Giving Patients Their Due—Results

Enough talk about it, just do it

Eons ago as a newly minted reporter, I wrote a political column for a series of community newspapers that had a brief Brooklyn spring under the leadership of a talented editor before it disappeared back into the ghetto known as “throwaways.” At the time, the voluble and irrepressible Mayor of New York City, the late Ed Koch, had a habit of asking citizens in every neighborhood he visited across the five boroughs the same question: “How am I doing?” That question became emblematic of his three terms in office.

Much has been said and written about how radiology needs to communicate more with its constituents, and we’ve seen practices make a greater effort overall in building stronger bridges with hospitals and referring physicians. When it comes to direct patient communications, radiologists have been slower on the uptake.

Leaders in radiology initially reasoned that patients should be made aware of whom it is that provides their clinical radiological services, a point of vagueness with most patients. The need to dispel the prevalent notion that radiologists specialize in radios, however, has not proven an effective rallying cry. 

Considering that radiologists have been busy doubling and tripling their productivity in the past decade and a half, getting up from the monitor to meet a patient a day is not practical in most practice settings.  There also is a serious disconnect between this idea and the radiologist workflow.

Another, more troubling, I think, obstacle is the concern with the relationship between the referring physician and the patient. This is the single most important way that radiologists can make the transition to patient-centric care: Communicate with your patients.

Many ways, many reasons

Face-to-face communication may not be practical, but there are many other ways to communicate, as outlined in the article on patient communications in this issue of Radiology Business Journal by Rich Smith (see article, page 34). At this point, there is no time to delay, and an obvious place to begin is in making results readily available to patients—if they want them.  Many patients will be happy to wait and receive results from the family physicians and specialists they know. More and more will not be content to wait.

Stage 2 of the meaningful use program requires that more than 50 percent of patients be provided online access to their health records within four days and 5 percent must view it, download it, or transfer it to a third party. The low rate of stage 2 attestation so far this year suggests that all providers are struggling with this requirement. Radiology presents a golden opportunity for providers to exploit that should not be overlooked in getting patients to access digital files (though many details must be considered and addressed). Who doesn’t want a picture of themselves these days?

This will not happen without two major adjustments in radiologist priorities. First, radiology must perceive itself as central, not ancillary,  to patient care. Second, in order for that to happen, radiology has to make patient communications a priority—like referring-physician communications is—and seek multiple ways to actively engage with patients.

Rather than approaching direct patient communications as a regulatory burden, it would be helpful to consider the serious patient-care issue that it represents. Why?

Patients want it. I hear this all of the time: Friends and family members complaining days after a procedure that their physician has not called them with results of a recent MRI or ultrasound study when you and I know that is rare for a report to not be available within 24 hours. Shouldn’t they be able to access their results as soon as they are available if bad news need not be conveyed?

Patients need it. The best reason to talk with patients is to engage them in their care: Physicians, alone, cannot improve the health of America.  Patients need to do their part, and giving them access to their health information is empowering. I recently had a low-dose CT lung-cancer screening study performed. From my primary-care physician, I received a one-sentence letter five days later saying my chest CT showed no evidence of suspicious lesions. The very concise and clear report from the radiologist (which I arranged to have sent through the film library) included additional, helpful information, advice, and recommendations.

Patients deserve it. Patient information belongs to the patient. They—or someone on their behalf—paid for the healthcare service. Finding ways to make the information consumer friendly is incumbent upon the provider.

If you are still on the fence about this, do what Former Mayor Koch did and ask your primary constituency if it wants access to reports. Ask your patients if they would like you to explain what the results mean. I think you know what the answer will be.