Radiologists, Own Your Words

A doctor is a person licensed to practice medicine, a physician is a person who is skilled in the art of healing. It’s time for radiologists to decide: do you want to be a doctor or a physician? Andy DeLao, a patient advocate with health care and radiation oncology experience, better known as @CancerGeek, asked during the Moreton Lecture at ACR 2016.

In preparation for his speech, DeLao asked six radiologists why they entered the field. All were good intentioned and essentially wanted to have a profound impact in the life of a patient. Good intentions doesn’t always correlate with good practice, though, and he likened a patient’s health care journey to a story.

“The problem is that the words that you use in the interpretation of images that you put in the reports, that story isn’t being told by you,” he said. “It’s being told by primary care and all of the other -ologists inside the health care system.”

But if radiologists are good intentioned, how did they get lost in telling their own story?

Think about the experience economy, DeLao suggested, the understanding that consumers desire experiences in addition to goods and services. The patient experience, he added, defined by The Beryl Institute, as the sum of all interactions, shaped by an organization’s culture that influence patient perceptions across the continuum of care.

“Think about that, the interactions that influence my perceptions in my journey inside of health care, but where is the radiologist in that journey?” DeLao asked. “I never see the white of [his or her] eyes, the words that you use to build my world that dictate the path I’m going to take inside this health care journey is told by somebody else.”

Radiologists undoubtedly influence the patient journey. If the patient doesn’t perceive that the radiologist is part of that journey, though, that’s a problem in the value equation radiology desperately seeks to solve.[[{"type":"media","view_mode":"media_crop","fid":"48701","attributes":{"alt":"Andy DeLao","class":"media-image media-image-right","id":"media_crop_4068242935212","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"5846","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"height: 180px; width: 180px; border-width: 0px; border-style: solid; margin: 1px; float: right;","title":"Andy DeLao","typeof":"foaf:Image"}}]]

The commodities in radiology are the imaging equipment, the goods are the images, the service is the interpretation of the images in the radiology report, and the experience is the radiology department. But if radiologists decide to meet their patients and explain this to them, they’ve made a connection. Just as important as the experience economy, DeLao said, is the connection economy, which highlights the importance of building relationships and loyalty, it notes that there is an abundance of choice and options and therefore a premium on attention and trust.

“Now we have a connection as humans, I understand you, you understand me,” he said. “I get the fact that you act and do the work that you do because you want to have a profound impact on my journey…the connection economy is all about being human.”

To build attention and trust, radiologists need to have open and honest dialog, transparent conversations, and assist their patients in their health care journey. To do this, though, requires spending time with the patient.

“Right now, because you aren’t using your own words to impact my world, you don’t have my time, nor do you have my attention,” DeLao said.

It’s time for radiologists to connect and let everyone know about their role. The connection economy stands on four pillars, which DeLao translated into 4 Ts for radiology:

1. Are you willing to spend time with the patient?

2. If you spend enough time with the patient, you will earn their trust.

3. With their trust, you can have a transparent, open conversation where you and the patient can understand one another’s expectations.

4. Together, you can help the patient manage their transitions in their journey inside of health care.

“The choice is simple, you either choose to connect, or you will be eliminated,” DeLao said. Think about the empty factories in Detroit, he suggested for the skeptics, which were once full of working people before assembly lines were introduced as a way to mass produce cars.

 There is an opportunity to change this, but it starts with radiologists owning their words, he said.

Consider your network, are you the trusted node inside of your network, be it your practice, your profession, or even broader? If not you, is someone in your practice a trusted node?

“If the answer to either of those questions is no, you need to figure out how to become a trusted node,” he said. “Build and expand your network outside of radiology to all of your stakeholders, the patients, providers, payers, politicians, and pharmaceutical and medical technology companies.”

They all need radiologists, they just don’t realize it, DeLao said, because someone else is using radiologists’ words and telling their own story through their own lense, which ultimately devalues the impact and importance of radiology.

Radiologists need to fight against being a cog in the wheel and make a choice and do something risky: connect with patients, he said.