Evolving role of a radiologist in healthcare

Dr Meinal Chaudhry, Head of Department, Radiology, Aakash Healthcare, elaborates how radiologists are now venturing into the realm of being the primary treating physician by the use of various interventional techniques

Radiology as a speciality is comprehensive, encompassing a range of imaging technologies and imaging-guided treatments including X-ray, computed tomography (CT), ultrasound, mammography and magnetic resonance imaging (MRI). Continuing technological innovation in radiology is leading to more sophisticated techniques that results in prompt and specific diagnosis, but the demands of healthcare as a vertical are soaring. For instance, in contemporary times, doctors are treating diseases which are more complex and were unheard of in the past. To achieve this, all elements of healthcare delivery including physical examination, diagnosis and treatment of the person should be efficient involving stringent quality control measures. Hence, the role of integrated healthcare delivery becomes very important involving the role of a radiologist.

Radiologists are medical practitioners who have comprehensive specialist training in performing and interpreting diagnostic imaging tests and imaging-guided procedures or treatments that involvesmultiple imaging modalities. However, present day radiologists add value beyond just image interpretation. Working alongside healthcare practitioners, radiologists are integral to the care of patients by guiding the Physician choose the right modality for diagnosis, making accurate diagnoses, prognosticating the outcomes, monitoring response to treatment and performing imaging-guided treatments. Minimally invasive surgeries are the trend of the times where the surgeries are performed using small key hole incisions. These surgeries rely a great deal on the ability of a radiologist to identify and localise precisely the diseased area thus making him a partner in the treatment of the patient. Other less invasive techniques like laser, radiation therapy, high frequency ultrasound treatments etc., rely greatly on the information which the radiologist passes on to the treating physician or surgeon enabling the surgeon to perform these techniques with ease.

Besides these roles, radiologists are now venturing into the realm of being the primary treating physician by the use of various interventional techniques.Such techniques at times prove to be a life saver for the patient, for instance – timely thrombolysis in a clotted artery by an interventional radiologist can lead to salvaging the extremity of the patient, stopping the blood supply to cancer cells so as to shrink the tumour volume. And all this is done with a very small incision on the skin surface. That’s the magic of an interventional radiologist.

With the technological advances in healthcare, telecommunications and IT are assuming a pivotal role; the radiologists now are providing their expertise on a global level via teleradiology. Experts from various fields of radiology can provide their second opinion to the physicians, remotely placed, leading to accurate and rapid care whenever needed, without borders. In fact with the amalgamation of teleradiology, telemedicine and robotic surgeries have led to procedures, which happen at a location close to patients without the hassle of travelling. These technologies have added a great deal to the patient experience in the healthcare.

Going further ahead with digitisation, Multimedia Enhanced Reporting in Radiology (MERR) now radiologist link the virtual images within the report where the treating physician can just click on that link to see insides the body of the patient and correlate it with  findings in the report. (So, all the broth is cooked, treating physician has just to dig the spoon right in and eat it.)

However, technology has its own advantages and disadvantages. So, quality check of the teleradiology reports and its continuous improvement is also a responsibility of radiologist community and they are scoring wonderfully well on that front.

Another important role of a radiologist in patient safety is ‘limiting’ excessive radiation to the patients. In the modern times when the population is becoming more and more aware of radiation and the risks associated with it. Radiologists perform a crucial role in personalising the radiation dose required by the patient for achieving certain diagnosis depending on the amount of information required from the study, enough to address the clinical need of the patient while keeping excessive radiation dose in check. Smart equipment which has automated dose regulations are available and technological strategies are certainly an important part of improving radiation safety, but in day to day practice, the role of the radiologist is to utilise clinical strategies to reduce patient dose to levels as low as reasonably achievable (the ALARA principle) while maintaining diagnostic quality images. This is also achieved by education the doctors and patients (self referral) to skip the tests that aren’t necessary.

While radiation safety and contrast administration werethe two areas of patient safety in which radiologist had a role traditionally. Another issue which has gathered attention in recent times is the prevention of medical errors. Medical errors happen because of multiple small failures in the chain of events and we as humans are ‘fallible’. Current focus has shifted from finding a fault in a person (person approach) to making the system robust (systems approach) to decrease the probability of errors. For example, a poorly serviced equipment in radiology department will lead to missed diagnosis and further can affect patient safety. To identify the scope of improvements in the systems and processes happening in department of radiology (which is one of the busiest department in the hospital) is also a radiologist’s job.  So, a radiologist’s role in patient safety cannot be understated.

Hence, the traditional perception of the radiologist in a dark room in front of a view box just for interpreting images is rapidly becoming obsolete. From just a helping hand or behind the scene medical practitioner, we are now joining the patient care team in the fore front by adding a lot of value in patient health outcomes.

Being a part of least acknowledged but most important teams of healthcare, this evolution in role is only making us smile. On a lighter note, I’d like to say, ‘More power to radiologists!’