In the past year, the radiology department at Massachusetts General Hospital opened a consultation clinic for patients as a pilot program.
The reasons for doing so were mostly based on a few experiences in which patients directly approached a radiologist with questions and they met, with the approval of the patients’ referring physicians. These experiences proved satisfying to both patient and radiologist. The patients better understood the meaning and implications of the results of their imaging studies. The radiologists felt that they could draw on their experience and knowledge gained by working with subspecialists from many different surgical and medical fields to both help patients and to advise their primary care doctors.
Primary care doctors have limited time with patients and have many things to take care of other than discussing the results of imaging examinations. Moreover, they do not have expertise in interpretation of images. Therefore, a radiologist can supplement a primary care doctor, particularly when there are incidental findings because radiologists often have considerable expertise in understanding the significance of such findings and can offer guidance in management decisions. Such a role is not unprecedented and is common in, for example, breast imaging and may become more frequent if other screening techniques, such as CT colonography, become adopted more broadly.
Radiologists have learned from their experience in the clinic. For example, they have become more aware of the power of language in their reports and have come to realize the importance of making the impression section clear to the patient while not provoking anxiety.
At present, the clinic remains in the pilot stage in which a small handful of primary care doctors refer individual patients who they feel will benefit from talking to a radiologist. The clinic does not, and will not, usurp the role of the referring physician in informing patients of the results of their studies. All patients who come to the Radiology Consultation Clinic do so at the behest of a referring physician; no direct patient requests are honored. As yet, the clinic does not have its own space but makes use of space that is normally used by the Radiology Interventional Clinic.
Initial reactions to the clinic have been positive. It has increased patient satisfaction with their care, while radiologists benefit from greater visibility – countering the threat of commoditization of radiology, in which radiologists’ only role is to interpret images as opposed to consulting with other doctors on appropriate imaging for individual patients. And finally, the clinic is in synergy with the RSNA, whose goal is to promote patient-centered radiology.
About the authors: Janet Cochrane Miller, D Phil; Garry Choy, MD; and Dushyant Sahani, MD spearheaded the Radiology Consultation Clinic at Massachusetts General Hospital.