referrals

[badasshairday]

Why don't radiologists self refer more often?

Examples:

1) Screening abdominal aorta ultrasound for a man over age 65 hx of smoking. Referral from Dr. PCP.

Impression: 4.9 cm infrarenal fusiform AAA. Recommend interval follow up with interventional radiologist.

2) Pelvic ultrasound for pelvic pain and menorrhagia in 48 year old woman. Referral from Dr. InternistPCP.

Impression: Two large intramural fibroids measuring x, y, z. Recommend follow up with interventional radiologist.

3) Mammogram. Biopsy. Wait we already do everything for that.

4) MRI of the back. Met's to the vertebral body and compression fractures. Rec follow up to MSK radiologist for kyphoplast.

5) MRI head: saccular aneurysm. Recommend referral to neurorads for coiling.

6: Malignant plueral effusion: Rec chest radiology referral for pleurex catheter.

etc.

We see everything in radiology. We are the first ones to see the majority of these pathologies directly from hospitalist, family doc, general internist, etc. Why not just take care of it?

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[omarsaleh66]

When I read diagnostic imaging in between cases, I try to cherry pick the studies which are relevant to IR. Pelvic US for fibroids, CT for HCC, cancer follow ups , etc.. If I see anything I can treat, I dont put it in the report, but I will call the ordering physician and tell them how I can help the patient.

Also I try to read the patient chart when they come down for a routine IR procedure and see if there is anything else IR can help with and call the physician and let them know

I go to tumor boards and try to offer my services

I am constantly reading IR journal articles and books even after fellowship to grow as an IR and learn concepts and things to expand my practice

I give out business cards, I try to be as available as possible to help out.

I see my patients in followup. There PCP sees that and sends me more patients

These types of things have helped me get cases that IR was not doing at my practice before. U really gotta be aggressive because its hard out there for a pimp

 

[fun8stuff]

Why don't radiologists self refer more often?

Examples:

1) Screening abdominal aorta ultrasound for a man over age 65 hx of smoking. Referral from Dr. PCP.

Impression: 4.9 cm infrarenal fusiform AAA. Recommend interval follow up with interventional radiologist.

2) Pelvic ultrasound for pelvic pain and menorrhagia in 48 year old woman. Referral from Dr. InternistPCP.

Impression: Two large intramural fibroids measuring x, y, z. Recommend follow up with interventional radiologist.

3) Mammogram. Biopsy. Wait we already do everything for that.

4) MRI of the back. Met's to the vertebral body and compression fractures. Rec follow up to MSK radiologist for kyphoplast.

5) MRI head: saccular aneurysm. Recommend referral to neurorads for coiling.

6: Malignant plueral effusion: Rec chest radiology referral for pleurex catheter.

etc.

We see everything in radiology. We are the first ones to see the majority of these pathologies directly from hospitalist, family doc, general internist, etc. Why not just take care of it?

I don't know if you could really say "recommend" for all of these. At the most I think you would have to say "Consider ...".... or better yet, call the clinician and discuss the possibility of doing X procedure like the previous poster suggested. A lot of these findings technically have clinical indications that affect management decisions that you may not necessarily be aware of from the imaging alone.

 

[Dr. USMLE]

Why don't radiologists self refer more often?

Examples:

1) Screening abdominal aorta ultrasound for a man over age 65 hx of smoking. Referral from Dr. PCP.

Impression: 4.9 cm infrarenal fusiform AAA. Recommend interval follow up with interventional radiologist.

2) Pelvic ultrasound for pelvic pain and menorrhagia in 48 year old woman. Referral from Dr. InternistPCP.

Impression: Two large intramural fibroids measuring x, y, z. Recommend follow up with interventional radiologist.

3) Mammogram. Biopsy. Wait we already do everything for that.

4) MRI of the back. Met's to the vertebral body and compression fractures. Rec follow up to MSK radiologist for kyphoplast.

5) MRI head: saccular aneurysm. Recommend referral to neurorads for coiling.

6: Malignant plueral effusion: Rec chest radiology referral for pleurex catheter.

etc.

We see everything in radiology. We are the first ones to see the majority of these pathologies directly from hospitalist, family doc, general internist, etc. Why not just take care of it?

About 6 months ago, I began wondering why we don't do this often and asked a few DRs at my TY. They said it's because they don't have the time. My knee-jerk reaction was that that's a very foolish response, but upon thinking about it, it does make sense.

However, "Consider IR consult" or some other such thing should be able to be incorporated as a "template" for certain diagnoses. For those IRs who are not doing 100% IR (i.e., almost all IRs), there really isn't any excuse not to at least recommend considering IR consult...would cut down on marketing costs and save the clinician time to think about what's appropriate.