Download Difficulties and Possibilities in Communication between Radiologists

Difficulties and Possibilities in Communication
between Radiologists and Referring Clinicians
as seen by Radiologists
Fatahi Nabi, Korpic Ferid, Hellström M
Nabi Fatahi med dr., forskare, senior lecturer
Nabi Fatahi 2010
Gothenburg University
Aim
To study radiologists' experiences of
written and verbal communication with
referring clinicians.
Nabi Fatahi 2010
Gothenburg University
Material
 Focus-group interviews with 12
radiologists, six women and six men
aged 27-61 years with 1-27 years
(median 10 years) experience, were
carried out.
Nabi Fatahi 2010
Gothenburg University
Methods
Main question:
How do you experience communication, verbal and nonverbal, between the radiologists and the referring
clinicians? What are the difficulties, what are the
possibilities, and are there barriers in communication that
can be overcome?
Analysis
Interviews were audiotaped and transcribed
Content analysis was used for analysis and interpretation of the
data.
Nabi Fatahi 2010
Gothenburg University
Difficulties and Possibilities in Communication between Radiologists and Referring
Theme Clinicians -as seen by Radiologists
Quality of written communication
Qualisys of verbal
Impact of
Ethical
Improvements of
Communication
economy
aspects
communication
Categories
Subcategories
Insufficient
Radiology
Difficulties at
Difficulties in
Cost of
Inadequate
Trust and
Better practical
information on
report
radiology rounds
individual
examinations
medical
mutual
routines
priorities
understandi
request forms
contacts
ng
Codes
Patient data
Structured or
Participation
Face-to-face
Change of
Symptom
Increased
Medical
Amount of
free text
Clinicians
contacts
examination
description
contacts
records access
information
Dictated or
'attention
Phone
type
Medical
Scheduled
Time aspects
Clinical questions
typed report
Conference
contacts
Time aspects
urgency
joint
times
Time aspects
Change of
meetings
Anatomical
Language
priority
Prescriber
specifications
barrier
Patient´s
education
Abbreviations
Nabi Fatahi 2010
Gothenburg University
needs
Quality of written communication
Insufficient information on request forms
“Sometimes they just write "abnormal findings?"
and then you need to interpret the text of the
request form to try to understand what type of
pathology thy are really looking for so that we
know what imeages to take”.
”I think it is very good to do the typing myself.
That way I can formulate and correct myself
instantaneously, and then feel that I can stand up
for what I am writing.”
Nabi Fatahi 2010
Gothenburg University
Quality of written communication
Radiology report
“Sometimes they just write "abnormal findings?" and
then you need to interpret the text of the request
form to try to understand what type of pathology thy
are really looking for so that we know what imeages
to take”.
Nabi Fatahi 2010
Gothenburg University
Qualisys of verbal Communication
Difficulties at radiology rounds
Of course, it is disturbing if some participants are
chatting while I am demonstrating cases.”
Nabi Fatahi 2010
Gothenburg University
Qualisys of verbal Communication
Difficulties in individual contacts
It can vary. It may take a few minutes if you're lucky
and they are in the web-based phone directory, but it
sometimes takes 50 minutes”.
“
Nabi Fatahi 2010
Gothenburg University
Impact of economy
“A problem occurs when the request comes from
outside, e.g. healthcare centers, and they ask for
an examination while we think we should rather do
a CT for better diagnosis. Then they may complain
as they have to pay more than what was planned
for. “
Nabi Fatahi 2010
Gothenburg University
Ethical aspects
“That they state that the examination is a little
bit more urgent in order to avoid a long waiting
time, and this disturbs the logistics and it may in
fact result in too many examinations to be
performed immediately, while you really need
those time slots for acute examinations.”
Nabi Fatahi 2010
Gothenburg University
Improvements of communication
Trust and mutual understanding
“We should have meetings with clinicians, but it
is difficult to get time over for this. I have
planned a meeting with the orthopaedic
surgeons here, but the time is just running out
and there is no time over for such meetings”.
Nabi Fatahi 2010
Gothenburg University
Improvements of communication
Better practical routines
“At another hospital I often entered the patient webbased information system, so I could read e.g. about
the patient´ s surgical history, but here I do not have
access to this”
Nabi Fatahi 2010
Gothenburg University
Conclusion
and practice implications
Although communication between radiologists and
referring clinicians generally functions well, a number of
difficulties in verbal and non-verbal communication were
highlighted. In order to reduce misunderstandings and
problems in communication between radiologists and the
referring clinicians, joint discussions on indications,
methodology and routines, outside the regular scheduled
clinical rounds should be implemented. Likewise, active
educational activities, such as lectures, seminars and
conferences, directed to the medical community at large,
are needed to optimize the use of medical imaging.

Nabi Fatahi 2010
Gothenburg University