ULTRASOUND Messages for December, 1997: Re: ob protocols

Re: ob protocols
From: Terry J. DuBose (tjdubose@juno.com)
Mon Dec 29 11:55:21 1997

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I would not feel good about scheduling patients every 15 minutes (OB or otherwise). I can do a complete OB examination in 15-25 minutes SCANNING TIME on a normal fetus (depending on age, 18 weeks typically takes less time than a 36 week fetus), but that does not include patient history, set up and turning the room around for the next patient. We are dealing with humans here. What happens when you find an abnormal fetus? Do you just backup the next 3-4 patients while you try to figure out a tetralogy? A 15 minute schedule might work if you are assuming every patient is thin and every fetus is normal, but then why do the exams at all?
You are correct that it is the physician's ultimate responsibility, but a lawsuit can name anyone who touches the patient. I have been involved in one legal case (GB not OB, and the jury found in our favor), but it was the sonographer (me), not the physician, who spent 3 days in front of the jury while the lawyers tried to make it sound like we beat the woman up, took her money and tossed her out the back door! If the physician is going to insist on a 15 minute room turn-around, I would get the protocol in writing and in detail. Otherwise, I would let the physician do the entire exam, including room turn around. I am a skilled professional with considerable education and experience, and not a handmaiden.
One question, do you deal with a population in which there is an extremely high rate of no-shows? That might be a mitigating circumstance. Good luck. Peace, Terry J. DuBose, M.S., RDMS
On Sun, 28 Dec 1997 16:13:53 -0500 DeCorah <mtmkdeco@capital.net> writes: >Our hospital has recently hired a "fetal medicine"
>specialist who will be consulting with area
>obstetricians on high risk pregnancies, etc.
>Our radiologists will continue to read Ob
>cases that our not specifically designated
>to this specialist.
>The fetal medicine specialist has asked that we
>schedule his patients every 15 minutes and that we
>take limited images. He will also scan
>every fetus himself or observe while we do so.
>
>This is a BIG change for us.. we are used to
>taking several images and then taking them to the
>radiologist for review. The radiologist will
>come back to see the patient only if he feels a
>strong need to do so.
>I am thrilled that we now have a physician that is
>willing to take time with each patient (and he is truly a
>caring person which makes this service even better).
>
>Our concern is that we will not have any documentation
>of the exam other than the six images he wants
>us to take. I've talked to him about the
>ACR's accreditation process and the documentation
>that they looked for on our studies when we went through
>our review before he was hired. He
>is willing to add a few more images to what we
>document but still wants
>us to schedule patients close together.
>We realize that in this situation he is ultimately taking
>responsibilty but we still feel very uncomfortable with this situation.
>
>I'd appreciate any feedback, is anyone out there
>performing OB exams under similar circumstances?
>SHould we change? He doesn't look at our
>films at all,since he's looked at the fetus himself,
>just wants to see the measurements we got.
>Or should we insist on complete documentation?
>TIA, Terry DeCorah
>

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