Do clinicians want radiologists' management advice? Interviews shed some light on 'unwanted' recommendations
New insights could help radiologists to better understand how to relay management advice to referring providers.
Published in Clinical Radiology, a new paper details the responses of 18 referring clinicians who were asked about how they perceive radiologists’ recommendations for further evaluation. According to the interview responses, opinions on the matter vary, which prompted the paper’s authors to suggest that radiologists should consider how referring clinicians might receive guidance related to managing image findings.
“Clinicians have more information about their patients and are a specialist in their field, whereas the reporter may not be,” explained study co-authors Deborah Pencharz and Thomas Wagner, both with the Department of Nuclear Medicine at Royal Free Hospital in London, United Kingdom. “In addition, the overall clinical responsibility for a patient, their further management, and outcome is typically the responsibility of the patient’s treating consultant rather than the imaging reporter.”
The authors focused their analysis on PET/CT radiology reports, as this modality frequently guides treatment decisions and often unveils incidental findings that would prompt radiologists to offer additional insight. Structured questionnaires were completed by 18 referring providers to gauge their opinions on radiologists including management advice in reports.
While their opinions were mixed, several themes emerged from the clinicians’ responses, including:
Advice on further imaging in areas outside of the providers’ expertise is more accepted than other types of guidance.
The clinical significance of a finding is appreciated.
Many of the clinicians surveyed either do not want management advice or do not feel obligated to follow it, especially in instances when following a radiologist's recommendations could delay treatment/disease management.
More than half of the providers reported not finding recommendations for multidisciplinary team discussions useful.
“Clinical correlation advised” was considered useful by 83% of clinicians, especially when differential diagnoses or clinical significance were provided.
The most recurring theme in the responses: Clinicians only want the information they need to make treatment decisions, rather than advice on what actions they should take.
The authors offered additional insight into what could be a driving factor in the providers’ opinions, based on previously published data.
“There is little documented in the literature regarding this topic although a survey of primary care physicians did find that they felt medico-legally obligated to follow the recommendations in reports and this finding was echoed by some of the present interviewees,” the authors explained. They added that medico-legal issues are important to consider, given that radiologists are not routinely responsible for managing patients’ treatment decisions in the same manner that specialists and primary care providers are.
In contrast, it should be noted that other studies have shown that certain radiologist-recommended follow-up evaluations have expedited patients' diagnoses and improved outcomes.
The study abstract is available here.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She joined Innovate Healthcare in 2021 and has since put her unique expertise to use in her editorial role with Health Imaging.