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Do we hide behind our reports? The challenge of directly communicating results to our patients
(DIAGNOSTIC IMAGING) -- “I hope my doctor can figure out why I’ve been having so much difficulty swallowing of late,” said the patient as I finished his upper GI study. During the procedure I clearly saw a large mass invading the lumen of Mr. Jones’ esophagus but I kept this knowledge to myself as I made small talk with him before heading back to the reading room. A few minutes later I would issue my report that would contain a diagnosis of esophageal cancer and recommendation for Mr. Jones to undergo an endoscopy and histologic sampling to confirm my suspicion of cancer. Why did I not communicate these results directly to Mr. Jones? Radiologists have often been described as doctor’s doctors. This description arises from our role as consultants whose reports are communicated to referring physicians to assist in diagnosing ailments detected by imaging. As radiologists we typically do not convey our results directly to patients. I believe this practice stems from three misconceptions about radiologists and our field: (1) radiologists are ill equipped to speak to patients about their ailments, (2) imaging is only one component of a diagnosis and (3) radiologists make diagnoses but can not offer therapies.
This article was republished with permission from CMPMedica, LLC
This article was republished with permission from CMPMedica, LLC
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Comment by kahy hasiak on November 4, 2010 at 9:02am
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I am a sonographer and recently completed a scan on a woman after the radiologist saw a large, spiculated breast mass on the mammo. Ultrasound showed very suspicious results, too. The radiologist knew that her physician was out of town so he came in to the room to talk to her (something he rarely does). He told her that she had a large mass, that was probably cancer and apologized for being so blunt, but that he wanted her to get in to see someone that week. He also informed her that he had called her physician's office with his findings. He left me in the room with her and I spoke with her, checking to see if she would like me to call anyone or if she was felt comfortable driving herself home. Two weeks later he got a letter from her, blasting him for being so rude and giving her such devastating news and then leaving the room. I was there and know he had handled it as compassionately as he could. She apparently needed to be mad at someone, so she chose him. Sometimes it's a darned if you do and darned if you don't situation.
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