Cutting to the chase: How can radiologists best communicate test results?

Radiologists are often keen to avoid direct communication with primary providers, but referring clinicians actually prefer stronger connections, according to a study of 407 medical residents published in Academic Radiology.

Clinical communication is at a crossroads, first author Zeeshaan S. Bhatti, MD, and colleagues wrote. While effective communication between hospital departments and providers is key to patient health and a hospital’s success, improved technology has created a gray area when it comes to delivering medical news. Doctors today are faced with an abundance of options: Closed- or open-loop communication? Phone calls and handwritten notes or emails and electronic memos?

“With the ever-rising volume of radiologic testing, this equipoise occurs on a daily basis and is a source of anxiety and frustration for radiologists,” Bhatti et al. wrote. “When confronted with this situation, radiologists are often torn between a medico-legal pressure to communicate, an uncertainty about the relevance of the finding in question, competing pressures that demand they continue their other work and a feeling that the recipient of their message may be irritated at the interruption.”

But if those recipients are referring providers, Bhatti’s team found, irritation is far from a common response.

The researchers surveyed 43 diagnostic radiology residents and a cumulative 364 emergency medicine, surgery and internal medicine residents at a University of Michigan quaternary care center in an effort to unravel the confusion surrounding clinician-to-clinician communication.

Around half of the radiology residents surveyed via an online platform did think the frequency of verbal communication between themselves and referring providers was “excessive”, the authors reported; none thought more direct communication was needed. On the other hand, just 1.3 percent of referring provider residents indicated direct communication was excessive, and 24 percent wanted more.

Sixty-six percent of the referring physician pool also said phone calls from radiologists added value to their care routines beyond a timely radiology report, and 83 percent said they preferred to receive phone calls about non-emergent unexpected findings in their patients.

In spite of these findings, however, the majority of radiology residents wrote they were less likely to directly communicate with referring physicians in the future.

“Although radiologists may feel internal and external pressure to avoid direct communication, and a tendency to minimize the importance of the communication they provide, our results demonstrate that referring providers in general find radiologist input to be valuable and worthwhile, and are much more likely than radiologists to feel that direct verbal communication is important, even for non-emergent unexpected results,” Bhatti and colleagues wrote.

The authors said they didn’t study why radiologists tend to avoid abundant communication, though they speculated it could be due to a more anti-social nature, fear of confrontation, time restraints or because residents are afraid to expose themselves to criticism.

“If the literature supporting clear lines of direct communication is not compelling, our data should reassure radiologists that the recipients of their communications in general welcome them and do not consider them a nuisance,” they wrote.