Radiologists are a crucial part of nearly every medical team, responsible for diagnosing and treating health conditions through the use of imaging technologies like computed tomography (CT) and magnetic resonance imaging (MRI).
What Do Radiologists Do?
In most clinical settings, radiologists act like expert consultants, interpreting medical images to advise referring physicians on treatment options. Most radiologists don’t operate the machines themselves; that job is left up to radiologic technologists. For some patients, radiologists take a more active role. Beyond being experts in the interpretation of medical images, radiologists are also experts in the use of radiation as a medical treatment. This is most common in oncology, the treatment of cancer, where radiation therapy is often used instead of, or in addition to, chemotherapy.
Like all medical doctors, indeed all medical professionals, radiologists have an ethical and legal obligation to perform their duties in line with accepted standards of practice. Medical malpractice is the flip-side of this legal obligation. When a radiologist violates their standard of care, leading to a misdiagnosis or improper treatment regimen, the affected patient may have cause to sue and hold the negligent doctor accountable in a civil lawsuit.
Yes, Radiologists Can Be Held Accountable For Diagnostic Errors
Despite their legal duties, radiologists often find themselves singled out as defendants in medical malpractice lawsuits. The most common cases involve misdiagnosed cancers, either tumors of the breast or lung. Along with being fairly frequent, these lawsuits typically result in the highest value settlements and jury verdicts. Mistaking a cancerous tumor for a benign one, after all, can have wide-ranging and disastrous consequences for patients.
Nearly 1 in 3 medical malpractice results is related to diagnosis. That’s not particularly surprising when you take a look at how routine diagnostic errors have become. Around 30% of all radiologic examinations are found to be wrong, researchers at Johns Hopkins University report, undoubtedly contributing to the stunning number of misdiagnoses that affect the lives of patients every year.
Diagnostic errors, however, aren’t always evidence of medical negligence, the concept on which any viable malpractice lawsuit will be based. What we’re looking for instead is whether or not the radiologist violated the standard of care in some area of their duties, ultimately leading to an error that harmed a patient. The standard of care is the crucial concept here, not the error itself. While certainly injurious, it may be the case that every reasonable radiologist would have made the same error under similar circumstances. Perhaps the circumstances were just terribly difficult.
“All Four Corners Of The Film”
According to Leonard Berlin, a professor of radiology at the University of Illinois, the standard of care for radiologists “has always been and continues to be to carefully look at ‘all four corners of the film’ and everything within.” In considering an image, radiologists are looking for anything, and everything, of significance. This can present difficulties, as Berlin explains, when a radiologist’s attention has been directed toward a specific organ or medical condition.
Let’s say that a doctor orders an X-ray of someone’s kidney and asks the radiologist to check for signs of a kidney stone. Thankfully, there’s no indication that the patient has a kidney stone, but the radiologist does notice, off to the side, an unusual lesion in the patient’s liver. How the radiologists reports the results of his or her evaluation is critical. Even though the ordering physician seemed focused on kidney stones, the radiologist has an obligation (both legally and ethically) to report any significant results, no matter the test’s explicit purpose.
A Radiologist’s Standard Of Care
There’s no definitive list of rules or regulations that govern the actions of radiologists. In other words, the standard of care isn’t set in stone. With that being said, many doctors, along with most courts in the country, choose to rely on a set of standards published by the American College of Radiology (ACR).
These standards aren’t legally-binding. The American College of Radiology is crystal clear on this point, writing from the outset that its “Practice Parameters are not intended to be legal standards of care or conduct.” In actual malpractice proceedings, however, judges and juries frequently differ to the American College of Radiology’s wisdom to determine whether or not a radiologist violated the profession’s standards. Interestingly enough, the ACR also publishes standards for radiologists who become expert medical witnesses in malpractice lawsuits.