A well-remembered article which appeared in Radiology, October 2006 entitled, “The State of Radiology in 2006, Very High Spatial Resolution but no Visibility” by Ruiz and Glazer, raises once more an important issue in Radiology—one that has appeared often in old clothes but now has shown itself in a new guise. I am speaking specifically about our role in the delivery of information. The subject is the radiologists’ involvement or lack thereof in relating to patients the results of recently completed imaging tests.

One of the problems for a radiologist in his or her capacity as a deliverer of care is where to position ourselves. The capture of most diagnostic workups in the past decade and a half by cross sectional imaging studies, particularly CT, but also to a lesser extent MR has placed the imaging interpreter at the fulcrum between the uncovering of abnormalities and the initiation of therapy. Today, by and large, the radiologist renders his or her diagnosis at a remove from the patient, increasingly so in space, yet, also decreasingly so in time. Advances in communication and the electronic rendering of images can mean that the radiologist can be placed anywhere in the hospital, as well as even anywhere on earth. And the twin advances of PACS and voice recognition mean that a report, soon after it is dictated and approved, can move instantaneously to the primary physician. Given the diagnostic incisiveness of imaging why shouldn’t a radiologist make known his diagnosis even faster—by telling patients right there before they leave the imaging suite about what are the findings and what they signify. Proponents of this idea, like the authors of the previously cited paper, maintain that it is not enough to be the doctor’s doctor as we portray ourselves, dispensing our expertise exclusively to the referring physician. Rather, we should take the opportunity to confer with the patient at hand. The justification for direct face-to-face communication with the patient stems from the notion that we as radiologists know more about the test we perform, specifically, and more about imaging in general. Thus, so as the logic proceeds, we know best what to tell the patient.