RSNA 2017: Is a radiologist the doctor's doctor, the patient's physician—or both?

There is an ongoing debate in radiology about what role radiologists should play in the healthcare system. Should a radiologist be a direct communicator to patients? Should they help physicians diagnose and manage patients? Or can they do both?

As radiology becomes increasingly patient facing, radiologists and health imaging professionals are scrambling to answer those questions.  

Luckily, a controversy session at RSNA 2017 may be able to help find an answer. On Nov. 29, three radiologists will come together at the panel, "The Doctor's Doctor or Patient's Physician: Can Radiologists Be Both?" featuring Geraldine B. McGinty, MD, MBA, Saurabh Jha, MD, and Matt Hawkins, MD.  

"I think it’s going to be a dynamic discussion," said Hawkins, director of pediatric interventional radiology at the Children's Healthcare of Atlanta and assistant professor of radiology and imaging sciences at the Emory University School of Medicine. "It's also going to present three different sub-specialized, very diverse perspectives coming from very different practice environments; I think it will show the complexity of the issue and how it's not so black and white."  

Hawkins, who specializes in interventional and pediatric radiology, will be presenting alongside McGinty and Jha. He discussed with Health Imaging what he plans to address at the session.  

"I think in many instances the answer might be that radiologists can't just do one or the other exclusively," Hawkins said. "When it comes to other diagnostic radiology specialties, what you have to be so super careful of is that you don't supersede the referring physician and tell the patients not only the interpretation of test results, but anything that the referring clinician may not agree with when it comes to management, or risk stratification or prognosis. If you burn the trust with the referring clinicians, it's hard to keep a practice open in radiology." 

Hawkins has experienced the disconnect and wavering of trust with clinicians in his own practice, describing an instance when he disagreed with a health provider's diagnostic radiology interpretation. He explained that this causes a great deal of confusion for patients and encourages patients to lose trust in the healthcare system. According to Hawkins, he believes that clinicians and radiologists speaking to patients is not the only exclusive approach to solving this problem. 

"Even though we [radiologists] could talk about the results of an imaging study, you know the patients are going to say 'what's next?' and we are not going to be equipped with our training to answer that question." Hawkins said. "Regardless of what radiologists think, not every referring physician trusts every radiologist."

Looking ahead, Hawkins explained that although a great amount confusion currently exists in terms of what role a radiologist should play, the relationship between the radiologist, clinician and patient will only improve if a conscious effort is made by clinicians and radiologists.

"If you have a radiology practice that's going to take the time to do the things to build those relationships with referring clinicians, then we're going to become integrated valued members with that team," Hawkins concluded.