Andrew John Gunn MD, Presenter: Nothing to Disclose

Susan Bennett MD, Abstract Co-Author: Nothing to Disclose

Dushyant V. Sahani MD, Abstract Co-Author: Research collaboration, General Electric Company Consultant, Bracco Group

Garry Choy MD, Abstract Co-Author: Nothing to Disclose

The radiology report is the principle method of communicating with the patient’s primary care physician. The importance of the radiology report is underscored by the establishment of the Radiological Society of North America (RSNA) Reporting Initiative, which promotes best practices in radiology reporting. One practice in radiology reporting is to make recommendations for further diagnosis and treatment within the report. The attitudes of primary care physicians regarding these recommendations and potential effects on their clinical practice are not well established. We surveyed primary care physicians to better understand the impact of recommendations within the radiology report on their practice.

An online survey was distributed to 229 primary care physicians at our institution through an internal listserv and responses were collected confidentially.

There were 100 responses (43.6% response rate) from physicians with an average of 19.1 years in practice. Overall, primary care physicians were satisfied with radiologist recommendations (mean=3.56, 1-5 scale); although, this satisfaction was lower than their satisfaction with radiology reports in general (p=0.02). 36% of respondents identified “too many recommendations” as the most significant problem with radiology reporting and these physicians were less satisfied with radiology reports than the group in general (p=0.04). Conversely, 11% identified “not enough recommendations” as the most significant problem. An overwhelming number of respondents, 94%, feel medico-legally obligated by radiology recommendations. 23% of respondents feel more medico-legally obligated if the recommendation is set apart from the clinical impression, while 58% of respondents feel less medico-legally obligated if qualifying language is added to the recommendation. Recommendations for further imaging were the preferred type of recommendation.

Recommendations made within the radiology report have a significant impact on the practice of primary care physicians even though their opinions about these recommendations are variable. This impact appears to be influenced by the wording and location of the recommendation within the report.

The radiologist should carefully consider the wording, location, and the potential clinical implications for primary care physicians when making recommendations within the report.

Gunn, A, Bennett, S, Sahani, D, Choy, G, Recommendations within the Radiology Report: Implications for the Primary Care Physician.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12029497.html