How often do you ensure that your patients have a full un- derstanding of their reports? Is your language clear and informative? Andrew J. Gunn, assistant professor of interventional radiology at the University of Alabama at
Birmingham, School of Medicine, describes the importance of
garnering patient feedback to improve communication and deliver better care.
Why did you choose to focus on patient feedback?
From very early on in my residency training, I noticed a wide
Why has this feedback been virtually nonexistent
variability in how radiologists described findings and the recom-
mendations that they made about those findings. When asked,
most had anecdotal reasons and experiences about why they
practiced a certain way. However, I felt there was a lack of train-
ing and research in this area.
Initially, we focused on getting feedback from referring doc-
tors. As part of this feedback, we heard concerns from referring
doctors that our report language needed to be adjusted to ac-
count for patients reading their reports. Patients are increasingly
able to access their radiology reports and bring their concerns to
referring physicians. Thus, trying to quantify patients’ issues
with radiology reporting seemed like a natural next step.
First, patient portals (i.e., [the systems] where patients are
accessing their medical records) are a relatively newer phenomenon. Previously, the radiologist could rely on the ordering doctor to translate the report for the patient. Radiologists are
becoming more aware of direct patient access.
Second, as we transition to a more “value-based” reimbursement model, radiologists are increasingly trying to find ways to
improve the value of the care they provide for patients. Third, I
think the increased recognition of the need for patient feedback
Q & A With Andrew J. Gunn
In this interview, one radiologist provides a closer look at how patient feedback
Andrew J. Gunn
on reports can inform and improve patient care.
Assistant Professor of
University of Alabama at
Birmingham, School of Medicine
on reports is part of a larger movement in radiology to embrace
How did you garner feedback from your patients?
In this study, we randomly selected eight actual radiology reports. After anonymizing the reports, we asked patients to provide structured feedback (using a form).
What were you attempting to learn and understand
from the patients’ feedback?
As we’ve done these studies with referring physicians and patients, I try not to have any preconceived notions about what
we’re going to see or learn. I’ve found that to be a useful approach
because it keeps me open to any ideas or trends seen in the data.
Initially, we were really trying to prove that patients would be
willing participants in the process and see if it was a feasible approach. Apart from that, I was mostly interested in seeing what
suggestions the patients would have for us as radiologists.
Patients from your study noted that they often
misunderstood their reports. Was this feedback
surprising or unexpected? Did the radiologists at your
institution believe they were explaining the reports
effectively before these findings were revealed?
The patients in our study had a mean comprehension of 2. 5
(scale: 1–5) but people tend to overestimate their understanding
and we studied an overeducated population (~ 60% had college
degrees) so you could expect the understanding of a more random population to be even less.
I think all radiologists do their level best to be accurate and
helpful with their reports. However, their audience has typically
Q & A continues on p. 11
Radiologists do their level best to be accurate
and helpful with their reports. However, their
audience has typically been other physicians.
Recognizing that there is another group of
people reading these reports is a good first
step to improvement.