I’ve been exploring the patient perspective recently – not at all voluntarily but with great interest. I’ve had 2 x-rays done in the past months and I can’t help comparing them.

First experience
Got a referral to a large hospital for an x-ray of my sinuses since I’ve had so much trouble with them lately. Made it to the hospital on the day of my appointment and after some waiting I was strapped in the x-ray-machine by the “x-ray nurse” (no-one had so far asked me why I was there, I assumed they new “all” about me from the referral…). Pictures where taken, and while I was still strapped in the machine, a man enters the room, gives me a not very friendly look, stares at the screen for a few seconds, says something to the nurse and then leaves. I ask the nurse who that was, and he explains that it was the physician who will analyse my pictures later. Ok… so, I was done, but I couldn’t help myself and before leaving I asked if the x-ray shows anything? I’m thinking that the nurse must have seen many x-rays and should be able to say something… but no – I have to wait for the answer to the referral to be sent back to my referring physician and then she will contact me. So I leave without having any clue as to whether something is actually wrong with my sinuses or if I’m just going insane.

Second experience
3 weeks later my physician calls me and says that I need to visit my dentist to exclude that there’s anything wrong with my teeth causing the problems with my sinuses. I call my dentist and get an appointment the following day (!). I still haven’t got the papers my physician sent me, but after a second phone call I feel confident I can explain the issue to my dentist. When I arrive, everyone introduces themselves, they ask about my problem and I get to tell the whole story (which to me feels good even though I would have liked them to have seen the x-rays from earlier…). My dentist takes the time to explain exactly why my physician wanted me to get the dentist to look at my teeth. She then proceeds to take the pictures. All the time, I can see the same screen she’s looking at with my dental record and the x-ray images. She’s not content with the first pictures, and explains to her assistant (and me!) why not, so a second set is taken. She then explains in detail to me what we are seeing on the screen, how she interprets it and why she concludes there is no problem with my teeth! She also explains what she can see relating to the problems with my sinuses – so I now have a much greater understanding of what the problem actually is. She also does her best to answer all my questions regarding this. The whole time, I feel as if I’m the most important person in the room, as if I’m competent to understand basic information about my own health, and as if it’s actually important that I do understand. Great feeling – and completely the opposite to the first experience.

Perhaps this was just a bad day at the hospital, perhaps my dentist is exceptionally good at patient participation, or perhaps it’s something more. Would it be possible for the experience of getting an X-ray at the hospital to be similar to the one at the dentist? What are the barriers? Is it a technical problem (the pictures takes longer to process? can’t have the screen in the same room as the patient?)? Or a lack of time (the physician not having the time to do the interpretation while the patient is still in the room?)? A matter of distributed responsibilities (the x-ray physician is not responsible for talking to the patient, this should be done by the referring physician)? Or simply a cultural difference? Either way – having the experiences so close to each other I couldn’t help compare. Anyone else with similar experiences?