Referring docs want direct contact with rads on important findings

Referring physicians generally are pleased with the quality of radiology reporting, according to a study published in the October issue of the American Journal of Roentgenology, but still would like to hear directly from radiologists regarding important findings.

For the study, Andrew Gunn, M.D., and colleagues from Massachusetts General Hospital invited five referring physicians from their institution to act as reviewers. Reports from abdominal CT, Chest CT, brain MRI, and abdominal ultrasound were considered to be appropriate for review if the indication was "abdominal pain," "shortness of breath," "headache," or "pain," respectively. Twelve reports from each of those groups (for a total of 48) were selected at random and distributed to the five reviewing physicians, along with the clinical scenario and an evaluation for each exam.

Based on a scale of 1 to 5, with 1 being "not useful" and 5 being "very useful," the reviewing physicians found the reports to be clinically useful (3.8 on the scale), and allowed for good confidence in clinical decision making (3.7). The problems with reports involved unclear language, typographical errors and reports that didn't answer the clinical question.

Of the reports reviewed, 35.4 contained recommendations for further diagnosis and treatment, 84.7 percent of which were deemed clinically appropriate by the referring physicians. The researchers also said that 31 percent of the examinations should have been directly reported to the ordering provider.

"A key piece of feedback we got from these referring physicians is that they would have liked to be notified about results more often," Gunn told AuntMinnie.com. "The comment was something like, 'You wouldn't believe the nonsense I get paged about, but important findings don't come through.' So that told us that radiologists should be calling and paging more often. It's good for patients, and it shows referring doctors that someone's reading the scan, someone is paying attention."

The authors suggested that reporting could be improved by including feedback from referring physicians. This could be accomplished by, for example, developing some sort of web-based evaluation that referring physicians could fill out at the time they are reading the report.

To learn more:
- see the study in the American Journal of Roentgenology
- read the article in AuntMinnie.com

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