Every day around the world, radiographers take millions of X-rays which will never be reported by a radiologist.
In many cases they will not even be seen by a doctor.
So then what happens? The person looking after the patient will look at the image and try and make a diagnosis, or they will ask the radiographer what he or she thinks. But the radiographer may or may not have had any training in image interpretation.
And the caregiver – who might be a doctor, a nurse or a clinical assistant – is a busy person. He or she starts by deciding what is the most likely diagnosis, using experience, clinical skill, and tests of which the X-ray is only one.
And after that there are decisions to make about the best treatment, giving or supervising the treatment, and monitoring the patient's progress. These all demand skill and knowledge.
But before treatment can start there is triage. Is there an abnormality that needs treatment? Can we be sure about what it is? Or might the patient have a diagnosis which cannot be treated locally, and should they be sent to a larger centre for further assessment?
X-ray findings often play a critical role in triage. And a radiographer who can give a reliable opinion about an X-ray can make a big difference here.
Mawa Reuben, Vanuatu
The aim of radiographer interpretation is to give the caregiver another pair of eyes - and in many cases, a more experienced pair of eyes - to take care of reading the images so that the busy caregiver can get on with all the other parts of their job.
Mawa (above) gave me a terrific example of this when I visited him in Port Vila Central Hospital in Vanuatu. Some time earlier he had taken a chest X-ray of an outpatient and after looking at the image, he went to the clinic and spoke to the patient’s caregiver, a nurse.
He told her that the patient might have tuberculosis. She disagreed, based on her clinical assessment, and that might have been the end of it. But Mawa strongly advised her to test for tuberculosis, which she did.
And he was right.
This is a very positive story on two levels.
If Mawa had not insisted, the patient would have gone back to his village and probably passed the disease to many other people, before eventually returning to the hospital with much more serious infection.
But also, this ‘win’ for Mawa is a moment in his career. That nurse would remember, and perhaps next time she will come and ask him what he thinks. And together, they can start matching the clinical picture and the imaging findings, and she can give him feedback when the outcome is known.
Repeating this cycle many, many times over a career is the best way for an interpreting radiographer to help their patients and their community, and to increase their own professional satisfaction.
And I hope that this website will be able to support that process.