RT Image July 20, 2009 : Page 26

THETELLINGTEST Talking topatients BY SABRINA RODAK COMMUNICATING WITH PATIENTS is an extremely important skill necessary for radiologists and radiation oncologists, for it can affect patient outcome, satisfaction, and retention, as well as potential lawsuits. In fact, communication can result in physical changes in the patient. For instance, a study published in the March 2009 issue of Radiology found that after waiting for breast biopsy results, women who received malignant diagnoses demonstrated changes in their level of the stress hormone cortisol similar to those who received uncertain diagnoses, but different from those who received benign diagnoses. The results suggest that the uncertainty associated with cancer greatly contributes to stress, which can negatively affect the immune system. The suggested increased stress and decreased immune functioning in patients would have powerful implications for the necessity of good and timely patient communication. PATIENT SATISFACTION Besides affecting the patient physically, the interaction between doctor and patient in radiology influences patient satisfaction, which is associated with patient retention and the patient’s likeliness to sue. Poor communication is related to high rates of lawsuits, while good communication is related to high rates of patient retention and compliance. In addition, appropriate communication with patients can affect their cooperation with a radiation procedure. Carol Rumack, MD, FACR, a specialist in neonatal and pediatric imaging and professor at the University of Colorado Denver School of Medicine, explains, “Nowadays, the kids don’t accept [being told what to do], and |26| July 20, 2009 they actually are more cooperative if you talk to them like real people.” Rumack illustrates an essential component of effective communication: assessing the individual patient’s needs and adapting one’s style accordingly. This need may be particularly evident to a pediatric radiologist, who can have patients that range from non-verbal toddlers to verbal young adults. M. Ines Boechat, MD, professor of radiology and pediatrics and chief of pediatric imaging at David Geffen School of Medicine and Mattel Children’s Hospital at UCLA, explains, “We have to use age-appropriate language. If I have a little baby that doesn’t speak yet – a newborn or a very young child – I’ll come talk to the parents and play with the baby a little bit and so forth. As they get older, I try to relate, particularly with the teenagers, primarily to the patient so that they feel that they are in charge of their body, of their procedure.” AGE AND COMMUNICATION The patient’s age is one factor that determines a doctor’s style of communication because it is associated with the different values and cognitive abilities of the patient. “Within the U.S. population, there are cultural differences in terms of the era when people grew up. Increasingly, younger patients often expect to be more involved in the decision-making process. Older patients may tend to defer more to doctors for some of the decision-making process. It is important to ensure all patients have the opportunity and the infor- mation to be engaged in making appropriate treatment decisions,” says Matthew Katz, MD, a partner in Radiation Oncology Associates and Chief of Radiation Oncology at the Saints Cancer Center in


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