AIM: Are docs leaving patients in the dark about radiation risks?

A majority of radiologists and emergency medicine physicians reported feeling comfortable educating patients about radiation risks associated with CT imaging, according to a survey that served as the basis for a research letter in the June 4 issue of Archives of Internal Medicine. In contrast, most frontline providers indicated that they did not have the time or training to sufficiently discuss the risks of CT imaging.

Chad R. Stickrath, MD, from the division of general internal medicine at the University of Colorado Denver School of Medicine, and colleagues conducted an online survey of healthcare providers to determine training in radiation safety, frequency of radiation safety discussions with patients and barriers to such discussions.

A total of 348 fourth-year medical students, attending physicians and house staff from internal medicine, emergency medicine, radiology, cardiology and pulmonary services responded to the questionnaire.

Overall, 21 percent of respondents received no formal instruction about radiation exposure risks, with 56 percent receiving between 0.5 to two hours and 18 percent undergoing more than three hours of training.   

Stickrath and colleagues found sporadic and infrequent education about radiation risks, with 71 percent of respondents educating patients 25 percent of the time or less when ordering CT exams. In addition, 56 percent of providers “never mentioned to patients the possibility of incidental findings and the risks of subsequent workup when ordering a CT scan.”

When asked if they felt comfortable educating patients about the risks of ionizing radiation from medical imaging, 53 percent disagreed. Only radiology and emergency medicine physicians had a higher proportion of providers agree than disagree, according to Stickrath et al. Moreover, nearly half of physicians suggested that time limitations posed a barrier to adequately educating patients about radiation risks.

Although frontline providers may be ideally situated to discuss risks at the time of ordering, the findings suggest physicians are not initiating such discussions, according to Stickrath and colleagues. “We found that most frontline providers had very little training in the potential radiation risks from medical imaging and that the providers felt uncomfortable discussing the risks with patients.”