DESIGN AND IMPLEMENTATION OF A NEW RADIOLOGY CONSULTATION SERVICE IN A TEACHING HOSPITAL

The steady increase in costs related to testing has been a major facto r in the overall growth of health care expenses [1], Concern is substa ntial about the excessive number of tests ordered by physicians withou t measurable improvement in patients' outcomes [2]. This is of particu lar concern in teaching hospitals, because in addition to the direct i mpact on national health care expenditures, these are the institutions in which young physicians train and formulate test-ordering practices . Proper selection of imaging tests is a complex process that requires detailed information about the patient; specific questions to be answ ered; and knowledge of the characteristics of the test, including sens itivity, specificity, risks, and cost. To date, no systematic method e xists for combining the expertise of the radiologist with that of the referring physician before the tests are selected. Therefore, we desig ned a new clinical service within the radiology department that allows formal, on-the-ward consultation to assist internal medicine housesta ff in the selection of radiologic tests. The goal of this study was to assess the feasibility of this formal radiology consultation service and to determine how often its imaging recommendations were implemente d for patients with complicated medical conditions.