Meeting in the Middle
How can radiologists make their practice more patient-centered?
Given Health and Human Services’ recent push to tie 90 percent of all fee-for-service payments to quality and cost measures by 2018, the relationship between radiologist and patient is set to undergo major changes.
I recently sat down with Casey Quinlan, cancer survivor, patient advocate, and chief content officer at Mighty Casey Media LLC, to talk about how radiologists can practice in a more patient-centered way.
Q: What does your work as a patient advocate entail?
A: My work with patients involves being seen as a source for information on how people can navigate the care delivery and health care payment systems. I talk one-on-one with newly diagnosed cancer patients. I also participate in discussions on patient community forums.
Q: What are the top attributes patients look for in a radiologist?
A: Number 1 is partnership and shared decision-making. That’s how the right care is delivered, and that’s how we put to bed the idea that “patient centered” means “all the scans the patient asks for.” By the way, the myth of the demanding “all the scans I can” patient was busted in a recent JAMA Oncology editorial that references clinical studies showing that patients ask for clinically appropriate treatment over 90 percent of the time.
In the cancer community, radiologists — and radiation oncologists — are our best friends. Or they can be if they take the time to talk with us and work with us. I know this because my own rad oncs did a poor job of communicating with me when I was receiving treatment, and we wound up at loggerheads (not over scans, but over specific side effects of treatment). All physicians need to communicate care and treatment options clearly with their patients, and patients need to communicate their values and preferences to their clinical teams. That’s how effective shared decision-making works.
Q: It’s one thing to use radiology appropriateness criteria when discussing an order with a referring physician; it’s quite another to employ these criteria when discussing the most appropriate course of treatment with patients. How do you recommend that radiologists explain the rationale for a certain test on a level patients can understand but still convey the subtleties inherent in clinical scenarios?
A: This is a tough one. I think the specialty itself needs to create tools that support shared decision-making and make those tools available to radiology practitioners to use in their practice settings. That includes hospital-based practitioners who work with hospitalists and other attending MDs. With the rise in mobile technology and facility IT infrastructure, this isn’t a massive leap. But it will take some investment. Interactive, easily navigable digital programs can help move the needle on patient understanding and also free up clinician time.
Q: What otherpatient-focused tips can you suggest?
A: Talk to the patient sitting in front of you as if you were talking to your mom, your brother, or your college roommate. If you do that, you’ll be 99.9 percent of the way to nirvana when it comes to patient engagement.
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By Chris Hobson, Imaging 3.0 content manager