Clarifying My Views of Teleradiology

My first book, What Do I Do Now? A Handbook for Life, included a sizeable chapter on relationships. One of the keys to any successful relationship is the ability to see the world through the other’s eyes. Unfortunately, for most of us this skill must be learned; our natural tendency is to do just the opposite and interpret words and deeds through our personal prism.

I should therefore have not been surprised by the wide range of responses to my blog post last week, “Counterpoint: Where Teleradiology Falls Short.” I received emails and calls from fellow physicians and others in radiology thanking me for bringing focus to the benefits of direct patient involvement by radiologists. Two internists also added their endorsements.

Of course there was the other side. Teleradiologists saw my blog as an attack on their industry and career choice. If you read Dr. Eric Postal’s latest blog entry, “To My Anti-teleradiology Colleagues,” you know what I mean. So I’m back to clear up some misunderstandings and hopefully bring peace to what should never have been a war.

While it is true that Dr. Postal’s well-done series on choosing a teleradiology career stimulated me to write a piece that contrasted distant diagnosis with a more hands-on practice, dismissing the former was never the mission. Highlighting the advantages of direct radiologist-patient interaction was the sole intended focus of the article. I had no intention of bashing teleradiology, either the industry or the career path. Most radiologists choosing a career in teleradiology are smart, well-trained, and dedicated to providing excellent patient care.

I am not a technophobe, nor do I fear change. I love technology and what it offers, (and yes, I long ago read Who Moved My Cheese?). For the record, I have an MBA and understand product cycles and disruptive technologies. Teleradiology represents a positive development. In addition to providing off-hours coverage, teleradiology can deliver excellent radiologic interpretation to underserved areas, and brings expertise to even urban settings that lack highly trained specialists.

Of course it also represents a new, profitable business model, and until it ceases to make money for investors it will likely continue to grow and evolve.

Interpreting films online for a teleradiology company - or sitting in a hospital radiology department or imaging center and rarely if ever seeing patients - seems to me to be an opportunity lost. Just this morning I entered an exam room to see a patient for a pelvic sonogram, and she immediately reminded me of our last appointment 18 months ago. At the time of her previous visit she had been recently diagnosed with and treated for breast cancer. She vividly recalled our conversation from that visit; I did not. What impacted her most was that I had taken the time to listen and to comfort her that day. She told her husband and friends how much better she felt after our encounter. The irony is that I hadn’t diagnosed her early breast cancer, or given her good news. I had just listened and talked with her. This morning the tables were turned: Her words of gratitude to me literally made my day.

If you have the wherewithal to get out of your chair and see patients, whether you are in an imaging center or hospital, or travel for locums positions to augment your teleradiology career, I urge you to do so. It’s good for the patient - always number one - and it’s good for you. It will add immense value to your career and to your life. Plus in a changing health care delivery world where value added must be proven, it might also just save our specialty.