The shift from volume to value puts a premium on the patient experience. Radiologists can do their part with effective physician-patient communication, but a survey published in Radiology shows a disconnect between the values espoused by leaders and the ground-level practices of radiology departments today.
“Although a large majority of the radiologists in our survey believed in the importance of promoting awareness of the radiologist’s role in health care and of being available for questions immediately after a patient’s imaging study or procedure, only a minority of these radiologists’ practices are implementing measures to achieve these goals,” wrote lead author and practicing radiologist Jennifer L. Kemp, MD, et al.
The Radiological Society of North America (RSNA) first identified the need to promote patient-centered radiology in 2005 and over the next ten years added presentations at their Annual Meeting, hosted workshops, and launched a Radiology Cares campaign with an online database of educational resources.
However, the results of a 2015 survey revealed a gulf between what radiologists thought was important and what they actually did.
71 percent of respondents agreed “it was important to be available to patients for questions immediately after the patient’s procedures and examinations,” but only 49 percent indicated their practice often made someone available for questions post-exam.
Almost three-quarters of respondents identified time or workload as the barrier that most frequently prevented them from communicating directly with patients—a problem when an increasing number of patients desire a direct consultation with their radiologist.
Interestingly, respondents cited “personal sense of satisfaction” as the biggest motivator to encourage more communication with patients. According to the authors, this introduces a paradox.
“Insofar as job satisfaction is associated with physician well-being, including radiologists, increased personal satisfaction from more direct patient engagement could help mitigate radiologists’ experience of burnout,” wrote Kemp et al. “This might be beneficial to radiologists whose pressured drive to maintain income by driving relative value units contributes to conditions that fuel burnout. At the same time, our results persuasively show that time and workload are significant barriers to more direct patient communication by radiologists, which highlights a key conundrum: Radiologists’ success in striving so arduously to maintain income may create impediments to the satisfaction and well-being of both patients and radiologists.”
Increased reimbursement for noninterpretive time is one of a few ways to break free of this tug-of-war between patient engagement and maximizing RVU’s, according to the authors.
Other solutions include installing reading rooms in subspecialty clinics, putting radiologists onsite and making them more available for patient inquiry. Social media offers radiologists to opportunity to engage with patients or the public, answering questions in a fast and casual manner. While CMS has recently included some patient-centered quality measures in reporting systems, they don’t yet specifically include radiologist-patient communication—but it’s a representative of the care industry leaders should work towards, according to the authors.
“Radiology leaders have made a compelling argument that if radiologists do not make a more successful transition to patient-centered care immediately, radiology as a profession will seriously decline over the long term,” wrote Kemp et al. “Radiologists who do not adopt more direct patient engagement into their practices now, even without immediate revenue offset, may find themselves in retrospect to have been short-sighted and to have acted outside contemporary standards of best practice.”