RSNA: PCPs seek more collaboration with rads (Part 1 of 4)

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CHICAGO—Referring physicians have diverse needs from radiologists. RSNA outlined specific details of four specialists’ needs during the What Referring Physician Needs to Know session presented today at the 96th annual scientific meeting of the Radiological Society of North America (RSNA).

Health Imaging News will share referring physicians’ wish lists in a four-part series during RSNA week. Part 1 details family physicians’ needs.

Moderated by Mary C. Mahoney, MD, director of breast imaging at University of Cincinnati in Ohio, the four-part session queried a variety of physicians to help radiologists better understand how to meet their needs. Mahoney asked the four physicians to respond to five questions:

  • What information do you like to see in radiology reports?
  • How do you want important results communicated to you?
  • Would you like radiologists to speak to patients about clinical findings (or lack thereof) on an imaging exam?
  • How do you figure out correct imaging exam?
  • Do you know about American college of Radiology (ACR) Appropriateness Criteria?

The family physician perspective

Family physicians reside in a ‘mock 2’ environment with a wide array of patient types and clinical problems. They need patient-centered collaboration and consistent communication from radiologists.

Robert W. Bales, MD, an assistant professor of family and community medicine at the University of Illinois College of Medicine in Rockford, offered perplexed radiologists new insights into family practice.

“My office is mock 2 with my hair on fire on most days,” stated Bales, who outlined the three broad objectives of family physicians—health maintenance, chronic disease management and translation of symptoms into a differential diagnosis to initiate the treatment plan or further work-up.

Bales confirmed several imaging challenges as a family physician. He works with multiple imaging centers and hospitals, none of which have standard ordering methods for screening studies like mammography. Generalists may not have the specific knowledge base to understand which test to order when as they follow cancer patients, he continued.

The wish list
“I like to see the diagnosis/finding and negative findings in radiology reports. I don’t like to see ‘clinical correlation advised.’ I understand it may be legally motivated, but the clinical findings triggered exam,” offered Bales.

Bales expressed a preference for radiologists to speak with patients in certain circumstances such as an abnormal mammogram. “It can be difficult for me to explain the findings to a patient.” However, he added that he would like a brief synopsis of the conversation if a radiologist speaks with the patient.

According to the family physician, radiologists should communicate important results to the physician by phone. Phone served as the physician’s preferred communication method in other scenarios as well. He admitted that it can be a challenge to select the correct imaging exam in certain cases. In some cases, he phones the radiologist for input and advice.

Bales was quite enthusiastic about the ACR Appropriateness Criteria and felt that every family physician needs to see the criteria. “It’s critical that radiologists and referring physicians work together to improve patient care,” he concluded.