Have you ever had a scheduled test in Radiology, and the plans change? Sometimes changes occur at the last minute, and sometimes you are not fully notified of the change. How and why does this happen?
As you know, our health care system is very intricate and sometimes very confusing for people to understand. Many factors determine which scan gets done and why. Most of your child’s medical indication for an exam is provided by your ordering physician. The doctor provides a medical history, symptoms, and any concerns they may have. For example, an MRI Brain might be requested for a 13-year-old female with growth hormone deficiency to evaluate for any pituitary abnormality. Once the order is placed in our EPIC system, our radiologists, who specialize in studying certain sections of the body, will review the information and protocol (give us a plan to follow). In the instance above, a neuroradiologist will confirm the MRI Brain order and protocol it to be done with IV contrast to enhance the pituitary gland for evaluation.
However, some cases are not that straightforward. Sometimes, the indication is not clear. It could say that the patient has a “bump on his neck.” Is it large or small? Is it hard or squishy? Is it discolored? It is not until the patient arrives that we can fully assess the concern. The ordering doctor may have asked for a CT scan to be done, but perhaps an MRI will better visualize the soft tissue mass. Or perhaps the bump is tiny and superficial, so it can be easily visualized, and an ultrasound can give a definitive diagnosis. In these instances, the image modality request can change. The process begins when our radiologist calls to speak with your ordering physician to determine which modality is best for the patient. Changes are made to the order, insurance is verified, and the patient/family is notified.
On the patient side of things, sometimes there can be confusion, lack of communication, and frustration. Here are some of the common questions that patients and families ask:
Q: My child has pain in BOTH knees. Why are we only scanning the left one?
A: Generally, to keep health care costs down, a physician will start with the most affected side. Then, later, if still needed, the other knee can be ordered and scanned.
Q: Why do you not scan the whole body?
A: Some modalities can scan the whole body (e.g., nuclear medicine bone scan or MRI Whole Body). However, most scans zoom in to the specific area of need to get the best detail. Also, for those modalities that use radiation, we keep your child’s dose to the least amount possible.
Q: Will you call me with the results of my child’s exam?
A: No, test results are sent to the ordering physician, the primary care/pediatrician, and they are sent to myChart within 24 to 48 hours.
Q: My child’s study was ordered with contrast. Why did you not give it?
A: Our radiologists decide if it is needed or not, based on the order’s indication. Many times, they can see everything they need without it. We only give contrast if it is truly warranted.
We do our best to prevent any gaps in communication. However, if you experience any of these troubles, we encourage you to speak up! If you have questions, start with your ordering physician. They know your child better than we do, as we only know a piece of your child’s care. Try to clear up any issues or concerns prior to coming to us. If you are already in our department, always feel free to voice your concerns with our staff. Our nurses and technologists will do their best to address your questions. In certain instances, if warranted, you can speak with a radiologist. We also have a patient advocate available to discuss any disputes. Even after your child’s appointment is over, you can address issues on our follow-up patient survey. Our Radiology Patient Family Experience Team reviews every survey to ensure your satisfaction.
Rest assured that our Radiology team will do everything we can to provide the best care for your child. Here are just a few examples of how Cincinnati Children’s works to personalize and prioritize your child’s care.
Angie has been part of the Cincinnati Children’s Radiology family since 1996. Over the years, she has worked in X-Ray, Cat Scan, and most recently in MRI. Currently, she is part of the Outpatient MRI Team, primarily working at the Liberty Township, Green Township, and Kenwood Campuses. Angie enjoys working in a stimulating environment and learning new things each day. In her free time, she stays active with her husband, two teenage daughters, and her Golden Retriever, Sonny.
Glenn Miñano is a media specialist in the Department of Radiology, providing graphic design, photography, printing, video services, and administration of the department’s online properties. His works have been published in several medical articles, such as the American Journal of Radiology and the American Institute of Ultrasound. He has been providing these services to the Radiology Department since 1996.
Meredith Towbin is a freelance copy editor and writer. She has copyedited the Department of Radiology’s blog since it launched. She also works as a copy editor for the home improvement website BobVila.com. Her writing has been featured on HuffPost as well as other writing sites.
