Set Up an Effective Way to Communicate with Referrers

As radiologists, our service is supervision, analysis and communication. All too often the first two of these are recognized by us as integral to our daily work, while the last takes a back seat.

There are numerous reasons for this, some obvious and some below the surface. Clearly, increased pressure on productivity is chief among the more obvious; so too is an electronic and remote reading environment. In a primarily outpatient world, I see more patients than I do referring physicians.

Some maintain that those choosing the specialty of radiology simply are more analytic than interpersonal. I think it is the peculiarities of the specialty that simply emphasize what is a common trait of physicians - that we are prone to be analytical first, social second - whereas some other specialties put emphasis on interpersonal interaction or don’t require as much communication between specialties.

All that said, those can't be allowed to be excuses for clear and regular communication. Communication must sit on par with analysis of images.

So given the reasons above, I've tried to build a system that helps remind me to be compulsive about my communications. When I first recognized this, I took an efficiency and business approach, figuring I would manage it with internal personnel resources of the practice. Specifically, I tried to create a system whereby my staff would communicate findings that were less urgent, get referring MDs on the phone.

But that was not foolproof. For instance, at times, it irked other physicians who thought they should not be kept waiting while I was put on the line, or should not get a report from one of my staff. There were occasional breakdowns in communication, or oversights.

It was easy to be too reliant on these systems, but the systems weren’t sufficiently rigorous. In some cases, well-meaning staff even felt it was their job to insulate me from direct communication to allow me to “do my job.”

There were obvious problems, and more subtle ones. The system involved risks. The obvious is lack of communication of necessary information. The less obvious is that communication is not just for sharing critical results. It is just as much for building trust and relationships. So I have taken back much of that work myself. But I try to engineer the system to be robust and redundant, and to ensure I communicate as much as possible. Overall, making communication easy comes down to a few details.

Many referring practices make it difficult to get their physicians and extenders on the line. So make friends with staff, and collect back line numbers and cell phones. Do this politely, and understand the occasional refusal to do so is well-meaning in most cases. Virtually everyone I ask gives me better access when I tell them I had a hard time reaching them, or just that I want to improve our communication.

If you do wait, don't lose your cool on hold. We all have times when it is hard to reach clinicians. Each interaction though is one where we are building a relationship with a practice. It is understood that you may have to express your dissatisfaction with the way things are done; but don't lose your cool.

Set aside defined time to return or place calls. Sometimes I am just too busy to place a call at that moment. If I try to talk then, it may be hurried. So instead, I've learned to gather non-urgent calls and relay them when I feel I have time. Typically this is late in the day, when I'm ready for a reading break. Have a reliable way to keep track of calls to be made, and do it religiously.

Make sure you have a process. Whatever important info you have, make sure you have process to follow-up that it is delivered, be it with your staff or using some sort of reminder system. If I can't reach someone, or have to leave a call back request, I send myself a text or email to remind me they are to call back.

Keep open lines of communication with top referring physicians. Even if you don't have critical information to relay, take time to call regular referrers with more mundane results just to check in. Then ask them how things are working and if they have comments or suggestions.