Who is responsible for an abnormality on pre-operative testing, or, aren’t radiologists doctors too?

A few weeks ago, I cited a case where a urologist failed to follow-up on a deadly cancer found on a pre-operative chest x-ray.

Jeffrey Parks takes exception to my opinion, and instead, wonders why the radiologist shouldn’t shoulder some of the follow-up responsibility.

“For some reason radiologists are immune to the usual expectations of physician responsibility,” writes Dr. Parks. “It must be nice to just have to dictate an addendum in your report about ‘follow up’ and ‘clinical correlation’ in order to exonerate you from all future culpability. A subtle liver or lung lesion gets passed off to the ‘ordering physician.’ Because you can’t expect a radiologist to care about what happens to patients whom they have been consulted to provide radiologic expertise on, right?”

Not sure about the radiologists in Ohio, where Dr. Parks practices, but those that I work with always speak to me by telephone to alert me of a dangerous finding. Those who simply dictate “follow up” without alerting anyone else really are practicing below an acceptable standard of care.

That said, I’m also not sure I would want radiologists, who often are unfamiliar with the patient, coordinating care after a suspicious finding. Realistically, the best we can expect is promptly communicating dangerous findings to the doctor who ordered the test.

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