Radiologist-Patient Communication: Current Practices and Barriers to Communication in Breast Imaging

Shadi Aminololama-Shakeri; Mary Scott Soo; Lars J Grimm; Meredith R Watts; Steven P Poplack; Jocelyn Rapelyea; Nicole Saphier; Rand Stack; Stamatia Destounis

doi:10.1016/j.jacr.2018.10.016

Radiologist-Patient Communication: Current Practices and Barriers to Communication in Breast Imaging

J Am Coll Radiol. 2019 May;16(5):709-716. doi: 10.1016/j.jacr.2018.10.016. Epub 2018 Dec 21.

Authors

Shadi Aminololama-Shakeri¹, Mary Scott Soo², Lars J Grimm², Meredith R Watts³, Steven P Poplack⁴, Jocelyn Rapelyea⁵, Nicole Saphier⁶, Rand Stack⁷, Stamatia Destounis⁸

Affiliations

¹ Department of Radiology, University of California, Davis, Sacramento, California.
² Breast Imaging Division, Duke University Medical Center, Durham, North Carolina.
³ Breast Imaging Section, Penn State Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, Pennsylvania.
⁴ Mallinckrodt Institute of Radiology, Washington University, Saint Louis, Missouri.
⁵ The George Washington University School of Medicine & Health Sciences, Washington, District of Columbia.
⁶ Memorial Sloan Kettering Cancer Center, New York, New York.
⁷ WESTMED Medical Group, Rye, New York.
⁸ Elizabeth Wende Breast Care, Rochester, New York. Electronic address: sdestounis@ewbc.com.

PMID: 30580958
DOI: 10.1016/j.jacr.2018.10.016

Abstract

Purpose: The aim of this study was to assess variability in radiologist-patient communication practices and barriers to communication among members of the Society of Breast Imaging (SBI).

Methods: A 36-item questionnaire developed by the SBI Patient Care and Delivery Task Force was distributed electronically to SBI members to evaluate patient communication, education, and screening practices. Data from 14 items investigating patient communication (eg, practices, comfort, barriers to communication) were analyzed and compared with demographic variables using χ² or independent t tests as appropriate.

Results: Ninety-three percent of radiologists reported that they directly communicate abnormal results of diagnostic mammographic examinations that require biopsy and malignant or high-risk biopsy results that require surgery. Radiologists (66%) and technologists (57%) often provide normal or negative diagnostic mammographic results. Most respondents were completely comfortable discussing the need for additional imaging, recommending biopsy, and discussing biopsy results directly with patients, and 71% rated their communication skills as excellent. Radiologists who spend less time in breast imaging reported only average communication skills. The most frequent barriers to communication were that practices were not set up for direct communication (loss of revenue) and discomfort with angry patients.

Conclusions: Although variation in breast imaging communication practices exists among radiologists and practice types, the majority of radiologists directly communicate the most distressing results to patients, such as those regarding abnormal diagnostic mammographic findings requiring biopsies and abnormal biopsy results leading to cancer diagnoses and surgery. The majority of radiologists are completely comfortable with these conversations, but all feel that enhancing communication with patients will lead to greater patient satisfaction.

Keywords: Patient-centered care; breast imaging; patient communication; patient satisfaction.

MeSH terms

Adult
Aged
Biopsy
Breast Neoplasms / diagnostic imaging*
Communication*
Disclosure
Female
Humans
Mammography
Middle Aged
Patient Satisfaction
Physician-Patient Relations*
Practice Patterns, Physicians' / statistics & numerical data*
Radiologists*
Surveys and Questionnaires