How to make patient consultation clinics in radiology a reality

One-on-one consultations with radiologists can lead to better overall patient care, and some healthcare providers have even launched clinics aimed at making such conversations more common. But implementing radiologist-patient consultation clinics can be quite challenging, according to a new analysis published in the Journal of the American College of Radiology—so what can be done to make them a reality?   

The authors explored the topic at length, pointing to the numerous benefits of such consultations between radiologists and the patients they serve.

“Consultation with a radiologist is not only a value-added service but also increases radiology’s visibility at large and improves patient perceptions of radiologists,” wrote authors Tirath Y. Patel, MD, of Houston Radiological Associates, and Sonia Gupta, MD, of Beth Israel Deaconess Medical Center in Boston. “Radiologists themselves would benefit from consultation clinics because it would add additional meaning to their work. It also improves relationships with referring physicians who should view radiologists as consultants and partners in team-based patient care.”

However, Patel and Gupta explained, numerous hurdles exist for any healthcare providers looking to implement such consultations. Location, for instance, is a central issue as radiologists often read examinations for patients who are nowhere near where they live. (This, of course, is becoming even more common with the growth of teleradiology.)

Another primary issue is time. Radiologists may want to communicate with patients, but they don’t have time to fit it into their busy schedules—they are expected to keep up with their worklists and interpret other exams as needed.

“The dilemma is that although increased patient communication may improve radiologist satisfaction, it removes radiologists from revenue-generating activities, such as image interpretation, when reimbursement (or lack thereof) is seen as an impediment to patient communication,” the authors wrote. “Additionally, if a radiologist is speaking with a patient about his or her results, they are effectively being taken out of the reading room and away from interpretation of additional imaging examinations that are in line.”

Noting there is “no easy method” to instantly fix this issue, Patel and Gupta did provide some potential solutions for imaging providers to consider. For instance, they wrote, direct consultations with patients could be viewed as value-adding activities that deserve proper compensation just like attending a tumor board or joining a committee at the hospital. It helps ensure the radiologists that their work will be rewarded, which would make them more likely to want to participate in the first place.

The authors also noted that reimbursement and compensation policies both “remain significant impediments to radiologists embrace patient consultation clinics.” If more policies were designed with improved communication in mind it would allow radiologists to go down these paths without losing compensation. Interventional radiologists are able to directly communicate with patients when following up after a biopsy—could diagnostic radiology get similar policies in place?

Another possible solution involves asking patients to pay a small fee to participate.

“Under current CMS guidelines, separate billing for patient consultation services is not only unfeasible but likely illegal as a patient consultation is part of the imaging interpretation payment,” the authors wrote. “However, there is a small but not insignificant subset of patients that would be willing to pay a nominal out-of-pocket fee ($20-$50) for consultation with a radiologist about their imaging study. Creation of a separate billing process for patient consultation would be another avenue that should be considered by radiology leaders to increase direct patient consultation.”

The downside to this solution, Patel and Gupta noted, is that it could result in “only patients with means” gaining access to such consultations. But the idea does show that there are ways to think outside the box if increasing radiologist-patient interactions is a true priority.

“Additional work is needed before radiology-patient consultation becomes more common, but whatever the method, direct patient communication would serve to benefit not only radiology and radiologists but also empower patients to participate actively in their care,” the authors concluded.