Re: Newsweek article
From: Allen Worrall (jworrall@alaska.net)
Wed Sep 25 10:01:52 2002
This seems like a very balanced and detailed article and presents both sides
of the argument very well.
Allen
Joseph A Worrall MD RDMS
OB/GYN Ultrasound at the Fairbanks Clinic
Fairbanks, Alaska, USA
jworrall@alaska.net
http://www.obgynsono.com
> ----- Original Message -----
From: Terry J DuBose
To: Multiple recipients of list ULTRASOUND
Sent: Wednesday, September 25, 2002 4:35 AM
Subject: Re: Newsweek article
Unfortunately, it isn't just this one article... these are as persive as
are the studios. Check this article out in our local paper this morning:
http://www.ardemgaz.com/ShowStoryTemplate.asp?Path=ArDemocrat/2002/09/25&IDAr02902
This is not going away... Terry J DuBose, M.S., RDMS
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'Keepsake' trend worries doctors
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Ultrasounds being used for pictures
--
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DEMOCRAT-GAZETTE STAFF AND WIRE REPORTS
Kasey Cathey of Sherwood is just a few weeks away from her due date. She
had ultrasounds at her doctor's office when she was eight weeks pregnant and
again at 20 weeks. Her insurance does not cover additional ultrasounds, so
she went to Baby Views in Little Rock to see her unborn son at 36 weeks.
"I wanted to see how he's doing," Cathey said, "and make sure he's
healthy."
Shea Foster, owner of Baby Views, said women see her for a variety of
reasons, including determining a baby's position and sex and just to have
pictures for relatives and scrapbooks.
At a doctor's office, ultrasounds are used for medical diagnoses.
Early in pregnancies, Foster said, "they are seeing if it is viable"
and whether there is more than one baby. "At 20 weeks they are screening for
birth defects and measuring growth. In the third trimester they check the
well-being of the baby, if the mother or child is under stress, and if the
mother has gestational diabetes" and make other diagnostic tests.
Cathey's session lasted about half an hour, as Foster pointed out
everything from each chamber of the heart to each tiny toe. Cathey's
husband, A.J., and sister Leesa Stephenson, also of Sherwood, watched with
unwavering attention while the videotape rolled. They left with their video
of the whole experience, three still photographs and, most important, peace
of mind as the big day draws near.
Cathey is one of many new parents rushing to take advantage of advances
in ultrasound imagery. The trend raises some controversy. Some of the new
technology makes the images - once grainy and incomprehensible - sharp
enough to show fetuses' facial features clearly.
The latest ultrasounds have medical uses, like checking for Down's
syndrome or other abnormalities. But to many mothers, they are starting to
look more like devices for getting their first snapshots of the baby.
Fueling consumer interest, General Electric Co. in May kicked off one
of its largest marketing investments ever, touting a new "4-D" ultrasound
with striking magazine ads and TV spots on cable channels. While all
ultrasounds bounce the sound waves off the body to generate an image, the
newer 3-D and 4-D ultrasounds also build a threedimensional image that
doctors can manipulate to get a 360-degree view. The 4-D machines show fetal
movements in close to real time. So the experience is more like watching a
home movie.
'REASSURANCE' IMAGES
As compelling images emerge, doctors say they are getting besieged with
requests for "reassurance" ultrasounds that are not medically necessary and
can cost $300 or more. Baby Views, in contrast, charges up to $125 per
session.
Insurance companies typically cover only one ultrasound during a
pregnancy.
Jamie Sandage, who sets appointments at Medical Park Women's Clinic in
Benton, said the office receives many phone calls from women who want a 4-D
ultrasound.
"We even get calls from out of state," Sandage said, but added that "we
only make appointments for established patients."
Sandage said most of the women who call want better pictures of their
babies, not medical diagnoses.
Dr. J. Richard Doss, an obstetrician at the clinic, said it is tempting
to perform reassurance ultrasounds because insurance companies "keep raising
rates and lowering reimbursements."
"There are a lot of outside pressures to supplement income," Doss said.
