The Royal College of Radiology in regulation with new legislation written into Ionising Radiation Medical Exposure Regulation (IRMER) 17 states specific roles of doctors as the “referrers” and the radiologists as “practitioners”, as mentioned below:
6 Employer’s duties: establishment of general procedures, protocols and quality assurance programmes
- (5) The employer must— (a)establish recommendations concerning referral guidelines for medical exposures, including radiation doses, and ensure that these are available to the referrer;
10 Duties of the practitioner, operator and referrer
- (5) The referrer must supply the practitioner with sufficient medical data (such as previous diagnostic information or medical records) relevant to the exposure requested by the referrer to enable the practitioner to decide whether there is a sufficient net benefit as required by regulation 11(1)(b).
11 Justification of individual exposures
- (3) In considering the weight to be given to the matters referred to in paragraph (2), the practitioner justifying an exposure in accordance with paragraph (1)(b) must have regard, in particular to— (c)in the case of asymptomatic individuals where a medical radiological procedure—(iii)requires specific documented justification for that individual by the practitioner, in consultation with the referrer
- (4) In deciding whether to justify an exposure under paragraph (1)(b) the practitioner must take account of any data supplied by the referrer pursuant to regulation 10(5) and must consider such data in order to avoid unnecessary exposure.
Many investigations are requested by junior doctors, some following consultation with senior colleagues, some under instruction of senior colleagues. Often we are ones being sent down to discuss a scan with the radiologists and it is a common situation to have the request rejected or an unwilling radiologist who doesn’t think the request is appropriate, because as referrers we are not up-to-date on our duties.
If we are lucky and the scan request is accepted, we are expected to inform the family and patient that the scan is being undertaken, leaving us then to answer questions regarding radiation which is an area of pet peeves.
It is important to have some awareness of the role we are expected to play as referrers, however it is evident we do not. The fact that this is in legislation and we are not taking any action to play our role effectively, makes it scarier.
I have designed a survey to assess knowledge and comfort surrounding image requesting and risk exposure discussion with the aim that if it shows unsatisfactory levels, that a radiation awareness course preferably at a junior level be made mandatory – either as a study day or an online course.
Below is the link, it only takes 2 minutes and I would be ever so grateful if it could be filled out.