The most common complaint heard by administrators regarding radiology is that radiologists do not participate in hospital affairs. The most common complaint heard by clinicians, is that we are not collegial in the way we deliver our services and we are out of touch with what delivering patient care means or requires.
Medicine in the new era of ACOs and the Affordable Care Act is beginning to function in a more fluid, and more open style of collaboration between physicians and hospital administrators. Unfortunately, most radiology services are still rendered in a siloed — or worse, fortress-style — of organization. In the past, the difference between the departments within a hospital and hospital administration itself were not as apparent. In the new paradigm, however, radiology and its introverted and insular practices are beginning to stand out as obstructions to moving forward with new programs and new ways of delivering care.
We define Matrix Radiology as radiology practiced within the matrix of healthcare. That is, within this matrix, each individual physician, healthcare provider, administrator, governmental and third-party payer are interrelated and each contributes to the process of providing high quality medical care.
If radiology is to be practiced in this more collaborative style, we must first remove the barriers that have been erected between radiologists, hospital administrators and our clinical colleagues.
First among these barriers is a lack of communication. Many radiologists believe the report serves as an adequate form of communication between themselves and the clinicians who are performing the medical care in the clinic or at the bedside. This couldn’t be further from the truth. We are participants in that patient’s care whether we are at the clinician’s shoulder or 1000 miles away, connected via teleradiology. In either case, our communication and interaction with that clinician has to be personal and interactive.
Second, our communication has to be in a form that is usable by the clinician. A common complaint is that “the interpretation needs an interpretation.” Clinicians and other healthcare practitioners don’t understand the language we use, the format and structure might be confusing, or frankly, unreadable, and the information provided does not answer the clinical questions or concerns raised. We need to structure our reports so they are easily understandable. We need to provide targeted information that focuses on the question at hand, as well as other information that may be needed for the appropriate treatment of the patient — and we have to be more specific in our impressions and conclusions. After all, as consultants we are paid to say what we think, not give a list of abnormalities, or a list of differential diagnoses provided without context.
Next, we have to become more collegial. Collegiality is frequently interpreted as being friendly, but the definition actually means “having shared, or sharing, responsibility within a group.” In the case of medical care, this means radiologists and clinicians are not only working together in a pleasant and productive atmosphere, we are also sharing in the responsibility of treating the patient appropriately and efficiently. It also means we are approachable and responsive to one another’s needs and concerns.
Finally, we must be available to the hospital and to the hospital system for efforts that will lead to improved efficiencies within the department, as well as improved healthcare within the community. This means we should participate in the marketing of programs that will help patients who are at-risk or high risk, or may be in areas of chronic care. These patients are at their most malleable and need a concerted effort by the health community (e.g. all of those within the matrix) to ensure the appropriate utilization of services, providing high quality and compassionate care at the lowest possible cost.
Matrix Radiology will be the way progressive radiology groups function going forward. It brings radiology and radiologists into the next generation of healthcare by encouraging them to become partners with clinicians and hospital administrators in order to provide the best possible healthcare for their communities. Finally, providing radiology within the healthcare matrix enhances the profiles of radiologists and the specialty of Radiology.