Local Physicians Consult with RAF When Imaging is Vital to Patient Care

In 2013, Buhler, Glasser, Newsletter, Volume 5 Issue 1 by Addison Clark

Diagnostic radiologists are best known for their behind-the-scenes interpretation of medical imaging test results. Yet their collaboration with other medical specialists is equally critical to patient care.

David L. Glasser, MD, president of Radiologic Associates of Fredericksburg (RAF), said he and the practice’s other board-certified, fellowship-trained diagnostic radiologists spend a significant part of each day discussing cases and medical imaging tests with patients’ physicians. Typical cases include:

  • Answering an orthopedic surgeon’s questions about a patient’s imaging tests before surgery to repair a torn meniscus.
  • Showing an oncologist how a patient’s lymph nodes and tumors are responding to cancer treatment.
  • Discussing test findings with a patient’s primary care physician to aid in a diagnosis.
  • Helping a hospitalist determine if a patient’s imaging tests indicate the patient may be well enough to be discharged.
  • Consulting with an OB-GYN on fetal development findings that may indicate the patient is having complications during pregnancy.
  • Asking a patient’s physician for more information in order to select the appropriate medical imaging test and protocol for his or her condition.
  • Sitting down with a trauma surgeon to compare a patient’s CT scan images with what the surgeon found when repairing a patient’s perforated bowel, so both doctors can learn from the experience.

24/7 Consultations

“We are consultants to the physicians in our community. Whenever a patient’s physician has a question or needs to discuss a case, 24/7, 365 days a year, one of our local radiologists is available,” Dr. Glasser explained.

RAF diagnostic radiologists collaborate with local physicians in several ways, always following The Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy and Security Rules to protect patient confidentiality, Dr. Glasser added. If a patient’s physician wants to speak to the RAF radiologist who supervised the patient’s medical imaging study, for example, the radiologist is available during his or her regular shift by phone, in person, or through the Primordial System.

“The Primordial System is like a secure instant messaging system that we use to communicate with some of our referring physicians,” Dr. Glasser noted. Referring physicians are encouraged to sign up for the system by contacting RAF Director of Administrative Operations Tammy Gressly at tgressly@rafadmin.com, (540) 361-1000.

If a patient’s physician needs a consultation after hours, a RAF radiologist is stationed at Mary Washington Hospital round-the-clock and available by calling (540) 741-1571.

RAF’s diagnostic radiologists serve patients at two local hospitals (Mary Washington and Stafford Hospital); four outpatient imaging centers (Medical Imaging of Fredericksburg, the Imaging Center for Women, Medical Imaging at Lee’s Hill and Medical Imaging of North Stafford); and RAF’s interventional radiology and vascular program, Virginia Interventional & Vascular Associates.

Physicians who refer patients to these facilities for testing receive routine results electronically or by fax, depending upon their preferences. Many local physicians use the Picture Archive Communication Systems (PACS) provided by Mary Washington Healthcare and RAF to access their patients’ test results and medical images securely online. Dr. Glasser said critical test results, such as finding signs of cancer on a CT scan, receive highest priority and are communicated preferably by direct phone call and/or communicated rapidly through an automated module that alerts the patient’s physician.

Innovations Ahead

To further streamline communications, RAF is planning to introduce a concierge system later this year that will help referring physicians more rapidly locate specific radiologists, many of whom rotate among the facilities served by RAF. Dr. Glasser said RAF is also studying other possibilities, including secure smart applications (smart apps) that would enable a patient’s physician to more easily access test results and images from mobile devices.

Community Collaboration

In addition to consulting with physicians on individual patient cases, RAF diagnostic radiologists serve with other local specialists on committees that are improving the health of the community. These committees include Mary Washington Healthcare’s (MWHC) cancer conferences, regular gatherings where doctors discuss their most difficult cases; the Virginia Heart & Vascular Institute, a collaboration of heart and vascular specialists at MWHC; the Mary Washington Hospital Foundation; and the MWHC Board of Trustees.


Pictured above are Aye Min, MD (left), Catherine D. Buhler, MD (center), and other RAF radiologists provide consultation to local physicians.