Patients-not just Images

1. Patient first:

Again and again, it becomes apparent from the comments in this survey that neuroradiologists have, for far too long, been working in isolation with images - unaware of what is going on with patients. Thus, their reports sometimes are irrelevant to the patient's clinical condition; causes much anguish to the patient and snowballs into unnecessary 'headaches' for the referring physician To be sure there are exception, but, this seems to be a common refrain from the participants on this survey.

2. Do not "show and tell":

Most have said that radiologists should not discuss the imaging findings with patients. since they have experienced that radiologists tend to talk about imaging findings to patients out of the clinical context and this makes their job in handling patients difficult, A few have agreed to the option that when patients want to discuss imaging findings : with the radiologist, a discussion could take place.

I feel this is an unfortunate truth. This has also been the opinion of an another group of referring doctors.

3. What if ?

Not infrequently patients 'demand' to talk to radiologists about the 'scan'.

In such situations I follow this practice without exception.

I have no hesitation in discussing the radiological findings with the patient

If the discussion moves to "Doctor, what should we do now?"

I say the following almost verbatim

"Please go back to the doctor who sent you here; he is the expert on offering you such advice. I have not been trained in this field and hence it would be wrong for me to suggest what you should do".

Most would heed your advice; but, some would persist:

"But, doctor, we are not happy with our doctor, he is... Can suggest another doctor?"

And I reply,

"Sorry, I cannot do that; it would be wrong on my part to do so; you should first go back to your doctor and see what he has to say".

4. "Cross pollination":

As pointed out by a few, the best interest of the patient is served when both the radiologist and the referring physician discuss imaging findings. This is more easily possible in institutional practice; but not impossible even when you are in a private imaging centre.

One should do all it takes to discuss relevant issues with referring physicians because all radiology is about the patient - not radiologists nor referring physicians.

5. The bottom line

The outcome of this survey, broadly outlines the fact that though AI may pick up findings better or faster than the human eye, the interpretation of these findings and the importance in a given clinical setting will be left to 'human doctors ' - at least - as if now.

As more and more work comes from the AI stables, it is becoming more and more clear that the honeymoon period with AI is waning off and that there is long and uncertain road ahead. More importantly, is is also becoming apparent that each institution may have to train its own AI systems - much as we do for voice recognition systems today.

Therefore, it would seem that neuroradiologists are not out of business -yet!

But with the likes of Google and IBM seriously working on AI in medical image interpretation, it is not a question of of if but when.

Thank you!

I am grateful to Dr. Sunil Pandya for helping me disseminate this survey to all parts of the country.

And, of course, I thank all those that participated in this survey.

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