The Radiologist-Clinician Relationship: Staying Relevant

In our previous post, we discussed struggles facing private radiology practices in today’s ever-changing, competitive landscape. We then discussed 5 key ways to embrace this competitive world and focus on personalizing your patients’ experience. Today, we’re diving deeper and talking about the impact communication has on a radiologist’s most important relationship — their relationship with clinicians. We’re sharing 4 key areas to focus on in order to foster the radiologist-clinician relationship and remain relevant.

Since the advent of the Picture Archiving and Communication System (PACS) and digitization of imaging, radiologists have become further distanced from clinicians. Prior to the modern of age of radiology, radiologists were the gatekeepers of images. Orthopedic surgeons, neurosurgeons, and ICU physicians would regularly go to the radiologist to take a look at the x-rays. Clinicians valued the radiologist’s feedback, and they were able to bring their own clinical experience to the table while examining the images in light of their own knowledge. This typical interaction gave the clinician an opportunity to convey feedback to the radiologist, and it gave him/her a real face to place with the radiologist’s name, that would otherwise have only appeared on a report.

In today’s modern age, clinicians are now able to access images from the comfort of their computer or mobile device. So, there’s less of a need to have physical interactions with the radiologist. Actually, unless there’s a significant discrepancy, clinicians rarely, if ever, visit the radiology department. Radiologists now have fewer and fewer opportunities to build a relationship with clinicians, resulting in greater disconnection.

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The greatest asset for a radiology department is the satisfaction of the clinicians who they work with. After all, the clinicians are the ones who will advocate for a small radiology department when a national teleradiology groups swoops in to displace them. So, building and fostering that relationship is vital.

Paul Chang, MD, a legendary entrepreneurial radiologist, shares a very telling analogy for the radiologist-clinician relationship using toilet paper. He makes the claim that unless radiologists reach out to clinicians and show them the true value they provide, clinicians and administration will see no difference between various radiology groups. He compares this to a customer’s experience of buying toilet paper. Unless the customer knows why one brand is better than the other, they’re all doing the same thing. The truth is, unless radiologists foster this relationship and make their individual value apparent, they lose their greatest asset. Therefore, it’s much more likely to be outbid by the lowest bidder, causing your radiology group to be displaced.

Luma Health recently conducted a survey to help radiologists better understand what clinicians think, and how they feel, when it comes to radiology services. We’ve combed through the findings and put together 4 key areas to focus on to truly foster a strong radiologist/clinician relationship. Since the main product radiologists provide are reports, many of these recommendations revolve around improving report quality.

1. Create More Open Communication

We get it. Taking time out between cases to make a phone call to a clinician can be disruptive to workflow and isn’t directly rewarded in terms of RVUs. However, according to our survey, 47% of respondents felt that radiologists didn’t call them enough. There is a legal responsibility for radiologists to relay urgent findings to the ordering physician. However, reaching out to clinicians more often than is legally necessary is a very effective way of staying connected and creating more open communication.

2. Make Time To Participate in Interdisciplinary Conferences

In an overwhelming response, clinicians said they wanted to see radiologists more involved in interdisciplinary conferences. Nearly 70% of survey respondents felt that there needed to be more radiology participation. For private practice radiology, attending these conferences can be a huge time sink and can take away from revenue producing work (i.e. reading cases). However, clinicians made it clear that they value radiologists’ input. It can make a huge difference in treating and managing patients. These conferences are also excellent opportunities to learn about who plays a key role in the decision-making process and what information should be included in reports to support good clinical decisions.

There is a big push within the radiology community to standardize reports. This would not only improve the ability to track results and patient care but it would also give clinicians clarity on where to look to find the results easily.

3. Stop the Hedging!

Hedging is a very common practice by radiologists in their reports. It’s done mostly to limit liability, but it’s also used when the radiologist is unsure of the significance of a certain finding. It can be hard to appreciate that most clinicians find this practice extremely frustrating. Radiologists practice in the absence of a clinical context. They’re distant from the patient, which is what often leads them to hedging.  As a specialty, we have realized this is problematic and are making efforts to move away from the practice. In our survey, 48% of respondents felt that radiologists hedge too often. Work towards less hedging and more concrete findings that provide true value to the clinician.

4. Organize Your Reports and Get to the Point

Clinicians actually read radiology reports, including the findings section. In our survey, 65% of respondents read the findings section more than 75% of the time, and 58% of respondents said they prefer a shorter report. Clinicians, like radiologists, have increasing workloads and need to be able to easily find the answers quickly and with clarity. There is a big push within the radiology community to standardize reports. This would not only improve the ability to track results and patient care but it would also give clinicians clarity on where to look to find the results easily. Findings would always appear in the same place, meaning the clinician wouldn’t have to sift through a long narrative to find answers. A happy clinician means a happy radiologist, and this leads to a better relationship.

In today’s changing, competitive landscape, private radiology practices must focus on the radiologist-clinician relationship. Focusing on these four key areas will help foster this relationship and allow your practice to remain relevant and thrive.


Tashfeen Ekram, MD, is a radiologist, self-taught coder, healthcare innovator and Co-Founder of Luma Health. Contact him on Twitter at @TashfeenEkramMD.

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