Feature | February 08, 2013 | Greg Freiherr

“Patients First” Promises Kinder, Gentler Radiology

RSNA radiology

A pillar in the hallway outside RSNA exhibit hall B advocates a change in radiologists' attitude toward patients.

Since my first RSNA meeting in 1984, I had been told the only radiologists who had patients were those who did interventions. The mainstream radiologist was a physicians’ physician, providing expert interpretation of medical images, identifying the subtle visual indicators of disease and ruling out diagnoses when signs of pathology were absent. This year was different. 

Pillars separating the exhibit halls implored radiologists to take ownership of the patients they scan. They read: “Convene with thought leaders for your patients;” “Embrace technology for your patients;” “Fund radiology’s future for your patients;” “Mentor the next generation for your patients;” “Be a lifelong learner for your patients;” and “Be the voice of radiology for your patients.”

In the opening day address, RSNA president George Bisset, M.D., explained the change of heart. Radiologists “are the patient’s doctor when it comes to imaging,” Bisset said. He advised radiologists to become invested in, and committed to, “your” patients — not “the” patients.

This change in perspective may be just what radiologists need. Reimbursements have dropped precipitously since the Deficit Reduction Act took hold in 2007. Worse times may be ahead. With the emphasis that Obamacare has on managing patients, radiologists are going to be hurting if they don’t have patients to manage. Information technology may be the key.

“Patients have immediate access to countless resources for information,” Bisset said. “Radiologists should be a part of the movement to build another model in its place.”

Through portals, such as Carestream’s MyVue, patients can access their images and diagnostic reports. MyVue, which the company launched at this past RSNA meeting, is so simple that patients need no formal training to use it. They just follow printed instructions on the download of images and reports, which they can review and even share with specialists or other physicians, as the future requires.

Dr. Bisset, who is chief of pediatric radiology at Texas Children’s Hospital in Houston, advised radiologists to “add features to imaging reports that help patients understand them better.” He further advised them to “look for ways to make procedures more patient-friendly.” 

Many of the tools to do so are already in hand. Philips has been hawking its “Ambient Experience” for years, which revamps the scanning environment with soft lighting, relaxing video and soothing music. GE recently signed onto the idea as part of its “caring hands” design philosophy featuring lighting, interior décor, scenery and music. The ultra-short, wide bore systems and high-end MR scanners illustrate how far we have come from the claustrophobic cylinders of a decade ago. CT and nuclear scans have gotten dramatically shorter and their radiation exposure substantially less over the last few years. And, thanks to flat panel detectors, interventional suites have become far less imposing, while providing better access to patients.

This trend toward improved patient comfort and safety is continuing. Philips and Siemens are promoting newly developed interventional systems that promise to cut dose by more than 80 percent for some procedures. Siemens is coming out with a point-of-care ultrasound scanner with wireless transducers, thereby eliminating the cables that could snag equipment or contaminate a surgical field. And GE has a work-in-progress MR scanner, called SilentScan, which might cut noise levels in the MR suite from a peak above 120 decibels to 76.

Radiologists have always put patients first through the precision and application of increasingly precise technologies, ones that make diagnoses more accurate and patient management better. Today the “Patients First” theme has the added dimension of comfort and safety. Industry is putting in the hands of radiologists the tools to make radiology kinder and more gentler than ever before, just as its leadership is building the culture to make this a reality.

It’s a welcome development at a time when such a change may be critically important for the future of radiology.

Greg Freiherr has reported on developments in radiology since 1983. He runs the consulting service, The Freiherr Group. Read more of his views on his blog at www.itnonline.com.