When It Is Time to Get ‘Pictures Taken,’ Choose Your Radiologist Wisely

By Dr Conrad P. Ehrlich

At some point in our lives, many of us find ourselves in the office of a radiologist, either for a screening exam such as a mammogram, or for a diagnostic imaging exam requested by our regular doctor to rule out a more serious problem. With the fear and anxiety felt by most people going in for an exam, the radiological provider you choose can make a huge difference in your experience and your results.

The role of the radiologist is critical to the health of every patient, and it is important to know that you have a choice. As one of the most advanced and accurate means for detecting the nature or severity of illnesses, diagnostic imaging is instrumental in determining whether treatment is needed, and if so, setting that course of treatment appropriately.

Many patients — today more educated about health issues than ever before — carefully seek out their own physicians, including their radiologists. In addition to the technology and experience behind the diagnostic imaging provider, there are other important things to consider when making your choice.

What is the role of the radiologist?

Diagnostic imaging providers typically offer MRIs, CT or “CAT” scans, ultrasounds, mammograms, fluoroscopy, bone density tests, x-rays, and outpatient biopsy procedures. While specialized technologists operate the equipment used for the exams and assist with biopsies, the radiologist reads and interprets the images and provides his/her findings to you and your doctor.

What are the differences from one diagnostic imaging provider to another?

Although many standards have been established in the field, differences do exist from one provider to another.

ACR Accreditation

It is in every patient’s best interest to choose a provider with the proper accreditations from the American College of Radiology (ACR). Imaging facilities are accredited by the ACR, an FDA-designated accrediting body, when they meet specific requirements for equipment, personnel, and image quality. All imaging facilities are required to be ACR accredited for mammography, while accreditations for CT or “CAT” scan, ultrasound, MRI and others are voluntary, yet demonstrate a facility’s ongoing commitment to patient care.

Independent Vs Affiliated

Maybe it is important to you that the provider has a more personable and less “hospital-like” setting. Facilities that are affiliated with hospitals or large medical groups may seem less personable to the patient. An independent provider may offer less bureaucracy, which can mean more accommodating appointment scheduling, shorter turnaround on test results, and a pleasing office setting accessible right in your own community.

Speed Of Results

Most providers promise a 24- to 48-hour turnaround on test results, as well as same-day emergency readings. But when you’re apprehensively awaiting results, wouldn’t you rather have them the same day or within 24 hours? Find out what the provider’s rate is for results within 24 hours. If they don’t know this figure, then swift turnaround may not be a top priority.

Preliminary findings on mammograms, for example, should be available the same day or while you are still in the office or the next day. This is important in case an additional review with ultrasound is necessary.

Services And Technology

In terms of services, is the provider using the latest detection and biopsy methods? Second-Look detection for supplemental review of mammograms, and new outpatient, nonsurgical biopsy procedures are some of the recent advancements to look for in your provider’s list of services.

Providers may also vary in the type and sophistication of the equipment they use. For example, there is often a trade-off between Open MRI and the High Field MRI. While Open MRI may reduce patient claustrophobia, it may not offer the same level of diagnostic information as offered by High Field MRI.

Who Is Reading Your Results?

At a minimum, you should know whether your radiologist is board certified, and if fellowship trained, in what areas. A radiologist is “board certified” when he or she has met the requirements of the American Board of Radiology, which certifies medical doctors to practice radiology in North America. Fellowship training is postdoctoral work that ensures competence in interpreting results for specific modalities, such as CT scan, MRI, or ultrasound.

Fellowship training is not required in the field, but patients owe it to themselves to learn more about their radiologist’s training and background. Most providers offer this information freely. If they don’t, then there may be a reason why.

For some radiologists, the job stops with the results interpretation, without ever meeting the patient and discussing results directly with him or her. In some facilities, exams are entered into a “pool” for interpretation by five to ten radiologists, which diminishes the level of any one radiologist’s knowledge of a patient’s particular case. Radiologists that subscribe to a more personalized, interactive approach ultimately benefit each patient in the long run, since they are the only ones reading your exams and have detailed, cumulative knowledge of your case.

Professionalism

Another key difference is the quality of care provided throughout the patient’s experience — a variable that is indicative of the provider’s overall culture and philosophy, and the professionals that care for patients.

Technologists and radiologists should exhibit patience and compassion by explaining procedures and results to you thoroughly. They should understand how you might be feeling about your exam because of their experience in the field, and their knowledge and understanding of your case.

Staff turnover is a key indicator of the staff’s dedication and the quality you can expect. Does your provider have high turnover? Ask your friends or family who may have used their services, and whether they have dealt with the same individuals on subsequent visits. Or, make note of it yourself for each appointment.

A provider’s flexibility in appointment scheduling is an indicator of how accommodating and patient-driven they will be. Will they do early morning ultrasounds? Will they be able to accommodate you in spite of a full schedule?

Where can I get more information on radiology?

If you have access to the Internet, an excellent resource to start from is www.radiologyinfo.org, a patient resource center developed by the American College of Radiology and the Radiological Society of North America. You may also contact these organizations by phone: ACR at 800-227-5463; RSNA at 800-381-6660.

Conrad P. Ehrlich, MD, is medical director at Housatonic Valley Radiological Associates located in Danbury, Southbury, and New Milford. He is board certified in diagnostic radiology, nuclear medicine, and internal medicine with special interest in women’s diagnostic imaging, and is fellowship trained in CT and ultrasound.