By Elizabeth A. Morris, MD, FACR, FSBI, FISMRM; Professor and Chair, Department of Radiology, UC Davis Health
Rolling through the stop sign saved his life. Early 50s and in decent shape, the man was cycling home from work when an SUV clipped his bicycle’s back wheel and sent him flying into the air. He was battered and bruised but seemed lucky to walk away with only a broken arm and a few cracked ribs. In the emergency department, the radiologist on duty read his CT to make sure nothing else was broken and noticed a lesion on his kidney. If not for the accident, the cancer wouldn’t have been caught—and successfully treated—early.
When incidental findings happen in places like the ED, radiologists must play a key role in ensuring the patient gets the proper follow-up, diagnosis, and, when needed, treatment.
Every day, radiologists can improve patient outcomes—and save lives—by taking a more significant, guiding role in the patient journey. Too often, there is the misperception that radiologists are responsible for producing a report rather than caring for the patient connected to that report. The view of the radiologist as a service provider is holding us back from taking a central role in the patient decision-making process and reducing opportunities for effective early intervention. As radiologists, we must agree that we own patient care and outcomes once we deliver a report.
There is an emerging culture change underway to build effective bridges among radiology, referring physicians, health system leadership, payers, and, most importantly, patients. Patient education will be essential as one study found that 40% of patients who required breast imaging didn’t think breast radiologists were a part of their care team—and only 14% understood they were physicians. [ i ]
Imaging such as X-ray and CT is currently a primary driver of relative value units (RVUs) for radiology. Changes, including updates to coding, that put the patient at the center of our work must become a new, central driver for value.
Clinical societies will also need to be a part of this community approach to support patient facing radiology in the form of consistent guidelines and standards of care that are the same across societies.
At the same time, we need to give radiologists the resources they need to succeed in this expanded role when 49% already report signs of burnout.[ii] Innovations in workflow optimization, clinical decision support, and artificial intelligence all have the potential to help radiologists get to the right answer faster and more efficiently.
In addition, communication across all stakeholders, including the patient, also will be critical. We need to demonstrate to referring physicians and other specialties that radiology, like few other disciplines, understands the nuances of their patients and can be a valuable partner in both diagnosis and treatment.
Industry leaders, such as Bayer, have already embraced this challenge. “At Bayer, we work with both our customers and the wider radiology community to help support radiologists to take an increasingly interdisciplinary role in patient care and education. We believe that continuous exchange across disciplines, along with close involvement of patients and their families, will ultimately lead to better outcomes. This is also key to exploring additional opportunities for improvement and innovation, from diagnosis to care,” said Gerd Krüger, Global President of Radiology.
One area where Bayer is helping to make inroads is breast density and breast cancer risk. Almost half of all women over 40 who have mammograms are told they have dense breasts. Having dense breasts can make it harder to see tumors during a mammogram. Dense breasts also increase a woman’s risk of developing breast cancer.[iii] Bayer has brought together healthcare providers, patients, and advocacy groups to identify patients’ unmet needs and barriers to accessing appropriate screening modalities. Based on these efforts, they have created a range of educational materials distributed through traditional media and social media to help women have more straightforward, productive conversations with their care providers about their screening needs and cancer risk.
At the end of November, imaging professionals gathered for the annual Radiology Society of North America meeting. The theme of the meeting was Empowering Patients and Partners. I was honored to be able to give the keynote speech on such an important topic that centers around partnering to advance the role that imaging can play in healthcare and the patient journey.
- NO'Mahony, et. al. Who's the doctor? Patients' perceptions of the role of the breast radiologist: a lesson for all radiologists. Br J Radiol. 2012 Dec; 85(1020): e1184–e1189.
- Medscape Radiologist Lifestyle, Happiness & Burnout Report (2020).
- Dense Breasts: Answers to Commonly Asked Questions. National Cancer Institute. https://www.cancer.gov/types/ breast/breast-changes/dense-breasts. Updated July 14, 2020. Accessed August 18, 2021.
November 2022 PP-PF-RAD-US-0920