With emerging technology in the field of radiology, radiologists spend more time with technology, reducing opportunities to interact and communicate with colleagues and patients. As machines handle more and more of their responsibilities, radiologists risk becoming more isolated from their patients and colleagues in their practices.
Dr. Raskin
is Voluntary Associate Professor of Radiology, University of
Miami School of Medicine, Miami; and Legal Counsel to the Florida
Radiological Society. He is also a member of the editorial board
of this journal.
If you were at the annual Radiological Society of North America
(RSNA) meeting this past December, you couldn't help but notice
that the theme was "Communication for Better Patient Care." The
President of the RSNA, Peggy Fritzsche, MD, urged her fellow
radiologists to communicate more with their colleagues, their
patients, and the public. With emerging technology in the field of
radiology, radiologists spend more time with technology, reducing
opportunities to interact and communicate with colleagues and
patients. As machines handle more and more of their
responsibilities, radiologists risk becoming more isolated from
their patients and colleagues in their practices.
Failure to communicate is one of the greatest problems facing
radiologists today. The radiologist may make a correct diagnosis
but fail to communicate the results to the referring physician. The
communication must be timely and appropriate and should be
documented. Direct communication may be necessary in situations in
which the radiologist feels that immediate patient care is
indicated. This can be accomplished in person, or by telephone, to
the referring physician, other healthcare provider, or an
appropriate representative. If that individual cannot be reached,
it is recommended that you communicate directly to the patient or
responsible guardian.
In situations in which a preliminary report is rendered before
the final report is prepared, any significant change between the
preliminary and final interpretation should be reported directly to
the referring physician, and the communication should be
documented. The courts have repeatedly held that timely
communication may be as important as the diagnosis itself. A
radiologist cannot escape the duty to communicate immediately with
the referring physician when immediate patient treatment is
necessary.
The American College of Radiology Practice Guideline for
Communication recommends that significant unexpected findings can
now be communicated in a manner that reasonably ensures receipt of
the findings. Prior to 2002, "significant unexpected findings" had
to be communicated directly. Now, in most cases, an interpretive
report may be reasonable to ensure communication of the findings.
However, if the patient's treatment is adversely affected by lack
of timely receipt of the findings, the radiologist may still be
named in a lawsuit. If the radiologist maintains that his or her
duty to the patient ended with the correct dictation of the report,
he or she will be perceived as being cold, callous, and
uncaring.
Radiologists should also recognize the potential obligations for
assuming the care and treatment of patients who are self-referred.
This may even require the communication of results directly to the
patient as well as appropriate follow-up. In such instances,
radiologists must ensure that their communications with patients
are documented.
In summary, when immediate patient treatment is indicated,
communicate directly, in person or by telephone, with the referring
physician or other healthcare provider, and document the extent of
your communication. Communication without documentation may leave
you vulnerable to attack by the plaintiff's attorneys. Take the
time to document your communication. Not only will this afford you
the best protection, but it's the right thing to do for your
patients.