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Communication: The Key to Improved Patient Care¹

¹ From San Bernardino MRI, Inland Empire Regional PET Center, 225 W Hospitality Ln, Suite 100, San Bernardino, CA 92408. From the 2003 RSNA Scientific Assembly. Received June 8, 2004; accepted June 10. Address correspondence to the author (e-mail: fritzsch@rsna.org).

View larger version (125K): [in this window] [in a new window] [Download PPT slide]   Peggy J. Fritzsche, MD

We must meet. We must interact. We must have more "face time" with others. New technology and human communication are the radiologic yin and yang—we must have both to succeed.

Technology is essential to clinical care, but more time spent with technology means fewer opportunities for radiologists to interact with patients and colleagues. When I started in medicine, the radiology department was the information hub of the hospital. Clinical rounds always passed through the department. Face-to-face discussions were common. Now machines are handling more of the radiologist’s responsibilities. Radiologists risk becoming more isolated in their work. Yet radiologists must communicate with four primary groups: (a) our patients; (b) our colleagues, including referring physicians; (c) medical students; and (d) the general public.

Communicating with Patients
Patients are the entire reason we are here. I am sure you have heard that radiologists are health care specialists who have little contact with patients. But, if your patients are like mine, you know they want to learn the results of imaging tests immediately after an examination. If there is miscommunication here, who is failing? The patient? The radiologist? Both?

Communication goes two ways. Physicians do not always communicate as well as they might. George Bernard Shaw once observed that "the single biggest problem in communication is the illusion that it has taken place" (1). Research indicates that 30%–40% of American patients have a moderate to low level of trust in doctors (Seltzer SE. Representing radiology requires negotiation skills. Diagnostic Imaging 2002; August). This is due to prior physician-patient miscommunication.

The heart of this problem is that physicians and patients speak with different voices (2). While physicians use medical terminology, patients use everyday words. We need to speak the language of our patients. As stated by author Stephen Covey, "Seek first to understand, then to be understood" (3).

Miscommunication between physician and patient, not a lapse in quality of care, is primarily responsible for many malpractice claims (4). It is our professional responsibility to communicate well. In addition, satisfied customers are return customers. Our satisfied patients will become radiology’s "ambassadors."

Communicating with Colleagues
In 1997, about half of physicians surveyed reported that communication with colleagues was supportive and respectful, but hospital physicians noted that communication was often competitive and selfish (5). This is especially troubling when a patient with a complicated illness may have four to eight specialists. In such a complex health environment, there is no room for competition or selfishness. As science and technology push specialists together, we must ensure that our bonds are strong.

Also, as research revolutionizes medical care, radiology must remain connected to the broader disciplines of medicine. We can maximize our impact if we integrate our efforts with innovative researchers in other fields (surgeons, oncologists, cardiologists, etc). The most important advances for medicine involve synergy across disciplines.

Therefore, talk to your colleagues. Let them know what is happening in your world. Consult. Review. Inquire. Attend multispecialty conferences. Patients and medicine will benefit, and so will the quality of your professional life.

Communicating with Students
Communication with medical students is crucial to the future of radiology. By exposing them to the dynamic field of radiology, we can entice the best and the brightest to join our specialty. But first, we must get them enthusiastic about radiology. It is in our best interest to have them become radiologists or at least gain a better appreciation of the contributions radiologists make to health care. These students will be the medical leaders of tomorrow. Find and mentor a medical student. Our guidance of young people may be the most valuable contribution we can make to our profession.

Communicating with the Public
Finally, the public represents current and future patients. Therefore, the Radiological Society of North America (RSNA) communicates with the news media. You may have noticed the improved coverage of our annual RSNA Annual Meeting by the media. Nevertheless, as medicine evolves, we must make a stronger effort to get our story out to the public. It makes sense to work toward a better understanding of the work of radiologists on the part of the public. Are we doing enough to educate people?

