Frequently Asked Questions in Radiology

1. How can we improve patient radiology literacy and why it is important?
Radiology literacy is quite low in the general public, generally due to the inaccessibility of radiologists who spend most of their day in front of a computer monitor and almost never in front of a patient. Similar to an air-traffic controller, the average traveler never sees this person who works with the pilot to keep everyone safe. A radiologist tends to function in this same under-the-radar fashion (forgive the pun).

This is changing as the public and our government become more interested in value over volume in medicine. Accountable care has become more important than the amount of care. Radiologists—experts in medical imaging—are starting to emerge from darkened reading rooms to review findings with the patient and show them what they look like on the inside. This is particularly true with breast imaging, where the radiologist is an integral part of the breast cancer treatment team and may be the first to tell a patient the bad or good news. In my field of prostate MRI, the same trend is occurring. After an MRI, I discuss the findings with the patient and his wife, discuss pros and cons of treatment, and talk about follow up and surveillance.

We are taking this even further with the pathology department as we develop Diagnostic Management Teams (DMT’s) which allow virtual interdisciplinary meetings (via Skype or GoTo Meeting) during which the radiologist and pathologist review findings with the treating surgeon and then the patient logs on to review this information with all of his/her doctors. Often, a scheduler or social worker is also linked-in to provide real-time appointments and assistance to the patient in this virtual environment. We have found that the care rendered occurs much faster with DMT’s, with improved patient satisfaction and understanding of their condition.

2. What are some pros and cons of pro-bono clinic volunteerism?
In my academic environment, much of our interpretive work involves uncompensated review of outside studies or free consultations with referring physicians, residents and students. In that sense, our faculty perform pro-bono work every day.

3. What are some complexities of radiology scheduling?
A serious problem as revenue takes a huge hit with no-shows and inefficiencies in productivity. The answer is to schedule radiology exams like the Apple store—you sign up for a slot online and be there for your service or lose your place. I am amazed at the Apple store, very few people no-show an appointment.

A combination of online scheduling with back-up patients to fill in for no-shows is the key to success. I would add that texting patients “on-call” when slots open-up is also helpful. I do not accept that pre-authorization is a problem as there are ways to work around that and CMS will insist on radiology decision support in the next 1-2 years meaning that pre-authorization of radiology exams will soon be an exception rather than the norm.

4. What are the political leanings of radiology professionals?

Decidedly conservative although more left-leaning in academic environments.

5. What are the Recreational vehicles of various radiology staffers like? RV’s, etc?
We don’t have any staff with RV’s as our hospital is on an island. We have a lot of boaters, however. Although my radiologists don’t RV, our technologists travel about the state in mobile vans performing ultrasound and breast imaging. We read this from our home base using teleradiology.

6. What are some of the pros and cons of the workspace of radiologists and techs?
The traditional reading room and technologist workstation environment has not changed for a long time. However, improvements in technology have gradually freed the technologist from a processor to a dedicated workstation to, now, a modality that can transmit images wirelessly to the PACS. So techs are less “grounded” in the radiology department than previously. This generally promotes satisfaction but may decrease social interactions among the staff.

For radiologists, the advent of fast landlines and internet connections has allowed teleradiology to flourish. My staff read from home one week in 8-10 weeks. While this seems wonderful, a dark side exists. Radiologists tend to be more productive at work compared to home, despite the fact that reading from home involves fewer interruptions for consultation and tumor boards, etc. There seems to be a blunting of productivity when reading from home, perhaps due to work/life separation and just a lack of initiative when sitting in one’s private or family space. Blurring that work/life line may not be a great idea and is certainly not for everyone.

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