Safety Measures

Radiologists should be prepared to answer tough questions

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Scott Huelskamp, Managing Editor

A few years back, my wife and I spent most of a Sunday in a hospital emergency room with my then-3-year-old daughter. At the time, my daughter was ill, lethargic, extremely light sensitive, and complaining of headaches – clearly giving cause for concern and out of character for this crimson-haired bundle of energy affectionately known as the “red tornado.”

After being examined by her pediatrician earlier in the day, he suggested we go to the ER for tests and rule out any serious problems. Although we are fairly healthcare savvy and have been around hospitals most our lives, the stress level jumped when doctors started throwing out terms like “meningitis” and “swelling of the brain.” As part of typical clinical due diligence and following the pattern of ruling out what it isn’t, our daughter was scheduled for a head CT. I remained in the CT room with her and watched as the radiology technician gently secured her little body so she wouldn’t wiggle, and I reassured her it was all going to be over quickly.

The last thing on my mind was to inquire about the dose level of radiation she was receiving or if it was appropriate for her size and weight. Ignorance was bliss. In the end, her tests came back negative, she spent a night in the hospital as a precaution and the headaches were probably the result of dehydration. Within a week, she was back to her old self.

While I certainly hope I don’t have to go through a similar experience again with any family member, you never know. In light of recent reports of errors in radiation therapy procedures, I might be more inquisitive the next time around. More patients may be asking the same types of questions, and radiology departments should be prepared to provide answers and quell fears.   
   
Lately, it’s been a hot topic. The New York Times ran several articles that examined radiation therapy errors. In early February, the FDA announced an initiative to reduce unnecessary radiation exposure from CT, fluoroscopy, and nuclear medicine exams, and promote safe use of medical imaging devices and eliminate unnecessary exposure. The U.S. House of Representatives even got into the act and scheduled hearings on the topic, although heavy snowfall in Washington, D.C. forced them to be postponed. Representatives from five industry organizations were scheduled to attend, including the American Society for Radiation Oncology (ASTRO), the American College of Radiology, and the American Society of Radiologic Technologists.

While most experts will tell you that major radiation errors are rare, the ears of the public perk up and take notice when the FDA and the House of Representatives speak out. And it’s just as important for radiology associations to show they are taking the talk seriously and developing safety measures to calm jittery patient populations. For instance, ASTRO has released a six-point patient protection plan to improve quality and safety, which includes creating a database to report certain medical errors and expanding educational training programs.

Patients will want answers. Your radiology department needs to show it is reducing the risks, while still supporting the benefits of these procedures.