George S. Bisset III, MD, discusses the changing role of radiologists in an interview with Health Imaging, and encourages his colleagues to focus on patient engagement and embrace their central role in the care continuum.
The RSNA 2012 theme is “Patients First.” How do you see the radiology community having greater involvement in the patient care continuum?
Prior to my entrance into radiology, I was a pediatric cardiologist, which put me in close contact with patients. As a result, I have always been a little frustrated by how little patient contact we have as radiologists. There is a sense that we are invisible to the patients and this can frequently result in us being perceived as an ancillary service. RSNA’s 2012 theme of “Patients First” is an attempt to put us in the shoes of our patients. As radiologists, we need to address the entire patient experience. That means we have to look for opportunities to interact with patients and function as advocates for expeditious and effective lines of communication.
Even though many radiologists have traditionally been hesitant to engage patients, if we’re going to enhance our visibility, we’ve got to make the effort. Also, radiologists talk about “the” patients, rather than “our” patients, as if we are remote from their care. Until radiologists consider themselves a vital part of the clinical care team, we’re not going to be putting the patients first. Again, part of our responsibility is realizing that behind every study that we interpret there is a patient with a problem. When it comes to imaging, we ARE the patient’s doctor. We’ve got to emphasize patient safety and doing the right exam for the right patient at the right dose.
How does RSNA 2012 encourage radiologists to engage with patients?
We have two course tracks devoted to patient-centered care. Also, most of the plenary sessions are focused on enhancing ways to put ‘patients first.’ For instance, Bohdan Pomahac, MD, director of plastic surgery transplantation at Brigham and Women’s Hospital in Boston, is giving a talk titled “Facial Restoration by Transplantation and the Role of Novel Imaging Technology.” For these extremely complex facial restoration cases, surgeons are very reliant on interactions with the radiologist as part of the care team.
Also during the plenary sessions, Sheila Ross and Karen E. Arscott, DO, will speak on “The Doctor as Patient; The Patient as Advocate.” If radiologists put themselves in the shoes of their patients, it will have significant impact on the way we practice.
In addition, two other speakers at the plenary sessions—Keith J. Dreyer, DO, PhD, and Paul J. Chang, MD—will focus on using IT to enhance our interactions and making care safer for patients. This theme will be carried throughout the week.
Delving into the complexities of patient engagement, Leonard Berlin, MD, will deliver the Annual Oration in Diagnostic Radiology on “To Disclose or Not To Disclose Radiologic Errors—Should ‘Patients First’ Supersede Radiologist Self-Interest?” Finally, Richard B. Gunderman, MD, PhD, will reinforce the importance of radiologists’ visibility with the lecture titled “The Story behind the Image.”
Looking at pediatric radiology, what are some trends within that specialty and how are they reflected at this year’s RSNA?
The rapid development and maturation of various technologies, and how those innovations can improve patient care, take center stage at this year’s meeting. For instance, the evolution in CT technology has been substantial. There has been a great deal of focus on radiation dose, and with some of the new iterative reconstruction techniques, we have decreased the dose for many CT exams to less than 1 mSv. Several exams are now performed using a fraction of the radiation dose that we used even 10 years ago.
Pediatric radiologists, bolstered by the Image Gently campaign, have been very focused on lowering CT doses. Even though we may not be able to predict the exact risks from radiation exposure in a single patient, we need to minimize dose. We also are considering other alternative modalities to replace CT when we can. We’ve seen that to a large extent in patients with suspected appendicitis, for which most pediatric institutions are substituting CT with ultrasound. Using lower dose and using alternative modalities, which have no dose, have been two important trends.
Also, advances in MRI techniques have led to further reductions in imaging times, which may permit less sedation