We Started a Radiology Consultation Clinic

One institution shares its experience offering patient consultations with radiology residents.

Consult

 

August 2015

At Massachusetts General Hospital (MGH), radiology residents are on the frontlines of patient care, rounding with primary care physicians to speak with patients about imaging results. Colin M. Segovis, MD, PhD, RFS secretary, talked with Mark D. Mangano, MD, chief resident in radiology at MGH, to get the scoop on how the clinic came about and which metrics radiologists are collecting to demonstrate the clinic’s value.

Colin Segovis: What is the mission of the Resident Consultation Clinic at MGH?

Mark Mangano: The mission of the consultation clinic is to provide an opportunity for patients to meet directly with radiologists to better understand the meaning and implications of their imaging findings. Our group recognized the importance of empowering patients with knowledge about their own health as a mechanism to improve the patient experience and hopefully improve outcomes. As radiologists, experts, and consultants in the data-intense field of imaging, we can leverage our expertise and empower patients with information about their imaging findings.

Segovis: How does the clinic work?

Mangano: In collaboration with referring primary care physicians, we provide 15- to 30-minute patient consults, primarily focusing on the topics of atherosclerosis, emphysema, and hepatic steatosis. We also address incidental findings and other imaging-related questions.

Segovis: How is the clinic staffed?

Mangano: The clinic is staffed by second- and third-year radiology residents with faculty oversight from an assigned attending. Currently, residents are granted time away from their rotation to volunteer in the clinic. However, responsibility for covering the clinic will soon be built into scattered core radiology residency rotations.

Segovis: What has been the response by referring providers?

Mangano: Since the clinic’s inception, we have mainly worked with one primary care physician during her routine visits with patients. Her experience has been overwhelmingly positive, and she has become a champion in advocating for future referrals to the clinic from her colleagues. We are in the process of adding additional referring providers and eventually creating an open referral mechanism. But first we are working to ensure the clinic can sustain the additional volume.

Segovis: What barriers where faced in creation of the clinic?

Mangano: The most significant barriers encountered while initiating the clinic and rallying support were related to workflow, manpower, and time away from RVU-generating activities. We are currently not charging for the clinic visit, so the lack of reimbursement remains a legitimate concern.

While we may move toward charging for visits in the future, we justified investment in the clinic by collecting data through a pilot phase, which showed patients were highly satisfied with the visit, preferred to meet with a radiologist on subsequent visits, had a better understanding of the role of a radiologist, and were more motivated to improve their overall health, diet, and exercise regimen.

With this information, we were able demonstrate the value of the clinic to the patient, referring provider, and also the radiologist. As we continue to collect data going forward, the expected benefits outside of direct monetary reimbursement include improved patient experience, improved understanding of the role of a radiologist, and possibly improved patient outcomes.

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