How to maintain control over imaging

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 - chest x-ray, radiology,

The quarterly masters of radiology panel discussion published in the July issue of the American Journal of Roentgenology focused on the strategies radiologists need to employ to retain control over imaging.

David B. Larson, MD, from the department of radiology at Cincinnati Children’s Hospital Medical Center, emphasized clinical excellence and service to patients. He recommended a strong customer service ethic for all constituents: patients, referring clinicians and hospitals. Finally, Larson touted teamwork. “Patients experience us as organized groups of professionals; we need to act competently as organizations, not just as individuals.”

Similarly, Norman J. Beauchamp, MD, from the department of radiology at University of Washington, Seattle, focused on value for patients. “We need to advocate for the patient by making sure that we constrain the use of imaging where it does not add value and foster the use of imaging only when it does.”

Beauchamp also advised imagers to share measures of quality, safety and service and focus on the role of imaging in improving outcomes and patient satisfaction scores and reducing length of stay. He noted the need for physical presence “because it fosters interactivity and relationship building and the clinician.”

“Service, service service…,” Ella Kazerooni, MD, from the department of radiology at University of Michigan Hospital in Ann Arbor, wrote. She homed in on patient-centered radiology, which begins with the first call and continues through results delivery.

Another forum for service, according to Alexander Norbash, MD, from the department of radiology at Boston University Medical Center, is attendance at multidisciplinary conferences. Radiologists view these conferences as extra nonbillable work, while other physicians consider them part of patient care. However, that ethos is evolving with radiologists attending more multidisciplinary conferences and recognizing the opportunity to show value, communicate and consult.

Kazerooni also recommended patient-centered performance metrics and radiology-specific patient satisfaction survey instruments. “Maintaining control of imaging revolves around establishing and effectively articulating meaningful patient-centered benchmarks for what defines good radiology practice in those domains so that we can show, communicate and compare our value in the same terms other medical disciplines do more effectively today.”   

Beauchamp concluded by focusing on collaboration and advised radiologists to be good partners when diffusion of imaging is best for patients, such as point-of-care ultrasound screening in the emergency department for an abdominal aortic aneurysm.

Finally, Kazerooni urged radiologists to take responsibility for communicating appropriate utilization and performing appropriate testing. The alternative, she cautioned, is continued marginalization.