RSNA and radiology need to reach the mass media and the public in several ways throughout the year, not just during the Annual Meeting by way of the newsroom. In the late 1990s, the Society conducted a survey of members’ needs in the area of public information. The survey asked what kinds of public information and education materials members had, how useful they were, and what kinds of materials they thought RSNA should produce. The results of this survey spurred RSNA leaders to initiate or expand various public information–related efforts.

In its public information program, the Society began with a focus on year-round promotion to the media of important research developments in diagnostic radiology and radiation oncology. This has required formation of a Public Information Advisors Network to provide information in subspecialty areas of expertise for communications with the media, for recommendations of spokespersons appropriate to a subject, and for review of press releases and news features for scientific accuracy. Further, the program of press releases on important research has been invigorated. Press releases are sent to medical news media each month and are posted online. In addition, the Society news magazine, RSNA News, has been revamped. Its frequency of publication has been increased, and its distribution has been widened to include the medical media and the Society’s corporate colleagues. Sections dealing with research and the RSNA Annual Meeting have been enhanced. News for technical exhibitors has been added. The Society has also scheduled special media briefings in New York, NY, that deal with specific radiology topics.

In addition, the Society has redoubled its efforts to provide information directly to a computer-savvy public with the development of a public information Web site in collaboration with the American College of Radiology. Today, RadiologyInfo: The Radiology Information Resource for Patients (www.RadiologyInfo.org) features descriptions of more than 75 diagnostic, interventional, and therapeutic procedures.

In 1999, RSNA accepted an invitation from Walt Disney World to develop a major exhibit for the theme park’s 3-year Millennium Celebration at EPCOT (6). Called "Medicine’s New Vision," the exhibit highlighted radiologists and radiologic technology in a series of video stories and games for thousands of visitors before its close in 2003.

Locally, RSNA has invited Chicago public high school students to explore the world of radiology at our Annual Meeting. These students then take part in a scholarship competition that includes projects based on learning tools provided by RSNA and in meeting presentations.

In conclusion, radiologists work with some of the finest physicians and the best technology in the world. But more Americans are unable to afford medical care because of the rising cost of medical insurance. To fix this disturbing trend, physicians must communicate with a strong voice.

Eleven years ago, RSNA President Robert G. Parker, MD, told radiologists assembled in the Arie Crown Theater at the Annual Meeting to become involved in health care issues. "If you don’t," he said, "decisions that will affect health care will be made without you" (7). His message is no less important today. Participate in the organizations that are working for change—radiologic organizations, as well as general medical organizations. Make your commitment official. Pay your dues. Place your name on the membership roster. This will add power and unity to our cause.

Simply put, my message is this: Push buttons less; talk more. We must find the best way to embrace the remarkable technologic advances in our profession. Technology is better when balanced with human-to-human communication. With better communication, we will ensure the vitality, the strength, and the continuing relevance of our profession. In the end, both our patients and our profession will benefit.

REFERENCES

1. Smith A. Andrew Smith’s quotation database. Available at: andrewsmith.us/quotations/index.html. Accessed June 18 2004.
2. Mishler EG. Discourse of medicine: dialectics of medical interviews Norwood, NJ: Ablex, 1984.
3. Covey SR. The seven habits of highly effective people: powerful lessons in personal change New York, NY: Simon & Schuster, 1989.
4. Levinson W, Roter DL, Mullooly JP, et al. Physician-patient communication: the relationship with malpractice claims among primary care physicians and surgeons. JAMA 1997; 277:553-559.[Abstract]
5. Akre V, Falkum E, Hoftvedt O, Aasland O. Communication atmosphere between physician colleagues: competitive perfectionism or supportive dialogue? Norwegian study. Soc Sci Med 1997; 44:519-526.
6. Radiology millennium exhibit unveiled at Epcot. RSNA News 1999; 9(11):5-6, 8.
7. Parker RG. The "cost-effectiveness" of radiology and radiologists. Radiology 1993; 189:363-369.[Free Full Text]

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