Out of the Shadows

One Midwest practice prioritizes more direct interaction with referring physicians and patients.

shadows

In the recent "Imaging 2.0" past, radiologists conducted their work in isolation. Most of the day, they sat in darkened rooms where they reviewed images and dictated reports, with little interaction with referring physicians and almost no contact with patients.

But as the industry evolves from a fee-for-service model focused on volume to a clinical-care model centered on value, radiologists can no longer afford to cloister themselves in the shadows of their reading rooms. Instead, they must take proactive steps to highlight the value they bring to patient care.

Radiology Consultants of the Midwest, P.C., a private radiology practice serving the Omaha and Council Bluffs metropolitan region in Nebraska, has strengthened its role on the medical team by developing a customer service–oriented culture in which its radiologists regularly collaborate with referring physicians and meet with patients. The approach allows the practice's 26 radiologists to become true consultants in patient care rather than mere image interpreters, says Patricia A. Helke, MD, FACR, president emeritus for Radiology Consultants of the Midwest. "The idea is to make radiologists valuable," she says. "And the way you do that is by providing service, so we've made a concerted effort to try to provide the best service to our local health system and patients."

Radiology Consultants of the Midwest makes customer service a priority in every aspect of its operations and has formed committees that are responsible for developing ways to improve service quality. The practice has many strategies in place to meet its customer service objectives. Recently, the radiologists began emphasizing three core initiatives tailored to increase dialog between the practice's radiologists and referring physicians: call reporting, concierge radiology, and traveling interventional radiology. Helke says the initiatives have been key to establishing relationships with referring physicians — leading to increased referrals and greater patient satisfaction.

Direct Communication

Under the call reporting initiative, the practice targets a percentage of referring physicians to call with exam findings each month. At first, radiologists called physicians who already referred a lot of patients; now, they've expanded the effort, calling physicians who aren't frequent referrers. The calls initially focused on critical results, but gradually they also included less significant findings. "We wouldn't necessarily call a physician about a normal chest X-ray," Helke explains. "But if there is a finding that we feel warrants a closer physician follow up, we make a personal connection with the doctor to relay the patient's results." Most referring physicians have been receptive to the calls, which have proven to be a simple, effective way to forge connections between referrers and radiologists, Helke says.

Radiologists are also building relationships with referring physicians through the practice's concierge radiology initiative. Through that program, radiologists travel to referring physicians' offices, including oncology and primary care practices, to read scans on certain days. The program allows radiologists to meet referring physicians in person to consult about appropriate imaging and communicate findings. This collaboration leads to improved patient care and allows referring physicians to get imaging results faster. Radiologists also meet patients as part of the program for more personalized care that puts a face with the radiologist's name on the bill, Helke says.

As part of the concierge program, the practice compartmentalizes its workflow, with subspecialty radiologists reading images only in their areas of expertise. For instance, neuroradiologists read only neuroimaging and generalists read only traditional films. The approach ensures high-quality reads while also pairing referring physicians with subspecialty radiologists who can best answer their questions, says Erik A. Pedersen, MD, chief information officer for Radiology Consultants of the Midwest and chair of the radiology departments at Bergan Mercy Medical Center and Boys Town National Research Hospital.

Similar to the concierge radiology program, the traveling interventional radiology initiative sends interventional radiologists out to provide care at local physicians' offices and hospitals that don't have large enough caseloads to justify hiring a full-time interventional radiologist. "We've had our interventional radiologists meet with the physicians who work at these hospitals and explain the kind of services they provide," Pedersen says. "Then a couple of days a week or as needed, the interventional radiologists take cases at these institutions that otherwise wouldn't have an interventional radiologist there to provide these services." The program increases the number of cases the interventional radiologists receive and also allows them to work directly with the referring physicians, Pedersen says.

Benefits Package

Radiology Consultants of the Midwest has experienced many benefits from its recent initiatives, perhaps most notably increased collaboration with referring physicians. Pedersen says that the referring physicians now call the radiologists to discuss things like appropriate imaging and request rereads of images their patients have received at other imaging centers. "We get lots of phone calls and lots of referring physicians who drop by the department to have us look at cases," he says. "It shows that the relationship is solid, and the physicians trust that the studies we're recommending are going to help answer their questions." Helke adds that those relationships have also led to a roughly 10 percent increase in referrals at a time when many institutions have seen referrals decline.  To read the rest of the case study click here.


By Jenny Jones, freelance writer for the ACR Bulletin

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