General practitioners requesting radiological investigations: a qualitative study of the perceptions of radiologists

Abstract

BACKGROUND: General practice provides person centred, continuing, comprehensive and coordi- nated whole person care to individuals and families in their communities. Patients present with early nonspecific symptoms of disease and general practitioners need to be very discrimi- nating when deciding on investigations. Indiscri- minate or inappropriate use of radiological investi- gations could expose patients to unnecessary harm and is a waste of resources. Failure to refer for necessary investigations may lead to inefficient patient management.This study was carried out to identify the various aspects of the process of general practitioners requesting radiological tests and radiologists’ perceptions of this process in Sri Lankan settings. METHODOLOGY: Person to person telephone interviews were conducted by one of the investi- gators with ten consultant radiologists working in different areas of Sri Lanka. A semi structured questionnaire regarding general practitioner requests for radiological investigations was used as a study instrument. Recorded information was studied in depth and then coded. Codes were then combined into themes and analysis was done independently by two investigators and reviewed together with discussion on any disagreements leading to a consensus view.RESULTS: The main findings of the study were that the majority of radiologists thought that most of the requests for radiological investigations were appropriate, however they were disappointed with the provision of background information with the requests such as basic data, clinical history, previous investigations and tentative diagnosis. It was generally thought that a structured referral form would improve the quality of the process of requesting investigations. Radiologists appreciated that a clear pathway of communication with general practitioners was important especially regarding the follow up of the patient.CONCLUSION: There is a need to improve specific aspects of general practitioner knowledge to facilitate efficient utilisation of radiological investi- gations and ensure patient safety. General practitioners need to be more diligent regarding provision of adequate clinical information regarding the patient to the radiologist in order to make optimum use of the investigation and the time of the radiologists. Good communication between the referring general practitioner and radiologist will improve the quality of care for the patient.