Radiologists - Patient Advocates for Safety and Appropriate Imaging

Have you ever heard the phrase: The Doctor's Doctor? Well, that is just one role of a radiologist.

Typically, a radiologist's role in the care of a patient is different from that of, for example, a gastroenterologist. When a patient undergoes a test such as a CT scan or an MRI, s/he communicates the findings to the patient's primary doctor either by written report or by verbal communication when the findings need to be more urgently conveyed.

But the time of closed-door radiologists is past. Nowadays, information needs to be conveyed to the patient in addition to the patient's doctor. Radiologists need to be more visible in this regard. The advent of HIEs, or Health Information Exchanges, raises the possibility that patients may be able to obtain their imaging study reports and keep them in their own personal health care file. There are early attempts to accomplish this goal with Microsoft's HealthVault, for example.

The time has come for radiologists to lead the way. Rampant over-utilization of radiology imaging is contributing to rising health care costs and resulting in increased federal scrutiny and imaging backlash. Patients would suffer if they could no longer obtain needed imaging studies to diagnose ailments. We would find ourselves back in the early days when CT scanners were few and far between, because they'd be too costly to maintain.

If non-radiologist over-utilization is corrected, and the government fairly values the use of appropriate imaging studies, then patient care may be enhanced. "Medicare payments to nonradiologists for noninvasive medical imaging recently surpassed those received by radiologists, according to studies at the Jefferson Medical College and Thomas Jefferson University Hospital in Philadelphia." One could argue that imaging studies that are ordered by financially independent physicians may be more likely to be medically indicated.

Radiologists are patient advocates. We have an interest in medical imaging, as it is our lifeblood. But because radiologists are typically independent from the ordering process, the risk of over-utilization is diminished. In addition, radiologists are well-trained to understand the risks and benefits of ionizing radiation. The same cannot be said for most other physicians.

Bottom line: If the utilization of radiology imaging is appropriate, and the government fairly values imaging studies, then patient care and safety may be enhanced.