The way in which radiologists communicate their findings to referring physicians can be just as important as what they are actually communicating, according to a recent article published in the American College of Radiology's ACR Bulletin.
For example, the article describes a situation in which Dushyant Sahani, an associate professor of radiology at Harvard Medical School and a radiologist in the division of abdominal imaging and intervention at Massachusetts General Hospital in Boston, provided second opinions to patients who believed they had terminal diseases based on initial radiology reports. Sahani's review of the cases found that all but one had findings that were fairly benign, but that the patients had been so confused by the language in the initial reports that they thought they were going to die.
Consequently, Sahani and other radiologists at MGH had a discussion about what should go into a radiology report, concluding that radiologists should keep in mind that they are writing for referring physicians and not other radiologists.
The American College of Radiology in 1995 published a "Practice Guideline for Communication of Diagnostic Imaging Findings," which has since been revised multiple times, the last time in 2010. According to ACR, effective communication satisfies the need for timeliness, minimizes communication errors and encourages communication between physicians.
According to the ACR Bulletin piece, referring physicians want radiology reports that:
- Avoid radiology-centered jargon
- Don't use different terms to describe the same condition
- Limit extraneous information
- List a radiologist's most consequential findings--in order from the most to least important; this makes it clear to referring physicians what information in those reports is of high-value
- Provide supporting information from radiologists for why they believe additional imaging studies are necessary
Institutions should consider embedding radiology reading rooms in clinical areas--rather than in one centrally located area--to increase face-to-face time between radiologists and clinicians, according to research published in the Journal of the American College of Radiology in May.
"The value of this study emerges from the documentation of the high degree of variability among institutions in communication practices among different kinds of radiologists and referring physicians," the study's authors wrote. "The extent of these different practices among the four reading rooms has important implications for future studies of communication patterns between radiologists and referring providers, as well as for designing effective interventions to enhance the role of radiologists as consultants."
To learn more:
- see the article in the ACR Bulletin (.pdf)
- read the 2010 ACR Practice Guideline for Communication of Diagnostic Imaging Findings