Radiologist as consultant: direct contact between referring clinician and radiologist before CT examination

The need for better direct communication between referring clinicians and radiologists has recently been emphasized. Responding to this need, a system was designed and implemented that used a radiologist as a consultant for scheduling body computed tomographic (CT) examinations. Under this system (in the "experimental" period), the referring clinician was required to consult with a body CT radiologist to schedule an examination in addition to completing a standard written radiology requisition. Before implementing this system (in the "control" period), only the written requisition was required. Ninety-five percent of referring clinicians were willing to cooperate with the new system. Benefits of the verbal consultation system included obtaining more clinical information (p less than 0.001) than was on the requisition alone (2.05 +/- 1.72 extra clinical data items), formulation of improved scanning protocols, a reduction in the number of post-CT diagnostic tests, and improved clinician-radiologist rapport. The costs of the system were mainly the nearly 5 min it took to schedule each case. It was concluded that a system that uses the radiologist as consultant and requires oral consultation between clinicians and radiologists can be implemented and has measurable benefits for patient care.