How--and why--radiologists must talk to patients

While traditionally radiologists have had limited contact with patients, that seems to be changing. A drive toward patient-centered radiology (a major theme at last week's Radiological Society of North America meeting in Chicago), is just one reason why radiologists should expect to play a more prominent role as front-line communicators with patients. 

In order to prepare radiologists to deal with this new challenge, Stephen Brown, M.D. (pictured), of Harvard Medical School and Children's Hospital Boston, along with colleagues at the Institute for Professionalism & Ethical Practice, have developed the Program to Enhance Relational and Communication Skills for Radiologists. Through this program, Brown and his colleagues hold day-long workshops designed to teach interpersonal and communication skills to radiologists. 

Attendees at each workshop are expected to participate in or observe simulated encounters with "patients" (hired actors)--followed by group discussions and analysis--involving the communication of difficult news, concerns about radiation dose, and error disclosures. 

Since the program began in 2011, eight PERCS workshops have been held in Boston. And last week, a three-hour version of the workshop was held at RSNA. In an exclusive interview with FierceMedicalImaging, Brown talked about the program and the issue of radiologist-patient communication. 

FierceMedicalImaging: What are the challenges radiologists face during encounters with patients? 

Brown: Broadening of radiologist-patient communication may be uncomfortable and confusing for radiologists, patients, and non-radiologist physicians. The limits of radiologist-patient communication have to be understood, and may differ from practice to practice, and radiologist to radiologist, depending on local culture and individual  experience. There are legal issues at play here, as well, that radiologists must be aware of, in terms of expectations for reporting results directly to patients. 

Also, translating complex medical and technical terms into language that can be easily understood is certainly a challenge for radiologists, as it is for physicians in many fields. This is quite true for communication about radiation risks, where highly technical matters of physics and imaging must be discussed in terms of risks to health, and then compared to the benefits of imaging, and the risks of not imaging.

Communicating about radiation risks is further confounded by--among other things--disagreements among experts about the scientific assumptions used in calculating risks, and basic conclusions to be drawn. All of this has raised public anxiety, which individual radiologists must be able to address effectively. 

FMI: What are the benefits of good radiologist-patient communication? 

Brown: First of all, patients get the information they want as soon as possible. That should enhance their understanding of that information, and also help them better understand their care, overall, so they can make better-informed decisions. It also helps create a bond between patient and radiologist. Research from Indiana University presented at RSNA this year showed that, compared to patients who had no direct interaction with their radiologist, those who met directly with their radiologist reported substantially better overall experiences. 

In addition, the radiologist no longer has to rely on others to be an intermediary, a situation in which both they and patients can be vulnerable to miscommunication by other physicians.

FMI: Can good communication skills be taught? 

Brown: Communication requires practice and formal training, like reading a chest CT or manipulating a catheter. Some individuals may be naturally better than others, but all can benefit. Effective learning about communication can come in a variety of ways--didactic presentations, interactive audio-visual and web-based programs, use of enactments with actors, and group discussions and learning.

Editor's note: This interview has been edited for length and clarity.



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