"It is hard to care for someone with Medicaid because Medicaid will not
reimburse whether it is [a highrisk pregnancy] or not."
For example, Doss explained that a pregnant woman with diabetes is
considered high-risk, but Medicaid does not cover the extra care needed to
ensure a safe pregnancy.
Ethically, Doss questions the use of medical equipment used purely for
entertainment.
"There is something about being a physician that makes me feel uneasy,"
Doss said, "but as long as the technicians are certified and they are using
quality equipment, there is no harm done."
Dr. Kemp Skokos, an obstetrician at The Woman's Clinic in Little Rock,
said literature seems to indicate there is minimal risk with ultrasounds.
"This is kind of a new thing, and I don't have any strong feelings
about it," Skokos said. "But I can see [potential] problems with it.
"I would agree that [ultrasounds ] are not meant for entertainment,"
Skokos said. "It opens up the question on all kinds of machines."
PORTRAIT STUDIOS BOOMING
Meanwhile, fetal-portrait studios, like Baby Views, are booming.
Fetal Fotos, founded in 1994 in Salt Lake City, now operates five such
stores around the country, and is opening more during coming months.
Many women send videos to relatives who live far away or screen the
tapes at baby showers.
Although there are no known adverse health effects, many doctors
discourage patients from getting more than one ultrasound because of the
lack of long-range studies and the prospect that false findings may lead to
unnecessary and invasive follow-up tests.
"Ultrasounds are a medical procedure and shouldn't be used for
entertainment purposes," said Lawrence Platt, past president of the American
Institute of Ultrasound in Medicine.
In 1994, as doctors were starting to explore new applications of the
technology, the U.S. Food and Drug Administration issued a warning letter
saying that using ultrasound equipment for "keepsake" fetal videos is "an
unapproved use of a medical device" and shut down some portrait studios. A
spokesman said the FDA is looking into the practice as such studios "appear
to be cropping up again."
Foster of Baby Views said there is no law against her business ; there
are just "people making a commotion over nothing."
Leon Hansen, who founded Fetal Fotos, said he got the idea from his
experiences delivering 250 babies a year. "You can do a 2-D ultrasound and
in 10 minutes see what you need medically," he said, "but that is not enough
for most people."
Fetal Fotos said it conforms with FDA guidelines and provides "limited
medical information," showing, for instance, that the baby is alive and
moving, its position, where the placenta is located, and the baby's sex. But
Fetal Foto technicians don't give diagnoses. If a technician spots something
that looks abnormal, the woman is told to get a clinical ultrasound.
Foster, a sonographer for 12 years, said that if she sees something in
the ultrasound that might indicate a problem with the fetus, she does not
tell the client, but contacts the woman's doctor. She requires her customers
to sign a waiver with her physician's information. The waiver also states
the ultrasound is not for medical diagnoses.
"If I saw something that concerned me, I would not say [to the mother]
everything is fine," Foster said. "If I see a clean bill of health, I don't
have a problem telling them that.
"It is not my place to say something is wrong," Foster said, "But at
the clinic, I do." She is a sonographer at Arkansas Women's Center in Little
Rock, where sonograms range from $130 to $300, and is a member of the
American Registry of Diagnostic Medical Sonographers. Information for this
article was provided by Amy Dockser Marcus of The Wall Street Journal and
Stephanie Harris of the Arkansas Democrat-Gazette.
This story was published Wednesday, September 25, 2002
On Tue, 24 Sep 2002 23:01:24 -0500 joshua copel <joshua.copel@yale.edu>
writes:
> I did speak to her. She interviewed me last week while preparing the
>
> article. She was pretty on target with her approach and told me that
> the
> story was shrinking as she wrote it because there wasn't much to
> say.
> Definitely wasn't trying to sell or promote the Fetal Foto outfits.
>
> While I haven't seen the article yet myself, it sounds like the
> message
> we all would want to get out there about scans for entertainment was
>
> included. Don't think they would do much follow up unless a more
> acute
> story breaks.
>
> Josh Copel
>
