As a lawyer with decades of experience working with radiologists, I have seen a lot of change take place in the radiology field. One of the constants, however, has been discussion about the importance of radiology consultations – even as that consultative practice has become more challenging to provide.
Early on in the 1980s, I saw many radiologists affirmatively offer hospital medical staff "open door" policies to discuss findings or to consult on the best imaging exam for a patient's particular circumstance.
But with the high volume of imaging studies in today's radiology practice, the need for efficiency and productivity has left radiologists far less able to offer referring doctors free consults to discuss the most appropriate tests for patients. This void has been filled by the emergence of radiology benefit management companies and prior authorization requirements for advanced imaging studies. There is also the possibility that, as early as 2022, Medicare will require that clinical decision support tools be used to determine the appropriateness of an advanced diagnostic imagining study for a patient before the procedure can be performed and qualify for payment.
To promote a more patient-centered approach to their radiology services, the Department of Radiology at New York-Presbyterian Hospital (NYP) developed a radiology consultation service (RCS) called Weill Cornell Imaging Consultation and Radiologic Expertise Service (WiCares). Rather than solely targeting referring clinicians, this service focuses on breast imaging patients as well as their health care providers. In an article published in the July 6, 2021 issue of Clinical Imaging, researchers from Weill Cornell Medicine describe how their direct radiologist-patient interaction has improved patient confidence and perception in the medical decision-making process, specifically around breast density and additional breast screening options.
The researchers report that while much of the radiology field experienced an unprecedented decrease in imaging studies during the initial peak of the COVID-19 crisis, the RCS at their institution showed a significant increase in services provided, and that it evolved to address pressing concerns related to COVID-19. They conclude that their RCS enabled high-quality communication with patients and referring clinicians, before and during the COVID-19 pandemic. The proof of the efficacy of the service’s consultative efforts was in its continually increasing utilization during the pandemic with the RCS able to utilize its resources to help direct patients by answering questions about the urgency of exams and more. They note there is no direct financial gain to the institution from RCS, but the program has improved the experience of patients and referring physicians, and differentiates their institution in terms of quality of care.
It is heartening to see these results. Radiologists can play a significant role in patient care apart from timely and accurate diagnostic results. The Weill Cornell program is an example of how the consultative role of radiologists can bring success and recognition to a radiology service.