Time for Radiologists and Patients to Be Partners

Radiologists may be the experts in diagnostic imaging, but they will never be the experts in individual patient experience, Jim Rawson, MD, chairperson of Radiology at Augusta University Health in GA, said at ACR 2016.

With payment models shifting from volume to value, Rawson expressed the importance of the patient, who is becoming the largest payer of health care expenses, and their experience.

“If we don’t ask the patient what’s important to them, we will be unsuccessful in our volume to value transition,” Rawson said. He asked why radiologists don’t talk to patients. Is it fear that patients will ask for something radiologists can’t do? Is it because it might take up time that could be spent reading studies?

Rawson, who is the chair of the new ACR Commission on Patient-and Family-Centered Care, shared some myths he discovered from a workshop that included practicing radiologists, patient advisors, and policy experts.

Myth 1: Radiology departments can’t hire patient advisor volunteers because it’s a HIPAA violation

This is not true, Rawson said. There are patient volunteers that work all over the hospital. There is a vetting process during which patients are interviewed and trained. Patient advisors or patient partnership programs have been very successful at helping practice work within their system and improve it.

Myth 2: It costs too much.

“This is part of our arrogance,” Rawson said. “How will we know if that the patients want costs too much if we don’t ask them?”

All projects have budgets, he added. If budget approval seems unlikely, try negotiating for a budget variance with a hospital administrator and have a patient with you, “it’s an amazing experience,” he said.

Since Rawson become chair of radiology at Augusta, every project, including equipment replacement, included patients at the design table.

“There is nothing left in our department that wasn’t designed by patients,” he said. They worked through a lot of issues and couldn’t do everything at once. He showed a picture of an MR scanner in his facility. The room was designed in response to how an MRI felt to a patient, not the way the images looked to a radiologist. The room is designed with wood tones, murals on the wall, and backlit skylines.

“This is a very different way to think about an MRI,” he said. “And all of you immediately recognized this as an MRI, even though it has those other elements, you lost no diagnostic quality, but the patient had a better experience.”

In fact, he said, since MRI’s are so sensitive to motion, you have better motion if the patient is more comfortable, so it’s better to read.

Myth 3: Everything the patients want should be done immediately.

One of Rawson’s projects took over a decade to complete because it couldn’t be done the way he and the patients wanted first few times.

“That dialog is an opportunity for you and the patient to learn from each other,” he said. “It’s an opportunity for them to learn about the constraints you are working under and [you can learn] the constraints they are working under.”

It’s easy to incorrectly guess what is important to the patient, Rawson said. It’s more important to ask them what’s important to them. Keep in mind, also, that preferences are local. What works in Georgia might not work in another geographic area.

What’s important, Rawson stressed, is to have an environment that’s safe and comfortable for your patients so they can tell you what does or doesn’t work for them.

“You’ll be embarrassed, you’ll be humbled, but you’ll find out it’s not as hard to fix as you thought,” he said.