Comments on: Radiologists and communicating mammogram results to patients and their doctors

By: Breast Imager

Breast Imager — Sat, 26 Sep 2009 16:57:31 +0000

In order to facilitate patient screening, we do not require orders for screens. We do, however require patients to name their PCP. Understanding that there is often a very tenous patient-PCP relationship, we do not rely on PCPs to communicate results or initiate necessary work-ups for abnormal studies. This protects PCPs from being held responsible for patients they don’t know, protects us from the liability of “dropped balls,” and MOST importantly, gives the patients some responsibility for their own care.

By: Radiologist

Radiologist — Sat, 26 Sep 2009 00:15:45 +0000

I was actually unaware of the law as all of the places I have worked have required a prescription for screening mammograms. It’s at the discretion of the facility whether to require it – it’s just not necessary to receive payment. A quick Google search of radiology facilities found a number of facilities which still require a script despite not needing it for payment . Personally, I feel all medical care should be initiated by a clinician, if only to avoid the situations described above. While I understand the sentiment driving the law, screening should not occur in a vacuum.

By: thirdparty

thirdparty — Fri, 25 Sep 2009 19:21:33 +0000

stargirl65,

Patients are allowed to schedule their own screening mammograms without a physician’s order ONLY if they provide the name of a physician to whom the report can be sent to. Radiology departments don’t just pick PCP names at random and assign patients to them. I understand your concern if a patient lists you as her physician and you don’t know who she is or haven’t seen her in years. This is the downside of allowing patients to schedule their own exams. This law was designed to encourage women to get a screening mammogram by reducing the steps needed to schedule one. It is not some rule created by radiologists.

Diagnostic mammograms on the other hand must have a physician’s order.

By: anonymous

anonymous — Fri, 25 Sep 2009 11:03:13 +0000

“Since it is not required for patients to have a referring physician to have a screening mammogram”

from the original post

By: Radiologist

Radiologist — Thu, 24 Sep 2009 23:46:39 +0000

BTW, the above comment was directed to stargirl65, not Tex or the original poster.

By: Radiologist

Radiologist — Thu, 24 Sep 2009 22:52:12 +0000

Radiologists never order the initial mammogram which is either screening or due to some symptom. Every patient who visits a mammography facility has a referring physician or else they would not have a script for the procedure. That referring physician is the point person for all communication. Your concerns confuse me. If you haven’t seen the patient how are you referring them for mammography? I’m missing something.

By: Tex Bryant

Tex Bryant — Thu, 24 Sep 2009 22:46:50 +0000

I am a proponent of the patient-centered medical home. Thus, if a mammogram indicates a mass needing a biopsy then the PCP should be involved in the process of advising and educating the patient. A PCP with a good relationship with his or her patients can make navigating the health care system much easier. There need not be a week’s delay in seeing the PCP, especially if the PCP site has open scheduling, which my physician does.

By: stargirl65

stargirl65 — Thu, 24 Sep 2009 21:08:37 +0000

I welcome radiologists into ordering mammograms and managing breast cancer care.

My concern is the radiologist ordering tests on patients and sending me the results when I haven’t seen the patient for years or at all. They list me as the doctor. This puts ME at significant risk from a liability standpoint. They need to list as the ordering doctor and then either manage things themselves, if they choose, or refer the patient to the appropriate person. It can be me or a surgeon. But the radiologists here get the test, send me the results, and then expect me to follow up based on their report. On occasion the report is on a patient that I have never seen and cannot contact. The radiology department put my name on the order since the patient needed to list a doctor and randomly? picked my name.

It simply needs to be a coordinated effort where the responsibilities are clear.