The Moreton Lecture: Stepping Out of the Dark Into the Light

Radiologists must not let others tell their stories.

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Moreton lecturer and patient advocate Andy DeLaO (@cancergeek) opened his talk by reminding radiologists why they were in the imaging profession. “Revenue and payment are the results of what you do, but the purpose, cause, and belief that you find in your work — that’s why you do it,” said DeLaO.

For radiologists, the purpose, cause, and belief in their work is making a profound difference in the lives and health of their patients. “I’m here to make a dent in the world,” said DeLaO, “And that dent begins and ends with the patient.”

But there’s a problem with that, noted DeLaO. Medicine has become industrialized, and the story of why physicians are in their profession becomes buried under the push to do things faster and more efficiently. Therefore, medicine is more about efficiency, metrics, compliance, etc. Problematically, said DeLaO, that means “the words doctors use day to day have nothing to do with patients.” Essentially, they are telling a story vastly different than the one they set out to tell.

Experience Economy

Right now, medicine belongs to the experience economy. In experience economies, you evolve your product from simple goods to the point where people are willing to buy and participate in your product based on the experience they are having. This is how most hospitals look at patient experience — they assume what patients want and determine factors like sharing a room vs. having a private room or the color of the paint on the walls. Yet few facilities include the patient in the process, said DeLaO.

So how can a radiologist understand the patient’s perspective and articulate that to the various stakeholders who influence the patient experience? By taking a step further and creating a connection economy, said DeLaO. Radiologists must go beyond providing what they assume is the ideal experience — a nicely lit radiology department for example — and meet with their patients. Creating that connection allows patients to recognize that radiologists have a profound impact on the patient’s health care story.

“Those words you use in your interpretive reports? That story is being told by other people,” said DeLaO. Radiologists are writing the stories but they’re allowing other specialties to take those stories and make them their own — to the patient, it’s that specialist working with them and shaping the patient’s world and experiences, not the radiologist, despite the fact that the radiologist has laid the plan for their health care journey. And there is a real danger in that.

If patients don’t understand your value, it’s likely that other entities don’t either — neither the politicians that govern legislation nor the insurance companies you may rely on nor your own administration. “You either choose to connect, or you will be eliminated,” warned DeLaO.

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Four Pillars

So how can you start creating a connection economy? DeLaO offered the four pillars of a human connection economy:

1. Permission. Do you have permission to talk to the patient? And, more importantly, are patients willing to listen?
2. Trust
3. Exchange of ideas
4. Coordination. How can you bring multiple people together to create a valuable exchange?

In order to build these pillars, DeLao suggests radiologists consider what he calls “The Four Ts”:

1. Be willing to spend time with your patients.
2. Doing so means you’ll earn their trust.
3. If you have trust, you must be willing to have a transparent conversation.
4. Together you and the patient help manage transition.

DIY Connections

Making connections with individuals is easy. “It’s as simple as picking up your phone and deciding to connect with someone,” said DeLaO. He offered real world examples of radiologists who are already building tribes and making connections, such as James V. Rawson, MD, FACR, who participates in a wide variety of social media activities like the #HCLDR chat, a multidisciplinary tweet chat designed to bring health care leaders together and empower future leaders. DeLaO also mentioned Ruth C. Carlos, MD, FACR, who created the JACR hackathon, which brought different health care stakeholders together to solve a common patient problem. You can also do things like create a summary report and give the patient your contact information, said DeLaO. That way, you are telling your story directly.

Six Rules of Health Care

DeLaO ended the Moreton Lecture by giving radiologists four rules to follow as they create connections with patients:

Rules 1 and 2: Health care begins and ends with the patient. Health care cannot exist without the patient.
Rule 3: Health care includes a physician, defined as someone who chooses the art of healing. The physician creates a team devoted to that art.
Rule 4: Only focus on one patient at a time.
Rule 5: Give the patient your full attention. Turn off all rings, ding, pings, and other things.
Rule 6: Radiologists have the ability to showcase their value. But to do it, they have to step out of the darkness.

It's important to note that the Moreton lecture had a first in College history. Donna Adams, patient advocate, was the first patient to address the ACR Council from the Council floor.

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