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Feb 11, 2019

What Radiologists and Technologists Can Learn from Each Other to Benefit Patients

Estimated reading time: 10-12 minutes

Emotional intelligence, communication and a team-oriented mindset between radiologists and technologists improve imaging outcomes and reduce costs

Marc Kerachsky, senior director, marketing of Philips Diagnostic Imaging Business Group, talks with chief of radiology, Dr. Jeffrey Miller, and technologist, Amber Pokorney from Phoenix Children’s Hospital on the importance of the technologist-radiologist relationship in driving the key determinants of great healthcare: patient satisfaction, high-level clinical care and cost efficiency. They share their perspectives on how to add value in their roles and work together more effectively to achieve “first time right” images and improve patient care.


Marc Kerachsky: Why does imaging play such a pivotal role in healthcare in general and at Phoenix Children’s Hospital in particular?


Dr. Jeffrey Miller, radiologist: More and more imaging is the focal point of both routine and critical clinical decision-making points in healthcare. Due to a variety of factors, doctors are spending less time with patients and relying more on imaging exams to identify patients who need further work up and treatment or not. It’s a tremendous responsibility. 


Marc Kerachsky: How does the technologist-radiologist interaction impact patient care? 


Dr. Jeffrey Miller, radiologist: Healthcare today is definitely a team sport; very rarely does any episode of healthcare happen in isolation and radiology is no exception. Technologists are the experts in manipulating the imaging equipment to produce the best results in regard to quality and efficiency. Radiologists are the experts in what kind of imaging best delineates potential findings or abnormalities for patients with various medical conditions. Both sides have a valuable contribution to obtaining a confident diagnosis.


Amber Pokorney, technologist: As a technologist, one of the under-appreciated roles we play in radiology is that of the primary customer service agent, someone who significantly influences patient satisfaction. In today’s busy radiology department, patients very rarely come into contact with the radiologist while they may spend a good amount of time interacting with techs like me. On the efficiency side of things, when techs do a good job of maneuvering patients through their visits in an expeditious manner, that’s a significant part of the high-level and cost-efficient care that we are all trying to achieve in healthcare.

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Marc Kerachsky: You mention that the technologist often has an under-appreciated role in imaging. What other types of expertise and value does the technologist bring to the radiology department that often gets overlooked?


Amber Pokorney, technologist: Think of us as the bridge between the technology and the doctor – and the patient is traveling over that bridge. With close interaction with the patient, technologists can readily learn things about that patient that radiologists can’t see on an image. This patient insight and interaction is crucial as it can help narrow down image interpretations in some cases. Additionally, technologists often best understand the emotional state of patients before the exam and use that knowledge to tailor the preparation for the imaging exam to suit the patient. For example, if the patient seems excessively anxious, the technologist can use multiple strategies to help lessen their anxiety to reduce motion during the exam which reduces the need for rescans.


Technologists also have a better understanding of what the capabilities and/or limitations are of the imaging equipment that hospitals use every day. Being subspecialized in a modality such as MR or CT, technologists are often more aware of the new techniques that can augment or improve standard imaging and even advanced imaging. In this way, technologists have a very important role in the radiology department because they are the collector of the data.


Dr. Jeffrey Miller, radiologist: That’s very true. Medical imaging is basically visual data. You can evaluate bad data, but more than likely your results are going to also be subpar no matter what you do. I could be the world’s greatest radiologist but if there’s a really bad imaging data set that comes to me from a technologist, the chances of me making a confident diagnosis – even if I know what I’m looking for, are significantly reduced. 


Marc Kerachsky: How can we facilitate closer communication between techs and radiologists for that first time right image? 


Amber Pokorney, technologist: One of the most critical elements of communication is that radiologists need to inform the technologist about not only what they’re looking for but also why they need it. This helps inform the process of acquiring that image and enables the technologist to make suggestions on how to best achieve what the radiologist is looking for.


Dr. Jeffrey Miller, radiologist: Amber is exactly right. Although, this of course is not always easy, and in order to do it correctly requires an investment of time and resources. It starts with foundational education on what kinds of things the radiologist looks for on different components of the various imaging modalities. 


For example, on a T2 MR image, the radiologist will look for signs of edema. After that, there are patient and disease process specific imaging findings that may be critical for the radiologist. Explaining this to the technologist at the time of the exam can help improve the likelihood that the exam will yield the necessary imaging information even under sub-optimal conditions. If a patient is moving during an MR exam, the technologist may move the most important sequences to the earlier part of the exam in hopes of catching the patient when they are most still. 


