“I hope my doctor can figure out why I’ve been having so much difficulty swallowing of late,” said the patient as I finished his upper GI study. During the procedure I clearly saw a large mass invading the lumen of Mr. Jones’ esophagus but I kept this knowledge to myself as I made small talk with him before heading back to the reading room. A few minutes later I would issue my report that would contain a diagnosis of esophageal cancer and recommendation for Mr. Jones to undergo an endoscopy and histologic sampling to confirm my suspicion of cancer. Why did I not communicate these results directly to Mr. Jones?
Radiologists have often been described as doctor’s doctors. This description arises from our role as consultants whose reports are communicated to referring physicians to assist in diagnosing ailments detected by imaging. As radiologists we typically do not convey our results directly to patients. I believe this practice stems from three misconceptions about radiologists and our field: (1) radiologists are ill equipped to speak to patients about their ailments, (2) imaging is only one component of a diagnosis and (3) radiologists make diagnoses but can not offer therapies.