Virtually every medical consumer has undergone a diagnostic test such as an X-ray, a CT scan or an MRI. Failure to diagnose certain health conditions at their early stages can have serious implications, so patients get the tests and wait with bated breath for their doctors to notify them of test results.
But the patient's doctor isn't always the one who reads and interprets radiological tests. In one case, unbeknownst to a Pennsylvania woman who visited the emergency room with a severe headache, a physician licensed in Pennsylvania read her CT scan from a computer in his Hong Kong home.
The doctor who examined the patient in the ER suspected that she had a life-threatening cerebral hemorrhage. The doctor in Hong Kong noted a ring around the mass on her brain scan, but did not include his impression of what the mass ring meant — a potential abscess — in his report. Perhaps because the doctors were across the globe from one another, they never conferred about the patient's condition. The hospital sent her home, and her abscess ruptured before her follow-up appointment.
After 11 weeks in a coma, the 36-year-old patient regained consciousness, but the damage to her brain was serious and irreversible. She cannot live on her own, and it is unlikely she will ever return to her occupation as a computer technician.
Teleradiology, the practice of doctors reading imaging film from remote locations, has its pros and cons. The benefit to the patient is that a radiologist is available 24/7 somewhere in the world. The downside, illustrated by the Pennsylvania patient's missed diagnosis, is that the remote physician rarely consults with the treating physician at the patient's bedside. Moreover, the practice may tempt some physicians to approve a technician's interpretation of a scan without analyzing it themselves.
Technology has enabled remote diagnoses, but at what cost? Patient advocates believe that patients have a right to know who is reading their scans, and that the radiologists who interpret the results should consult with the patient's treating physician.
Source: msnbc.com, "Is a doctor reading your X-rays? Maybe not," Katherine Eban, Oct. 26, 2011