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Re: Sonographers, supervision & HCFA From: Joshua Copel (joshua.copel@yale.edu) Thu Dec 25 08:48:07 1997 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: ellison r marshall: "New Zealand" Previous message: Roberta Speyer: "OBGYN.net WEEKLY UPDATE" Reply to: RE> Sonographers, supervision & HCFA Folks, please relax about all this stuff, especially HCFA and practices at other hospitals! I don't like the HCFA regs either, and I have written a letter to them urging that ultrasound revert to "general" supervision, rather than "direct" supervision. The address is in the regs at the web site originally posted a couple of weeks ago, and they will accept comments until 5 PM 12/31. Report times and lost films are probably the responsibility of JCAHO. AIUM accreditation does require information about report times, we expect virtually ALL reports within 24 hours, with a standard to call the responsible practitioner immediately for abnormals. We can't control who tells the patient the results & when. That is a matter of practice style, even though we may all on this list agree that patients should be told of significant abnormal results immediately. The problem situation for sonographers, as I have been repeatedly informed by sonographers, is that they do sonograms, but do not make medical diagnoses. So, we stilll need a physician to consider the differential diagnosis and determine correct disposition/management. I definitely do watch our sonographers do scans ("breathing down their backs"), and I expect them to observe me, and especially the more junior MD's, for everyone's benefit. Yes, I push them to identify anatomy they didn't know they could see, or to get Doppler signals from vessels they weren't sure they could identify. That is part of their professional growth. I do believe that, for Ob sonography, the best practice is for no patient to leave the sonography room without an MD seeing the sonogram live or obtaining images personally. Patients appreciate it and it just makes sense. Josh Copel ------------------------------ Date: Wed, 24 Dec 1997 04:18:58 EST ------------------------------ From: DRoss38040 <DRoss38040@aol.com> -- ------------------------------ I understand what you are saying....we have this situation in New York City, too. But is the alternative to having no doctor, having a doctor breathing down your back? And I am sure you take your work and responsibilities seriously enough to call somebody if you see an ectopic pregnancy. I have worked independently... Too much independence is a big problem as you are saying.... but too little is bad, too. Believe me! Your situation is just what Dr. Copel is talking about. This is definitely an abuse of the patient's inability to complain. But don't you think they went overboard to remedy this situation? And does their new regulation take into account that these doctors will no longer service these patients and so they will have to do without? Or go to the emergency room! The All-Too-Real (her name is DIANE) DIANA ROSS RT,RDMS Next message: ellison r marshall: "New Zealand" Previous message: Roberta Speyer: "OBGYN.net WEEKLY UPDATE"

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