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Radiology referrals?

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I would appreciate some advice from my radiologic friends.

I am a family doctor, primarily working in urgent care that I do several per diem primary shifts monthly.

My question is why I can’t use a radiologist like any other specialty consultation. While most of my work involves pretty simple things like chest x-rays and basic orthopedic films, and I do have ready access to the radiology tech who is often very helpful, we get a fair amount of more complicated presentations that require next level imaging. Almost without fail I will get my request wrong which involves a tech at the hospital calling back to have me change an order for issues of nomenclature, hospital specific protocol differences and occasionally for just ordering the wrong test when a different test would’ve been a better choice. A good recent example was a patient with hematuria and chronic left flank pain. Ultrasonography didn’t show anything abnormal and I ordered a CT urogram, in part because our EMR had it in a drop-down list. After too long a time someone from radiology let us know that is not an acceptable order and that I needed to change it to a “CT abdomen and pelvis with and without contrast.” Additionally, the addition of a basic metabolic profile is something that they don’t need when I add it and do need when I don’t order it.

Why can I not make a referral to the radiologist with the pertinent clinical details and have them make the correct test choice? When I refer to a surgeon, I don’t order an appendectomy. When I refer to an oncologist, I don’t order chemotherapy. Wouldn’t it make more sense to refer the next patient to a radiologist who can make the correct imaging choice? I’ve been practicing in the same institution for 20 years so I know most of the radiologist by name well enough to call them if I’m really stuck but they are hard to reach and often grumpy. Plus, guess who else is busy? Me.

Is this an institutional thing? Is it a regional thing?

submitted by /u/upstate_doc
[link] [comments]

source https://www.reddit.com/r/Radiology/comments/15awpv0/radiology_referrals/
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