Patient photos aid docs reading faceless CT scans

[December 02, 2008]  CHICAGO (AP) -- Imagine sitting in a dark room all day, evaluating CT scans and other medical images on a computer screen but never actually seeing real patients. That's life for many radiologists.

But an intriguing Israeli study found adding photos of patients' faces to the file made these doctors more meticulous when looking at the X-rays. They reported more details and said they felt more empathy for patients who were otherwise strangers.

Adding patients' photos is a simple, low-tech way to reap rewards for both doctors and their patients, the researchers concluded.

Several experts not involved in the study agreed, although Dr. James Thrall, chairman of the American College of Radiology's board of chancellors, said making it common practice in the United States could be problematic because of privacy laws.

Also, the benefits of including photos might disappear when the novelty of the practice wore off, said Thrall, a Massachusetts General Hospital radiologist. Still, he said it merits more research.

The study involved 15 radiologists at Shaare Zedek Medical Center in Jerusalem and 318 patients who agreed to be photographed before undergoing CT scans. The color photos appeared automatically when the doctors opened the patients' computer files.

The study's focus was not on the ailment the scans were meant to evaluate, but rather on incidental findings that often show up on CT images, such as kidney cysts in patients scanned for suspected appendicitis. Doctors reported these extra findings in 81 scans when the photos were included.

Three months later, the doctors unknowingly viewed the same 81 scans, but without patients' photos. This time, the doctors failed to report 80 percent of the incidental findings.

"We look but we don't always report" these incidental findings, particularly if they are considered unlikely to affect the patients' outcome, said study co-author Dr. Irith Hadas-Halpern, a radiologist at the Jerusalem hospital.

Still, they often are things patients would want to know about or that could affect them down the road, she said.

The patients' photographs made doctors look more carefully and report more detailed information on these findings, she said.

Also, all 15 radiologists reported that the photographs made them feel much more empathy toward the patients.

"Once you see that this is a human being ... the attitude changes," Hadas-Halpern said. "You see this is a young woman, an old suffering man. It adds something."

Hadas-Halpern said it would be particularly beneficial to radiologists involved in outsourced telemedicine. These doctors often interpret computerized scans sent from time zones away, literally far removed from the patients.

The study was being released Tuesday at the Radiological Society of North America meeting in Chicago. Dr. Yonatan Turner, a radiology resident, hatched the study idea as a way to make the job less impersonal.

Dr. Joan Anzia, a Northwestern Memorial Hospital psychiatrist, said adding photos is "simple and ingenious."

"Feeling more connected with the patient and actually working a little harder totally makes sense from what we understand about the way the brain works in terms of facial recognition and attachment," Anzia said.

From early infancy, she explained, the brain is programmed to respond to faces, and that response is the beginning of an emotional attachment.

Dr. Eric Stern, a University of Washington radiologist, said the study was important "because technology has absolutely dehumanized the patient."

Stern said he saw a rare example of patients' photos accompanying radiology files when he reviewed chest X-rays of Southeast Asian immigrants as part of a tuberculosis control program. Photos were included for identifying purposes because many patients had similar last names, Stern said.

"I found it to be an unexpected pleasure to be able to put a face to the X-ray," he said.

Stern said there could be drawbacks to using patients' photos if something about their appearance -- race or an angry demeanor, for example -- triggered radiologists' biases.

But he said the benefits of potentially increasing empathy would far outweigh potential biases.

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On the Net:

Radiological Society: http://www.rsna.org/

[Associated Press; By LINDSEY TANNER]

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