Volume 187 - Issue 8
Towards the appropriate use of diagnostic imaging
Authors: Richard M Mendelson and Conor P J Murray
Med J Aust 2007; 187 (8): 473-474. || doi: 10.5694/j.1326-5377.2007.tb01366.x
Published online: 15 October 2007
Published online: 15 October 2007
In reply: We thank Kenny and colleagues for their comments and congratulate the members of the Quality Use of Diagnostic Imaging (QUDI) Program of the Royal Australian and New Zealand College of Radiologists on their continuing efforts. We are also grateful to Frank for his constructive suggestion.
We entirely agree that a multifaceted approach is needed to improve the appropriateness of referral for diagnostic imaging. We believe that the majority of general practitioners are willing to be educated and guided with regard to their referring practices. However, to do so they require up-to-date guidelines that are easily accessible in electronic form, based on evidence and consensus, practicable and able to be integrated into their everyday desktop applications,1 much like pharmaceutical guidelines are currently. The QUDI Program has chosen to focus on producing guidelines on selected topics, while we, with our “Diagnostic Imaging Pathways”,2 have chosen to work towards a more comprehensive clinical decision support and educational application. Of course, the two approaches are entirely complementary.
It also behoves radiologists, at an individual level, to interact with their referrers, to vet requests (ensuring that requests are appropriate and contain adequate clinical information, as emphasised by Kenny and colleagues) and act as the consultants they were trained to be. Sometimes this may be to their short-term economic detriment. However, one hopes that such short-term disadvantage would be countered in the longer term by greater professional satisfaction and a better relationship with referrers, who are likely to remain loyal to those radiologists on whom they can rely for advice and education in addition to trustworthy image interpretation.
References
- Bairstow PJ, Mendelson R, Dhillon R, Valton F. Diagnostic imaging pathways: development, dissemination, implementation, and evaluation. Int J Qual Health Care 2006; 18: 51-57.<eMJA full text>
- Western Australian Department of Health. Diagnostic Imaging Pathways. http://www.imagingpathways.health.wa.gov.au/ (accessed Aug 2007).
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