Building a Better Team
Members of the care team provide tips for strong partnerships.
Every team has a common goal. For a sports team, it could be winning the big game. For a school group, it’s likely acing that big presentation. But in medicine, the common goal is always the patient’s well-being. For the patient care team, teamwork helps assure that the patient receives the best quality care. That’s why it’s important for radiologists to work well with other health care professionals to ensure the proper diagnosis and treatment.
Still, these partnerships aren’t always easy. Members of the care team, such as radiologists, referring physicians, and radiologic technologists, sometimes work in a vacuum of high-volume, chaotic scheduling, and pressure to produce. In light of such new initiatives as Imaging 3.0™, it’s important that each of these members of the care team work outside of their specific, often volume-based responsibilities and assess how to become more valuable to each other as well as to the patient. Here are some tips from various perspectives for how radiologists can best contribute to the care team.
According to Beth Weber, MPH, RT(R), RBMS, CRA, radiologic technologist (RT) at Avera Heart Hospital in South Falls, S.D., interacting face-to-face with other members of the team is extremely valuable. “It’s important to know a face on the other end of the phone, but a lot of people don’t put much value in that,” Weber says. “Being in the same room and having that face-to-face conversation humanizes the discussion.”
Rather than remaining isolated in the reading room to maximize reads, Weber encourages radiologists to meet with their RTs in person. Get to know your technologists, hospital administration, and other staff members by asking questions and showing genuine interest. Do they have a family? What school did they attend? Weber also suggests bringing up an interesting case or asking about a recent patient. “It’s OK to say, ‘How’d that patient ever turn out?’ Be interested and do some follow-ups” to show your genuine interest in your colleagues and your shared patients, she says.
Nabile M. Safdar, MD, MPH, vice chair of informatics at Emory University Department of Radiology and Imaging Sciences in Atlanta, agrees about personalizing interactions. This has become even more important in a world where technology makes it easy to avoid in-person communication. “Increasingly, people are reading from remote sites,” he explains. But that doesn’t mean you can’t make an effort to personalize every interaction with patients and colleagues — whether it’s simply picking up the phone to follow-up, ensuring you have met your RTs and clinicians in person, or meeting with a patient directly when he or she has questions. Weber says that having strong personal relationships with your staff makes it easier for the patient care team to work together on issues like getting better histories. Clearly, this can be hugely beneficial to patient outcomes.
For Safdar, face-to-face interaction with other care team members also extends beyond daily practice. “Sometimes establishing a good relationship means meeting in person, talking on the phone, or joining a hospital committee,” he adds.
“If you can really understand the specific needs of your referring physicians, you can tailor your interactions to best suit their needs and your own.” —Sachin H. Jain, MD, MBA
When working as part of a team, tension is inevitable. Even though personal contact can help avoid these strains, what should you do when they arise? Weber says one helpful approach is to be open-minded and receptive to feedback. “Maybe the last conversation you had with an RT was not a smooth one. Don’t turn your back and say, ‘Well, I’m not going to deal with this person or situation.’” Instead, Weber suggests making an effort to ensure the next interaction is more productive.
Weber also suggests encouraging RTs and other staff to come to you with questions and feedback. Always thank RTs for their work and give them the opportunity to follow up with you. “An open-door policy makes you more approachable,” she says. And don’t forget to contact RTs with positive feedback. “Make an extra effort in saying, ‘Hey, those images looked really good,’ or ‘I really appreciated you getting that better history because it helped my diagnosis.’ We live in a world of negatives, and it’s great to have a positive once in a while.”
Safdar has seen positive results from having an open-door policy with RTs. “If I protocol a study in a way that isn’t the best, I want RTs to feel comfortable telling me I should consider doing it differently in the future,” he says, “or saying, ‘I’m concerned that you forgot to specify the T2 sequence.’” Providing critical feedback to colleagues is uncomfortable for many people, but doing so can greatly improve patient care. Safdar emphasizes that radiologists should be sure to let RTs know that they expect and value their input. This is an integral first step in creating a culture in which team members at all levels feel comfortable contributing to smoother operations and better care for patients.
Sachin H. Jain, MD, MBA, attending hospitalist physician at Boston’s Veteran Administration Hospital and lecturer in health care policy at Harvard Medical School in Cambridge, Mass., says radiologists and referring physicians have a similar opportunity to keep educating one another. “I think building that sort of continuous learning relationship will ultimately enable quality improvement and a stronger bond going forward,” he explains. Asking questions and providing feedback can be a two-way street. Jain says that the best interactions he’s had with radiologists include both physicians seeking to know more about the patient: “That common bond brings us together in the clinical situation.”
“We need to keep supporting each other, and we need to do it for the patient.” —Beth Weber, MPH, RT(R), RBMS, CRA
Know Your Role
When it comes to tensions, Safdar believes many problems stem from the confusion of roles. For radiologists who communicate directly with patients, it’s often difficult to know which information referring physicians would prefer to deliver themselves. To avoid confusion and conflict with a referring physician, “I often just arm the patient with the right questions,” Safdar says. “I tell them, ‘I’m the radiologist. I’m not the person who makes your health care decisions. That’s between you and Dr. Smith. But if I were you, when I went back to him, I would ask these questions: Do I need to get surgery or can I continue with a more conservative treatment? Do I need any other tests?’ That approach respects the patient-physician relationship while acknowledging that patients increasingly want more information about their imaging results before meeting with their primary-care or referring physician.”
Jain adds that individual referring clinicians have different preferences, and radiologists should get to know theirs well enough to decipher what they expect. “Some referring physicians really like getting phone calls from radiologists, others prefer email, and others prefer talking in person,” Jain says. “If you can really understand the specific needs of your referring physicians, you can tailor your interactions to best suit their needs and your own.”
In addition to knowing one’s role, team members need to realize that nearly all health care professionals are under pressure. “I don’t think radiologists always realize how difficult it is for other physicians to manage the plethora of results they receive from labs, pathology, and imaging,” explains Safdar. He adds that because of forces on both sides of the fence, care team members occasionally resent each others’ questions or comments. “There has to be an understanding that when people call to ask a question, they’re not doing it to bug you,” he says. “It’s out of concern for the patient. That should be enough common ground to forgive any interruptions, misconceptions, or misunderstandings.” Weber agrees: “We need to keep supporting each other, and we need to do it for the patient.”
Click here to hear a technologist's perspective on how to create a smoothly running team.
By Alyssa Martino, freelance writer for the ACR Bulletin