The patience liability

I am not a patient person, an admission that often invokes a fair amount of guilt. But two of this week’s top stories illustrate the power of impatience.

For those of us who are impatient and lack an insider’s understanding of clinical research, the span of time that it takes for medical knowledge to be translated into practice borders on the surreal. Estimates range from seven to 20 years; even the low end seems far too long.

Yet the intractability of established practice patterns came across loud and clear in a study published June 24 in Pediatrics. Researchers demonstrated that clinicians continue to bypass guidelines and order head CTs for children presenting with uncomplicated headaches. And the culprits extend beyond the usual suspects—emergency medicine physicians.

The researchers suggested additional guidelines and educational programs to encourage physicians to comply with American Academy of Neurology practice guidelines endorsed by the American College of Radiology.

However, in some cases, the impetus for change springs from less welcome sources.

Consider State University of New York (SUNY) Downstate Medical Center in Brooklyn. Two years ago, SUNY endured the national spotlight for its profligate use of babygrams in its Neonatal Intensive Care Unit.

SUNY launched into action and devised a process improvement plan. A mere two years later, it’s a national model for pediatric dose reduction with its success detailed in the Journal of American College of Radiology.

In both of these cases, patience, and its hapless cousin, complacency, can derail practice improvements.

So hats off to the impatient among us who leverage this maligned trait to drive essential change.

If your practice has implemented meaningful patient-centered change, please submit a nomination for Health Imaging’s Imaging 3.0: Patient-Centric Imaging Awards. I look forward to learning more from leaders in this area and profiling these practices in the September/October issue.

On another note, Health Imaging will not be published from July 1 to July 5. Best wishes for a happy Fourth of July to our readers who wave the stars and stripes.

Lisa Fratt, editor