Did you ever talk to a radiologist (or a pathologist) – I did, maybe you should too

Several months ago my GI physician ordered a “rule out” MRI. On my next visit my doctor clicked on the images and went over them with me; it was clear he had gone down to the radiology suite and gone over the “films” with the radiologist. In fact since the senior MRI radiologist was on vacation, he reviewed the images with him too when he returned.

While I did get a copies of the MRI reports, I never spoke directly to the radiologist. No one ever does with the exception of women talking to their breast radiologist.

Fast forward to another MRI and x-rays for chronic back pain. In each case I asked to meet the radiologist and in both cases the radiologist went over the images with me, before I went back to the referring physiatrist. WOW!!

Now the back MRI and x-rays were outpatient in a free-standing imaging center, and the radiologist was right there. Not so easy if you are in an ER, or a hospital bed, or if the images are read “off-site.”

Like dermatologists who are now really surgeons, some radiologist are now interventionalists like cardiologists and vascular surgeons.

What is Interventional Radiology?

“In the realm of interventional oncology, we specialize in image-guided tumor treatments including radioembolization, chemoembolization, radiofrequency ablation, cryoablation, microwave ablation, and high intensity focused ultrasound. For venous diseases, we offer state-of-the-art therapy for DVT, varicose veins, and chronic venous occlusion. In women’s health, we offer a variety of services to alleviate pelvic pain including uterine artery embolization for the treatment of symptomatic fibroids and gonadal vein embolization for pelvic congestion syndrome. We are experts in the endovascular treatment of arterial disease, from angioplasty and stenting of occluded blood vessels to endograft repair of aneurysms.” (A)

You wouldn’t, I hope, let a cardiologist stent you without knowing who is doing the procedure, and his or her training, experience and performance results. Same goes with an interventional radiologist. You should meet the IR radiologist before and after the procedure.

What is “teleradiology”? “Night Hawks”

“Teleradiology is the ability to obtain….medical images in one location and their transmission over a distance so that they can be viewed and interpreted for diagnostic or consultative purposes by a radiologist.

This recent practice is becoming widely implemented by hospitals, urgent care clinics and specialist imaging companies. The reason for its increased implementation is because it addresses the lack of adequate staff to provide radiological coverage and the lack of expertise in this specialty.”

Many hospitals do not have 24/ 7 in-house radiology coverage. In some such cases images are read by off-site radiologists, often referred to as “Night Hawks”, employed by for-profit corporations, covering many hospitals at once. While the hospital radiologist may do the final read and report, Night Hawk readings may be used for emergency clinical decision-making, e.g., in the ER. and help determine whether you are admitted or discharged.

You have a right to know who is providing your care including who is viewing your imaging and providing radiologic diagnoses. ASK!!!

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