Neurologists value imaging reports more if they come from subspecialized radiologists

Neurologists are likely to put more worth into radiology reports if the radiologist responsible for them holds a subspecialization in the field, Dutch researchers reported early this month in Clinical Radiology.

For several years, the question of whether radiologists will fare better if they pursue a subspecialty has trickled through medical communities, first author A.W. Olthof and colleagues wrote. Large hospitals are most likely to have whole subspecialty teams on call for neuroradiology, nuclear radiology or pediatric radiology emergencies, for example, while it’s not uncommon for smaller practices to have zero subspecialized radiologists.

Olthof and co-authors said that as focus in the clinical environment is shifting to the value radiology reporting can add to a case, radiologists should be cognizant of components beyond just technical and diagnostic efficacy. They should tailor their reports to the referring neurologists if they know that physician’s needs, and add the elements of diagnostic thinking efficacy, therapeutic efficacy and patient outcome and societal efficacy to their process.

“The question is whether the perceived value of the radiology reports has a relationship with the degree of subspecialization of the radiologist or with the expertise of the neurologist,” Olthof et al. wrote. “The expertise of the neurologist is relevant because communication always depends on both sender and receiver.”

To delineate the relationship between radiologists and referring physicians and to assess the perceived value of radiology reports by both groups, the researchers distributed a web-based survey to neurologists and residents, noting their levels of subspecialization.

The authors found most neurologists said they personally interpreted all computed tomography and MRI studies themselves, and that those physicians’ self-confidence in their interpretations is high. Residents were more likely than neurologists themselves to believe radiologist’s reports gave helpful advice and answered questions, and neurologists working at university hospitals were more inclined to appreciate radiology reports than those at general hospitals. Radiologists also had a higher rate of subspecialization at teaching hospitals, Olthof and colleagues said.

“In both the university and general hospitals, the majority of neurologists read all cases of MRI and CT examinations themselves,” they wrote. “Hence, radiologists should realize that neurologists are not only interested in the reports, but also in the images.”

The authors said that from the results, they believe subspecialization in radiology leads to higher-quality radiology reporting, as perceived by neurologists. They said this study was the first step in gathering more frequent feedback from referring physicians to improve the quality of radiology reporting.

“Because of their expertise in radiology, neurologists are valuable sources of feedback for radiologists,” Olthof et al. wrote. “Paying attention to the clinical questions and giving advice tailored to the needs of the referring physicians are opportunities to improve radiology reporting.”