E2600. Why Can’t You Just Take Some Pictures? A Guide to Handling Inappropriately Ordered Imaging Studies and Difficult Referrers
Authors
Naftali Stern;
New York Medical College
Daniella Herman;
Westchester Medical Center
Brandon Ballane;
New York Medical College
Ekramul Gofur;
Westchester Medical Center
Mayer Rubin;
Westchester Medical Center
Perry Gerard;
Westchester Medical Center
Jared Meshekow;
Temple University, Lewis Katz School of Medicine
Background
Subspecialty consultation is the cornerstone of multidisciplinary medicine. With ever-evolving advancements in the complexity of clinical practice and escalating patient volumes, the requisite cognitive and imaging expertise exceeds any single physician or clinical specialty. Numerous studies have revealed that nearly all hospitalized patients will obtain a diagnostic radiologic examination. In this regard, diagnostic radiology is exceptional because it possesses a distinct body of knowledge and a highly specialized skill set that enable it to identify and diagnose the spectrum of pathologies across a multitude of organ systems safely and efficiently. Some referrers, though, are not familiar with the diagnostic and technical restrictions and diagnostic imaging studies. Unfortunately, this leads to unusual consultation requests and could foster contentious physician-physician relationships in the healthcare environment.
Educational Goals / Teaching Points
To provide a systems-based review of commonly encountered inappropriate diagnostic radiology imaging requests. To outline the principles of effective radiology consultation, general diagnostic study request etiquette, as well as provide an overview of consultant courtesy. To offer suggestions for dealing with difficult clinicians and referrers. Discuss imaging recommendation guidelines and appropriateness criteria.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Systems based examples of inappropriate diagnostic imaging requests. General principles of effective consultation. Imaging request etiquette. Radiology consultant courtesy. Imaging guidelines and appropriateness criteria. Suggested methods for dealing with difficult referrers.
Conclusion
Radiologic consultation is ubiquitous in nearly all healthcare settings. Familiarity with common inappropriately ordered diagnostic study requests as well as how to manage difficult referrers will prove invaluable in promoting better physician-physician communication, interdepartmental collaboration, as well as improving clinical outcomes for patients undergoing diagnostic imaging studies.
