Before I got involved with the American College of Radiology (ACR), the only radiologist I knew well became a radiologist so he didn’t have to speak with patients. In my own considerable imaging experiences as a patient, I don’t think I ever talked with a radiologist. So, my first reaction to patient- and family-centered care (PFCC) for radiologists was to assume it was some sort of oxymoron. Then came my second thought: that if radiologists can engage in effective participatory medicine, anyone can.

As an interested observer of advances in Artificial Intelligence (AI), I also assumed it was only a matter of time before the image-reading and report-writing radiologist would need to develop means to better engage patients — if only to avoid being replaced by a machine. It also occurred to me that technology-savvy radiologists could help other clinicians and patients better navigate ever-increasing volumes of data. So I’m delighted to see radiology beginning to aggressively expand their work as models of participatory medicine.

Imaging and Patient-Centered Care

Radiology plays a significant role in patients’ care and their experiences. The current issue of the Society for Participatory Medicine newsletter gives us an excellent map of the territory into which radiology can expand to add value to patients beyond technical expertise, and provides a valuable model for all areas of medicine.

• Medicine is full of complex decisions — both for physicians and for patients and caregivers. While shared decision making often focuses on post-diagnostic choices, Andrew J. Barnes, PhD, and his colleagues lead us through the complexities of decisions about a diagnostic procedure. Finding useful models in behavioral economics emphasizes the importance of broadening one’s perspective to establish models of quality care that include patient thought processes. Read more>
• One of the chronic issues in communication between medical professionals and patients is a combination of the complexity of medical language and the focus on cognitive vs emotional issues. Patricia F. Anderson, PhD, and her colleagues demonstrate the value of a graphic approach that minimizes the cognitive demands (critical for many underserved populations) and allows for a higher level of emotional engagement. Read more>
• Much of medicine has tended to treat the patient as object rather subject. Patients are talked about rather than to, health care professionals communicate with one another rather than directly with patients and their caregivers. Tessa S. Cook, MD, PhD, and her colleagues focus on the power of emerging electronic technologies (most importantly patient portals) as a way to enrich direct communication between radiologists and their patients. The power of the technology and the capacity for asynchronous communication can create a means for enhanced dialogue. Read more>

• Increasingly, communication is brief, idiosyncratic, spontaneous, and conducted via electronic media. C. Matthew Hawkins, MD, and his colleagues lead us through the possibilities for enhanced participatory communication by radiologists using those forms of communication that are rapidly becoming the default modes. As they illustrate, increased uses of social media can take people out of the middle of the communication chain, and provide immediacy and an active role for the patient in determining what is of value to them. Read more>
• Jill Harrison, PhD, and Susan Frampton, PhD, conclude this issue with Berwick’s Era 3 as a model for understanding the essential need for enhanced patient participation as the lever that moves quality health care to where it needs to be in the future. Research is the infrastructure of the future of medicine. Patients are an essential part of the team that will create that future. Read more>

Taken together, these authors open the doors to a wider perspective on how not just radiology, but all medical specialties, can begin to better engage patients and caregivers in partnerships that benefit all. You can find more information about each of these topics and more PFCC-related articles in the December 2016 JACR Special Issue: Patient- and Family-Centered Care.

David Andrews is a member of the ACR Commission on Patient- and Family-Centered Care. He is a retired college professor at Keene State College, New Hampshire.