“Benefit/risk communication, if done properly, it embodies the practice of patient-centred care,” according to Dr Jonathan Portelli, University Hospital Mosta, Malta. By explaining complex information to patients, the medical practitioner helps to reassure them and assuage their concerns. Moreover, there is a legal obligation, the Council Directive 2013/59/– Euratom, which lays down basic safety standards against the dangers arising from exposure to ionising radiation.
In the lecture “Benefit/risk communication to adult and paediatric patients: top tips,” Dr Portelli pointed out that not much has been written about benefit/risk communication, as illustrated by the limited number of research literature. Different studies have shown that practice is varied regarding who should give information, how much and in which situations.
A surprising finding shows that the level of confidence – of the medical staff – varies. The reason being that staff meets a patient at a critical moment. So, as the patient may be confused, scared or put on brave face, they might not engage in meaningful conversation about the procedures. It is then up to the radiologist to gauge the needs, perceptions and expectations of the patient before sharing information.
Due to various factors, such as work pressure, lack of resources and standards and guides, the radiologist does not want to create fear in the patient and thus limits the amount of information.
However, there are some steps, they can take to enhance more effective communication.
1. Enhance your knowledge about possible questions that the patient could ask.
2. Establish standards/guidance: create a communication toolkit, a Q&A sheet and infographics; make sure messages are consistent in all forms of communication.
3. Invest more time preparing before you talk to the patient.
4. Aim to give a good first impression.
5. Engage in dialogue with the patient by using a calm voice and steady pace. Listen to the patient.
6. Reassure the patient by pointing out the expected benefits and purpose.
7. Explain the risks in the context of the benefits.
8. Put risks in perspective: use graphics to illustrate your point; avoid risk numbers.
9. Encourage patient involvement: ask questions and observe their body language.
10. Support dialogue: provide the patient with relevant support information; contact details. Thank the patient.
Taking communication a step further, Dr Christoph Becker, University of Geneva, elaborated on the communication needs of patients and radiologists by using information technology (IT) solutions in a lecture, titled “How to enhance radiologist-patient communication through IT”.
The patient-centred radiology process, so far, is not changing as medical staff communicate and support patients, administer medication, and provide care as before, face-to-face. However, the way results are effectively being communicated has changed due to IT. Nowadays, the patient has access to written reports; direct email contact for questions; requests for a second opinion services and dialogue via a patient portal. A patient portal is secure, offering encrypted communication, and access 24/7 to personal health records which contain all data about the patient and treatments.
Traditionally, the radiologist would report to referring physician, who would contact the patient. Now, patients have direct access to their results. So, they can contact the radiologist or referring physician directly. Patients have the freedom to choose second opinions. The benefits are myriad and the informed patient has:
- online access to all personal medical data;
- homepages of different healthcare providers;
- medical education material and literature;
- patient organisations via social media;
- direct contact with physicians; and
- alternative choices and second opinions.
Covid-19 has expedited the Brave New World. Now it is up to us to embrace and manage the challenges of a new normal, whether face-to-face or via a screen.
Image credit: https://synapsemedical.com.au