Should patients request and radiologists provide reports to patients? Patients clearly have a right to their report but are rarely if ever asked whether they would want the report sent to them personally. Directly providing reports is a step in the right direction. Precedent has existed in mammography for years where results are required to be reported to patients in lay person’s language by the Mammography Quality Standards Act. There are many reasons to directly provide reports to patients but there are those who suggest the language is highly technical and could create confusion or anxiety. The paternalistic attitude hearkens to days when care givers did not emphasize the importance of patient autonomy and shared decision making. In an environment which values patient centered care and promotes health literacy, providers should encourage participatory care.
A study (2) published in 2012 explored patient preferences and showed overwhelming support for getting radiology results directly. Patients reported anxiety while waiting for results and expressed relief by getting the report directly. Patients have numerous resources to educate themselves about reports and disease conditions. Radiologists can easily provide links to resources for patients to gather additional information. The knowledge that patients will have ready access to reports also encourages radiologists to dictate reports which are easily understandable especially in the conclusion which is the likely focus of a layperson.
Patients who do not want the report can opt out so there can be no perceived mandate unless requested by the patient. Another concern by radiologists was that departments would be inundated with calls and inquiries which has not occurred at those institutions providing direct access. In 2012 at Penn Medicine, a pilot program was started releasing reports to patients after a three day waiting period (to allow clinicians to have access first). Curtis P. Langlotz, MD, PhD, a staff radiologist stated
“We saw no change in patient calls to clinics or to radiologists, and we received no complaints from patients,” (1)
The distribution of reports to patients was so well received that Penn continues to make reports available through a secure web based portal. Penn releases 1 million reports per year with no increase in patient calls. Both Vanderbilt University Medical Center and Wake Forest Baptist Health have been providing reports directly to patients for years.
Facilitating the communication of information and providing a link to the report, when it is available, can only promote shared decision making which has been shown to enhance patient satisfaction. Even as a communication and risk management tool, giving reports directly to patients will make them aware if follow up is recommended, and provide another opportunity to ensure good care.
Leonard Berlin, MD, a noted expert on medical legal issues in radiology, believes radiologists can get patients more involved in their treatment decisions which he endorses. Dr Berlin believes there should be a change in the reporting convention.
Providing easy access to imaging reports has been shown to be favored by patients and cause little or no administrative burdens on caregivers . The time has come to promote patient engagement in radiology.
Nicolas Argy, MD, JD
Copyright © 2016 Nicolas Argy
1. Beth W. Orenstein, Reporting to Patients January 2013 Radiology Today Vol. 14 No. 1 P. 22
2. J Am Coll Radiol 2012;9:256-263.