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Radiologists’ responses to inadequate referrals

  • Malpractice
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To investigate radiologists’ responses to inadequate imaging referrals.

Methods

A survey was mailed to Norwegian radiologists; 69% responded. They graded the frequencies of actions related to referrals with ambiguous indications or inappropriate examination choices and the contribution of factors preventing and not preventing an examination of doubtful usefulness from being performed as requested.

Results

Ninety-five percent (344/361) reported daily or weekly actions related to inadequate referrals. Actions differed among subspecialties. The most frequent were contacting the referrer to clarify the clinical problem and checking test results/information in the medical records. Both actions were more frequent among registrars than specialists and among hospital radiologists than institute radiologists. Institute radiologists were more likely to ask the patient for additional information and to examine the patient clinically. Factors rated as contributing most to prevent doubtful examinations were high risk of serious complications/side effects, high radiation dose and low patient age. Factors facilitating doubtful examinations included respect for the referrer’s judgment, patient/next-of-kin wants the examination, patient has arrived, unreachable referrer, and time pressure.

Conclusions

In summary, radiologists facing inadequate referrals considered patient safety and sought more information. Vetting referrals on arrival, easier access to referring clinicians, and time for radiologists to handle inadequate referrals may contribute to improved use of imaging.

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Acknowledgements

We wish to thank the respondents for their participation. This work was supported by grants from Oslo University College.

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Authors and Affiliations

  1. Faculty of Health Sciences, Oslo University College, P.O. Box 4 St. Olavs plass, NO-0130, Oslo, Norway

    Kristin Bakke Lysdahl

  2. Section for Medical Ethics, Faculty of Medicine, University of Oslo, P.O. Box 1130, Blindern, NO-0318, Oslo, Norway

    Kristin Bakke Lysdahl & Bjørn Morten Hofmann

  3. Faculty of Health Care and Nursing, Gjøvik University College, P.O. Box 191, NO-2802, Gjøvik, Norway

    Bjørn Morten Hofmann

  4. Department of Radiology, Haukeland University Hospital, P.O. Box 1, NO-5021, Bergen, Norway

    Ansgar Espeland

  5. Section for Radiology, Department of Surgical Sciences, University of Bergen, P.O. Box 7800, NO-5021, Bergen, Norway

    Ansgar Espeland

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  1. Kristin Bakke Lysdahl
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  2. Bjørn Morten Hofmann
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  3. Ansgar Espeland
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Correspondence to Kristin Bakke Lysdahl.

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Lysdahl, K.B., Hofmann, B.M. & Espeland, A. Radiologists’ responses to inadequate referrals. Eur Radiol 20, 1227–1233 (2010). https://doi.org/10.1007/s00330-009-1640-y

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  • DOI: https://doi.org/10.1007/s00330-009-1640-y

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