Patient Agency in Imaging: Radiologists' Insights.

Abstract

Objectives: There is a notable rise in patient-initiated imaging requests, with one possible reason being the increased availability of online health information. This study specifically examines the impact of patient-initiated radiological exams on radiologists. Exploring their perspectives on how GPs acquiescing to patients' medical imaging requests impacts healthcare resources and skew patients' expectations of the capabilities of radiological studies. The findings of this study are crucial for understanding the evolving dynamics of radiology practice and its challenges.

Method: A comprehensive cross-sectional opinion survey was administered to radiologists in private multi-specialty medical centers across Australia between November 2023 and February 2024. The survey included structured and open-ended questions distributed via an intranet platform within the same company and reached a wide range of radiologists. A total of 37 survey responses were received from the 100 surveys sent to radiologists, resulting in a response rate of 37%. Of these, 10 provided incomplete responses, leaving 27 for analysis.

Results: Nearly half of the participants (48%) had over 20 years of experience. The majority of radiologists self-reported X-rays (27%), ultrasounds (25%), and computed tomography (CT) scans (24%) as the most commonly requested non-indicated imaging studies. Radiologists attributed these requests to patients' exposure to online medical information and their desire for reassurance. Approximately 24% of radiological studies were deemed unnecessary due to a lack of correlation between clinical history and the imaging or procedure requested to address the clinical issue, with 30% of radiologists reporting feeling pressured by GPs and patients to expedite report completion. Proposed strategies included patient education, communication, and the establishment of clear guidelines.

Conclusions: The study highlights the potential for a growing burden of patient-initiated imaging on radiologists. This burden is further compounded by patients' unrealistic expectations and lack of understanding of diagnostic imaging's limitations, as considered by those surveyed. Radiologists have stressed the crucial role of the broader healthcare context in collaborating with such requests. Patient education was emphasisX-ed to reduce unnecessary imaging and manage patient expectations.

Practice implications: Educating patients about the limitations and appropriate use of diagnostic imaging can help reduce unwarranted requests and manage patient expectations. The study emphasises the need for clear, evidence-based guidelines to assist GPs in addressing patient demands for unnecessary imaging studies. Another contribution from the study is the necessity for improved communication strategies among radiologists, GPs, and patients to ensure a collaborative approach to imaging requests, thereby reducing pressure on the radiologists' workload. Finally, this study highlights how avoiding unnecessary imaging can alleviate resource strain, optimise workflows, and enhance the quality of patient care.