That’s when knowing the “why” can be extremely helpful to radiologist, tech and ultimately, the patient. Similarly, having the technologist inform the radiologist prior to the exam as to any concerns that might compromise the image is very important, as well.

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Marc Kerachsky: Can you expand upon the idea of developing emotional intelligence between techs and radiologists? 


Dr. Jeffrey Miller, radiologist: When groups of people who have different personalities, backgrounds and life experiences come together around a shared goal or activity, the extent to which these groups can understand the strengths, weaknesses and preferences of each other can profoundly influence their degree of collective success. This definitely applies to techs and radiologists who are often very focused on their individual jobs and roles. 


Emotional intelligence, basically putting yourself in someone else’s shoes, can occur when there is an openness to see beyond one’s own vantage point in patient care encounters. When a radiologist recognizes that a tech may be upset because they were just dealing with a very sick patient or when a tech realizes that a radiologist is abrupt with them on the phone because they are being bombarded by a succession of phone calls and interruptions, emotional intelligence can lead to increased resilience for both individuals so that the care of the patient is not adversely effected.


Marc Kerachsky: How does valuing each other’s unique contributions help you weather the inevitable challenges and changes in healthcare and work better as a team?


Dr. Jeffrey Miller, radiologist: The answer to this question is simple even though the implementation of it is probably one of the most challenging aspects of all complex work environments, not just healthcare. One of the ways to get people to be more engaged is to create conditions in which they feel like their work is valuable and is leading towards some goal that is important to them. This is the best way to build effective teams.


In radiology, it is often the radiologists themselves that get a lot of the credit for what happens in their departments. A much better situation would be for all of the members of the team, the technical staff, the administrative staff and the clerical and other support staff, in addition to the radiologists, to feel valued and recognized for their unique and important roles which all, ultimately, are imperative to the care for patients who pass through our department. When this point is kept in mind, all decisions and actions can just boil down to simply, “what is best for the patient.” When the patient is associated with the ultimate outcome, the rest will fall into place.


Marc Kerachsky: Let’s talk about how the strength of the tech-rad bond can help drive costs down and increase efficiency. From your perspective, how can it translate into higher level operational benefits for hospitals or health systems?


Amber Pokorney, technologist: That’s easy. When I have a good relationship with a radiologist and know what they want and expect from the imaging that they will be interpreting, I don’t have to keep bugging them about it or ask for clarification, which is not a very efficient way of doing things. Also, if I have that level of comfort, I am more likely to suggest a better way of doing something based on an observation or experience that may be unique to my vantage point.


Dr. Jeffrey Miller, radiologist: Unfortunately, health care in this country is a limited resource. The lack of optimal cost efficiency in healthcare continues to impact not only the entities at the higher levels such as the federal and state governments, health systems and hospitals, but also the patients themselves. We have to consider cost in everything we do now, because if we don’t keep costs down, not only will these higher entities run budget deficits, but patients will continue to lose out on the access to health care that they need because it is simply too expensive. 


However, as I said before, we are driven by adding value not just reducing costs - there needs to be that connection to a higher purpose. From an organizational and systems view of this, the only way you can get close to a 360-degree innovation viewpoint of health care processes is to maximize the number of individuals who are contributing to process improvement and adding value to the patient journey from their unique role. In the end, this leads to the greatest value and cost efficiency scale. We all want high-quality, cost-effective healthcare but we must work together to achieve it. 

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Marc Kerachsky

Marc Kerachsky

Senior Director, Marketing, Philips Diagnostic Imaging Business Group

As part of his role with Philips, Marc’s goal is to drive a strategy that is customer-focused to bring the real value of imaging to patients and staff alike.

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Dr. Jeffrey Miller

Dr. Jeffrey Miller

Chief of Radiology and Pediatric Neuroradiologist, Phoenix Children’s Hospital, Phoenix, AZ

In addition to his role as chief of radiology at Phoenix Children’s Hospital, Dr. Miller is also an Assistant Professor of Radiology at the University of Arizona College of Medicine-Phoenix and at the Mayo Clinic-Scottsdale Arizona.

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Amber Pokorney, BSRT (MR)

Amber Pokorney, BSRT (MR)

Lead Research MR Technologist, Phoenix Children’s Hospital, Phoenix, AZ

Amber has 16 years of experience working in clinical and research MR settings at several hospital and outpatient MR departments. 

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