and economic reasons, because reimbursements are now tied to patient experience through Medicare and even private insurance. That’s new; that’s now. But even beyond just the money aspect of things, I believe radiologists truly want to make their practices better.

And I would say 10 to 15 years ago, the field was advancing technologically. The emphasis was still on the latest CT scanners getting better or MR getting better. We were really a diagnostic service, like a lab test. More and more so, radiology is playing more of a pivotal role in actually making diagnoses. When you look at the whole field of medicine, I actually think radiologists are gaining importance in the practice of medicine. Fifteen years ago, I would say we were important, but even more so now. In medical schools, they even teach much more radiology now instead of just physical exams, and that’s a testament to the power of imaging. Images are a thousand words. Images are so powerful. They allow for true decision making around treatments, so I think that patient experience follows that. And I think that’s the real change.

It’s a natural evolution of why we’re paying more attention to patient care, because we are becoming more important to every patient who goes to the doctor.

Are there any specific areas where you think radiology departments and private practices are consistently lacking in regards patient experience?

I don’t think so. I don’t think there is one area. Basically, every department wants to improve the patient experience. In terms of places where they could do more, it’s hard to say. What’s interesting is you are even seeing traditional fields that aren’t normally patient-facing becoming more patient-facing, so I think the overall direction of everyone’s thinking is toward more patient-centered care. I think that’s a good thing for the whole field.

Can you discuss the importance of radiology departments establishing a “culture” and hiring individuals who fit that culture?

If you look at other industries like the hospitality industry, like the Ritz-Carlton, for example ... it’s a business where it’s more than just providing hotel rooms and the building itself as the product; the service around that is very important, and that’s through people. If you look at their philosophy, and I think it’s a good one we should follow in healthcare, they hire people who care about doing good for their customers. Their personality types are very important. It’s people who want to do good, who want to provide the best service.

For healthcare, we’re in a service business, and while we provide products like medications and medical devices, that’s not really necessarily the healthcare system’s job. The system’s job is to provide the  service around these things, so the people involved are very important. From the beginning, we should hire people who care about these services and people who may have had training, and I think by doing that, the "culture" is set. You don’t have to put in as much training and as many resources into moving the workforce to where you want to be, because the workforce is self-motivated.

Training was mentioned predominantly in the summary of your ACR 2016 presentation. Can you touch on the importance of training radiologists about patient-centered care?

I think it’s very important to the future of the field that current trainees care about doing better for patients.

One of the examples I will bring to light is that at our training program at Massachusetts General Hospital, we require a rotation now where radiology residents meet with patients to go through imaging findings at the request of our referring physicians.

So there’s two things going on here: First, the radiology residents will be able to learn to interact with their patients and learn the powers of their words ... this allows them to see the human side of things, to connect with the patients, to see that the power of your words do matter. And the second thing is that this is all done in collaboration with our primary care referrers. It’s not done in a vacuum, because as a blanket statement, it may not be the right first step and may not be applicable in all cases. We set up this clinic in collaboration with our primary care physicians to decide which patients should come see us on a referral basis, so residents also learn how to better serve our referrers. We’re actually embedded inside their clinic. Normally, you say, “This is for Dr. Smith,” but here, you get to see Dr. Smith and talk to Dr. Smith’s patients. We understand what they are looking for. When we’re helping our referrers, we’re helping our patients.

That sounds interesting! How has the feedback been from residents going through this particular program?

Residents love it. Residents see tremendous value in this. In fact, other residency programs in our hospital outside of radiology have also noticed this, and this is a lesson for our other trainees.

And it’s good for our field that people know we are willing to go out there and help our primary care doctors. Even at the trainee level, they are starting to develop relationships and learning how to practice in a multi-disciplinary setting. And it reminds them that they are still physicians; I think there is a certain value there in the training. Also, it breaks up the typical day, it adds variety to the training.

What kind of impact have improvements in modern technology had on patient experience?

I think that because radiology is traditionally a very technology-focused field of medicine, there are a lot of opportunities to enable patient-centered care through informatics and technology innovations. At ACR 2016, I’m also going to talk about our work around IT and how that helps us achieve patient-centered goals.

For example, we have a patient waiting room wait-time monitor. It’s like when you’re at the airport and it shows you what the current wait time is, so patients don’t feel we don’t respect their time. We want to keep our wait times transparent as well as communicate to the patients, “This is how much you have to wait.”

Also, we actually have a behind-the-scenes app that allows us to monitor our resource utilization so that we are able to improve our service and decrease wait times. And we’re also using electronic surveys to send to patients so we know what they are most satisfied with and what we can improve as well. These are some examples of how we can use information technology to achieve the same goal of patient-centered care.