Radiologist Adds a Human Touch: Photos
By DINA KRAFT
JERUSALEM —When Dr. Yehonatan N. Turner began his residency in radiology, he was frustrated that the CT scans he analyzed revealed nothing about the patients behind them — only their internal organs. So to make things personal, he imagined each patient was his father.
The Effects of Including a Patient's Photograph to the Radiographic Examination (RSNA)
But then he had a better idea: attach a photograph of the actual patient to each file.
“I was looking for a way to make each case feel unique and less abstract,” said Dr. Turner, 36, now a third-year resident at Shaare Zedek Medical Center here. “I thought having a photo of the patient would help me relate in a deeper way.”
Dr. Turner’s hunch turned into an unusual medical study. Its preliminary findings, presented in Chicago last December at a conference of the Radiological Society of North America, suggested that when a digital photograph was attached to a patient’s file, radiologists provided longer, more meticulous reports. And they said they felt more connected to the patients, whom they seldom meet face to face.
In the digital age, adding a photo to a file is a simple procedure, and the study’s authors say they hope it becomes a standard procedure — not just for radiologists but also for pathologists and other doctors who rarely have contact with patients.
Radiologists spend most of their working hours in darkened rooms with large, high-resolution computer screens where they read and analyze dozens of scans and X-rays each day.
The process can feel mechanical and detached. But Dr. Jonathan Halevy, the director of Shaare Zedek, says that “when there is a picture, your attitude and approach changes — the human aspect is inserted.”
Important clues to patients’ conditions can sometimes be seen in their faces. Clicking through photos of patients who participated in the study, Dr. Turner pointed to an older man with a bruiselike hematoma around the eyes — a possible sign of brain injury. Paleness or jaundice might indicate various kinds of organ problems.
In the initial study, a group of Shaare Zedek radiologists rotated through three groupings, reviewing more than 300 files of patients who had agreed to have their pictures taken.
In the first group, radiologists received a photo of the patient along with the file; after three months they reviewed the same file, this time without the picture. In the second group, they interpreted the patient’s file without a photo, and three months later were presented with the same file, this time with a photo. A control group interpreted scans without photos.
The researchers found that the radiologists’ reports were significantly more thorough in all cases when a photograph was attached to a patient’s scan. Reports were longer, more recommendations made, summaries usually included and more incidental findings recorded.
In a questionnaire that was also part of the study, the radiologists said that the photos helped them relate better to the patients and that they themselves felt “more like physicians.”
Dr. James H. Thrall, radiologist in chief at Massachusetts General Hospital and chairman of the American College of Radiology, said attaching photos to patient files could prove difficult in the United States. Privacy rules might require patient consent each time a photo was used.
Still, he added in an e-mail message, “if further investigation supports the concept it could be done.”
Dr. Thrall also expressed concern that if patient photos eventually do become part of standard protocol, their effectiveness as a tool for better medicine might dull over time — though he added, “That is just a hypothesis to be tested.”
Dr. Turner cautions that the research is still preliminary and that more study is needed. He is seeking other medical centers to take part in an expanded study.
Such research, he said, might be a way to test theories about facial features and the body. Some practitioners of alternative medicine, for example, say the distances between features can indicate physical conditions.
Dr. Turner was accepted to both film school and medical school, and he was drawn to radiology as the most visual field in medicine. He said his interest in the power of faces was piqued by his reading of the French philosopher Emmanuel Levinas.
He included a quotation from Levinas in his presentation of the research to his American colleagues in Chicago: “Among all the organs of the body, the face is the one which stays most naked. ... In front of the face of the other, silence is impossible.”
