The Radiology Consult

A rise in radiology consult, in parallel with an ever-growing offer of value-based services, is currently increasing patient awareness of the radiologist’s role in clinical care. A German and a North American example of radiology consult are shown in this chapter. The German example, taken from the Radiology Department of the Thoraxklinik University Heidelberg, chaired by Prof. Dr. Claus Peter Heussel, will show different aspects like the workflow regarding severely immunocompromised patients being submitted to thoracic CT, the image-guided biopsy and re-biopsy of nodules or masses, regular tumor boards, and the Interstitial Lung Disease multidisciplinary conference (with pneumologist, radiologist, and pathologist). The University of Pennsylvania at Philadelphia embedded thoracic radiology reading room within an integrated Lung Center Clinic, is the North American example. A survey taken in this large tertiary academic medical center by Dr. Mortani Barbosa Jr. found an overwhelming positive response from the referring healthcare providers, and major positive impact on patient care and management. The most common reasons for consultation were to clarify interpretation of imaging studies and diagnoses, to assess for temporal changes, and in up to 25% of the cases to discuss management options. The radiology consult models we proposed can be implemented in most mid- to large-size hospitals. The radiologist as a consultant should be seen as the future but also a return to a past in which the interaction of radiologists and referring practitioners was the foundation of diagnosis and medical decision-making.