Clinic vs. Hospital: Why is Medical Imaging Done in Both?
Medical imaging exams, such as X-ray, ultrasound, MRI, mammography, or CT, can be performed in a variety of settings including hospitals, urgent care centres, and community clinics. Where you are sent usually depends upon your health care practitioner’s recommendation.
Radiology has been used as a diagnostic tool in medicine since 1895, when a German scientist first discovered X-rays. As medical imaging technology evolved over the years, new imaging techniques were discovered, and medical imaging became more sophisticated and more accessible.
For the most part, radiology services and the first radiologists were found in hospitals. As radiology became more fundamental to modern medicine and doctors used it to diagnose and treat many diseases and conditions, there was an increased need for access to this technology.
Radiology services then began to expand into the community, making it more readily available to patients. However, the process for medical imaging exams remains consistent whatever the setting.
WHAT HAPPENS WHEN YOU ARE SENT FOR MEDICAL IMAGING?
Once your doctor has identified the need for a medical imaging exam, you will be given a requisition form. Most medical imaging exams require an appointment which your doctor’s office might book for you, or you can book yourself. X-rays are offered in the community on a walk-in basis at any medical imaging clinic and appointments are not required for general X-ray procedures. Simply bring your form with you.
Most medical imaging exams involve a technologist conducting the exam and a radiologist interpreting the images and compiling a report for your doctor.
A technologist is qualified and registered to perform exams by their profession’s national professional association and certifying body. They are acquiring diagnostic images according to specific protocols, so that a radiologist can interpret the images to provide an accurate report of the findings and results of your study. Should the technologist identify any immediate concerns, they will bring them to the attention of the radiologist; however, they are not legally permitted to divulge any results directly to you, the patient.
After the technologist has completed your medical imaging exam, your images are examined by a radiologist, who is a medical doctor specialized in interpreting the results of imaging exams.
The radiologist reviews your imaging to look for abnormalities to help identify what may be causing your symptoms. This is called diagnostic medical imaging, which is ordered to investigate a specific concern.
Your doctor may also order a screening medical imaging exam, which helps detect diseases before you have symptoms, while they can still be successfully treated. An example of this is regular mammography screening to help detect early signs of breast cancer before it can be felt. A radiologist will examine these exams and compare them to previous images year over year to identify changes that might require further examination.
Once the images have been reviewed, the radiologist produces a report that contains a summary of his or her findings, a possible diagnosis, and recommended next steps. This report is sent to your referring physician.
If there are immediate concerns with the examination or your doctor has asked for an immediate result, your results will be phoned or faxed to your referring physician. Otherwise, results will be received by your doctor within one to two business days depending on the type of exam. Your doctor will then be able to review your results with you, along with the results of any other test you may have undergone, and determine the next steps in your health care treatment plan.
RADIOLOGISTS ALSO PERFORM TREATMENTS
Radiologists also perform certain procedures under image guidance. These procedures are performed by Mayfair radiologists at Mayfair Diagnostics’ clinics and in hospitals to treat certain conditions or to investigate specific concerns.
Breast and thyroid biopsies – these procedures examine a specific area of the breast or thyroid for abnormalities. A needle is used to take a small tissue sample, which is then sent to a laboratory for analysis.
Image-guided pain therapy – these procedures use X-ray and ultrasound to guide treatment for pain management by allowing Mayfair physicians to precisely inject medication through a small needle, or perform treatment on soft tissues.
Interventional radiology procedures – these procedures are performed in hospital where Mayfair physicians, called interventional radiologists, use medical imaging to perform minimally-invasive procedures that treat a variety of conditions, such as an enlarged prostate, uterine fibroids, or vascular concerns.
In Alberta, community clinics perform 15,000 diagnostic imaging procedures every weekday, allowing a higher proportion of patients to receive their tests outside of hospital than any other region in Canada. Generally, patients don’t need to wait as long for an appointment in a clinic as they would in a hospital, and clinics are often more conveniently located.
Community radiology clinics are funded the same way as your family doctor’s office. Your radiologist owns and operates the clinic, assuming all related expenses for their highly qualified staff, state-of-the-art medical imaging equipment and computer systems. The radiologist bills Alberta Health Services a specific amount for each procedure, and a large percentage of these fees go to pay for the cost of running the clinic.
Radiologists at community clinics send their reports to the same health information network that hospitals and family medicine clinics use, ensuring that your health care practitioner can easily access the information they need from your medical imaging exam.
Alberta Society of Radiologists (2020) "Get the Whole Picture." www.getthewholepicture.ca. Accessed January 15, 2021.
The Conference Board of Canada (2017) The Value of Radiology in Canada. Briefing, January 2017. Accessed January 15, 2021.
Digital Museums Canada (2001) “Athena’s Heirs: The History of Medical Technology in Canada.” www.virtualmuseum.ca. Accessed January 15, 2021.
Lipinski, J.K. (1983) “Some observations on early diagnostic radiology in Canada.” Canadian Medical Association Journal, Vol. 129, Oct. 1. Accessed January 15, 2021.