After many months, years even, of soul-searching, the Society of Cardiovascular and Interventional Radiology has finally determined that it is indeed a subspecialty of radiology and that its future is best served by remaining under the protectorship of the American College of Radiology. That determined, the society’s leadership has crafted an ambitious plan to raise awareness among both the public and the medical profession about the services its members provide.

This is a great move for interventional radiology as its leaders have sagely recognized that the very future of the specialty depends on the success of such a campaign. But let’s get real: if interventional radiology has a perception problem (and it does), what of radiology and its profile with John Q. Public? I am willing to wager that a significant percentage of the population does not even know that a radiologist is a physician. In reality, the radiologic technologist has far more daily contact with the patient than does the radiologist.

Before you shrug your shoulders, consider this: the primary care physician, the internist, the cardiologist, all may have “owned” the patient in the past, but today-and more important, tomorrow-the patient increasingly will be self-owned. As health care consumers become more knowledgeable about health care, the consumer will play an increasing role in the physician-patient partnership. In deferring to the physician who refers to communicate its services to the patient, the radiology profession is in deep denial about its role in this relationship. Rather than concerning itself with who owns the patient, the specialty needs to redirect its attention to what is best for the patient.

In Connecting with the New Healthcare Consumer, edited by David B. Nash, MD, MBA, and colleagues, one author cites a surprising statistic from a 1999 Omnibus study: The patient-physician relationship is rated as second in importance only to marriage and is viewed as extremely important by 67% of those surveyed, exceeding the importance of relationships with spiritual advisors, pharmacists, co-workers, and financial advisors. 1

Moreover, when physicians and patients were asked who bears the ultimate responsibility in the relationship if one or the other is forced to take charge, 89% of physicians and 90% of patients said it was the patient who bore ultimate responsibility. 1

Many diagnostic radiologists engage in regular communications with patients, some subspecialists more than others. Who is best qualified to answer the questions: Should I have an annual mammogram? and Is an image-guided needle biopsy of a breast lesion as reliable as an open surgical biopsy? and What are the potential side effects of uterine fibroid embolization?

Several years ago, one of radiology’s leaders urged radiologists to step out of the reading room and interact with at least one patient each day. While better advice never was spoken, it is neither logistically possible nor would it be particularly beneficial for the radiologist to meet every patient.

Nonetheless, radiology must take every opportunity to interact with the patient and the public at large, whether through Internet-based information sources, communicating with major employers, participating in speaker’s boards, or devising a system for access through the referring physician.

Reportedly, the most contentious topic at the meeting of the American College of Radiology last September in San Francisco was whether it should establish a standard for direct patient communications. Why not?

Cheryl Proval

[email protected]


  1. Magee M. Relationship-based care: strengthening the patient-physician relationship. In: Nash DB, Manfredi MP, Bozarth B, Howell S, eds. Connecting with the New Healthcare Consumer. New York: McGraw-Hill; 2000:135-162.