Taking The Time To Review X-Rays With Patients

I am sure most of you reading this are guilty of seeing a patient under time constraints and walking in and out quickly to keep the "flow" of the office going. This happens especially when you review an X-ray and simply tell the patient everything is normal. Alternately, you may be one of those on the opposite end of the spectrum who refuses to "dumb" down the radiograph or, more commonly, magnetic resonance image (MRI) or computed tomography (CT) scan, and just tell the patient he or she needs surgery as a result of a fracture, torn tendon or … well, you get the point. Have you ever thought of how important it can be to patients to actually see the images, especially when it is their own foot? You and I see these 26 bones daily but many of our patients have never seen them. They don't care about the names of the bones or structures. In fact, most of them can barely process the long name of the condition you just diagnosed. However, showing them the X-ray and sometimes the pathology associated with it can go a long way. After all, a picture is worth a thousand words, right? The point that I am getting at is if you review X-rays, you will grab the attention of your patients and influence them subconsciously to trust you more as a physician and make them more likely to return or refer a friend or family member than if you just simply say “It’s negative.” Seeing patients is an art in itself. Imagine you were in their place and you spent 20 minutes driving to the doctor’s office, another 20 minutes waiting in the waiting room, and then 10 more minutes in the exam room waiting for the physician. That is almost an hour to think about your injury or pathology. In your mind, you are trying to visualize what could be wrong. You then hear you need an X-ray and after that, you again wait. I think one would agree the patient would at least like to see the X-ray. When your patients leave, it is almost guaranteed that they’re going to tell someone about the experience they just had. What makes for a better story: "The doctor told me I need surgery" or "The doctor showed me an X-ray of my foot and you could see this huge bump because he said my bone was dislocated. It needs to be put back into place surgically or I may end up with severe arthritis and more pain than I am in now. I always thought a bunion was just a lump." Again, most would agree on the latter of the two. Providing your patients with a copy of the X-ray will even take the visit to another level. Now they are taking the pathology with them and using props to go along with their story. You would be amazed how many people will show their X-rays not only to friends and family but also to their coworkers. Saying you are not technologically advanced is no excuse. Most patients have smart phones if you do not so they can easily snap a picture of the X-ray whether it is a digital image or traditional film X-ray. (If it does not show up well, try touching the smart phone screen to adjust the brightness and produce a sharper and more balanced image.) If photos are digital and you would like to email them, take a screen shot and send the photo as a file. You may want to black out the name to avoid any privacy issues if your mail is not secure. What about MRIs and CT scans? I agree that it takes time for even you to view all the images, not to mention years of repetition and experience to read them so how in the world are you going to show this to your patient? Obviously it will depend on the pathology but if you have a torn tendon or a talar dome lesion, all it takes is a few seconds to point out the change in signal that represents the defect. Scrolling back and forth a few times through the images will also look "cool" to patients and help them visualize it even more as they will see what normal looks like. Spending just a few extra minutes with your patients to provide them with a visual education of why they are in pain will go a long way in terms of marketing. It is free and at the end of the day, it is the right thing to do.