0:00

Many of us are quite aware

0:02

that there are significant barriers to communicating

0:06

with patients and families about errors, uh,

0:09

that are endemic to the medical culture.

0:12

All of us are afraid of lawsuits.

0:14

We all fear the financial repercussions that can come

0:17

with a significant adverse event.

0:20

We all fear losses of our professional standing.

0:24

In addition, there are deeply embedded

0:25

institutional barriers.

0:27

Many institutions continue

0:29

to place greater emphasis on individual culpability rather

0:33

than on systems flaws.

0:35

There are poor mechanisms within our institutions

0:38

to help facilitate our disclosure

0:40

or to support the clinicians who are involved in the,

0:43

in the errors in, in facilitating the communication.

0:46

And the institutions themselves have significant fears

0:49

about their reputation.

0:52

Of course, we as radiologists specifically,

0:54

have limited direct patient contact with.

0:57

There's little opportunity for pre-existing relationships

1:01

that could potentially help manage the communication better

1:04

when the communication gets particularly difficult.

1:07

We're historically behind the scenes

1:09

and our relationship with patients is

1:11

often seen as secondary.

1:13

This leaves us dependent upon the treating physicians often

1:17

to characterize to the patients and families our actions

1:22

and our diagnoses in a way

1:25

that makes us vulnerable

1:28

and in a way that makes that, that make

1:33

leave patients and families with a flawed

1:37

or limited understanding of the care

1:39

that actually took place.

1:41

And this is an important reason why we may want

1:44

to be more upfront as radiologists with

1:48

the direct communication.

1:51

We all have space, time, and logistical constraints.

1:55

There are no professional guidelines within radiology,

1:58

and most of us, uh,

1:59

or many of us, uh, have, are in institutions

2:02

where there are no specific hospital

2:04

or departmental guidelines to help us

2:06

with the communication.