Direct access MRI for general practitioners--influence on patient management.

At the Kent and Canterbury Hospital between April 1994 and September 1995, 170 magnetic resonance imaging (MRI) examinations were requested by 58 different general practitioners by direct access. By use of a retrospective postal questionnaire, information regarding subsequent patient management was obtained and compared with the proposed management, had MRI not been available. Speed of diagnosis with a consultant opinion was shown to be a major advantage compared with conventional outpatient referral. Hospital outpatient referral was avoided in 55/135 (41%) patients. In 20/83 (24 %) patients who were subsequently referred, the speciality to which the patient was referred was changed as a result of the MRI, ensuring more appropriate initial referral. Twenty-three of 54 (43%) general practitioners have said that they have changed their request pattern for plain radiographs now that they have direct access to MRI. We have shown MRI to be valuable to the general practitioner for patient management decisions and so we recommend that MRI should be available to general practitioners by direct access.