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Re: New Generation of SonographersFrom: DuBose, Terry (DuboseTerryJ@uams.edu)Fri Apr 28 15:58:19 2006
I just have to join into this foray. While it is true that there are many without proper education performing sonography, it includes physicians and non-physicians, not just sonographers. I will address sonographers, who are not "techs", but educated sonographic anatomists. In the USA before 1992, many physicians were still fee-for-service; and they and the sonographers worked as a diagnostic team. We would scan, and then discuss the case with the physician. If needed the physician could walk in and watch the scan, or she/he could scan. However, in large institutions, with many machines, the sonographer that has become intimate with the various models can get the optimal images faster than a physician that simply does not have time to master all the various models. That being said, there is more to the story. In 1992-1994, the Clinton administration was working on a universal insurance program that was never fully defined. During that time those against "universal health coverage" were running "Harry and Louise ads <http://www.sourcewatch.org/index.php?title=Harry_and_Louise_ads_defeat_ health_care_reform> " on TV; with Harry reading the paper, "Louise, it says here if the Clinton health care plan goes through, the government will be telling us which doctor we can go to." The next ad would have Louise reading the paper, "Harry, it says here that if the Clinton health care plan goes through, the government will be telling our doctor how to practice medicine." Various permutations of the ads went on for weeks before the mid-year legislative elections. While the medical community rung their hands watching to see what Washington was going to do to medicine, the corporate culture gobbled up most of health care; and now we have corporations telling patients which preferred providers they can see, and telling physicians which diagnostic tests they can order... exactly what everyone was saying they did not want. In addition, the corporations in their drive for larger profits are demanding more "through put", leaving less time for a sonographer (or anyone) to do a considered examination. We are doing more and more cases with fewer resources, spending less time with each patient. Sonographers, nurses, physicians, and all in medicine are caught in this cycle. I have come to the conclusion that Corporate Medicine has reduced the Hippocratic Oath to "Your money, or your life!" And please do not refer to sonographers certified by the American Registry for Diagnostic Medical Sonography (ARDMS) as 'techs", we are SONOGRAPHERS. The ARDMS is nearing 50,000 certifications, and in the last year has begun board exams for Interpreting Vascular Surgeons (http://www.ardms.org/aboutardms/news.htm#pvi), at the surgeons' request. In addition, the American Board of Vascular Medicine has requested the ARDMS administer their exams. The ARDMS is the only diagnostic imaging certification that has been accredited by the ISO (International Organization for Standardization) and ANSI. The ARDMS certifies individual's world wide, not just in North America. They have administered their certifications in West Africa, China, and are in discussions with other national medical communities. The ARDMS is the most respected credential for sonographers/sonologists anywhere. Just my 2 cents. Terry J. DuBose, M.S., RDMS, FSDMS, FAIUM Associate Professor & Director Diagnostic Medical Sonography Program University of Arkansas for Medical Sciences, CHRP 4301 West Markham St. Mail Slot #563 Little Rock, Arkansas, 72205 USA 501-686-6510 DuBoseTerryJ@UAMS.edu http://www.uams.edu/chrp/sonography/ http://www.obgyn.net/us/panel/panel.htm http://www.io.com/~dubose/ --------------------------------------------------------------- ________________________________ --------------------------------------------------------------- --------------------------------------------------------------- From: ultrasound@obgyn.net [mailto:ultrasound@obgyn.net] On Behalf Of Rizwan Sent: Friday, April 28, 2006 2:50 PM To: Multiple recipients of list ULTRASOUND Subject: Re: New Generation of Sonographers Nowell, I think we are up against two separate issues here. One, increasing number of incompetent techs and two, reluctance to work. For the first I believe that its a matter of percentage. In any given profession at any given time, only 10% are good to excellant whereas 90% are average to below average. And that the number of good ones will become smaller and smaller in comparison to the exponentially growing numbers of below average ones. Now if there were only 25 below average techs in your area 25 years ago, the number must have exponentilly increased to 2500 by now and that is what gives an impression of deteriorating standards although their proportion with good ones has not changed. For the second I believe that the Western world itself is to blame. Its clearly an imbalance between rights and duties primarily vouched by unions and insurance companies. I come from an asian background where pace of work is much faster, for many arguable reasons. But to my frustration I was forced to work at ameboid pace in the americas because the radiologist sitting in the office next door didnt want to see more than a certain number of films. My manager told me that enhanced work speed would jeopardise the quality of work. I said to her "you monitor the quality while I work at my pace" but she wont let me do that since it would spoil the work atmosphere. Honestly Nowell, you'll agree that in a us exam if you dont pick up anything in first 5-10 minutes it is quite unlikely that you will, if you keep scanning for another 30 minutes. Either there is nothing or you are not good enough to pick it. However I agree with the comment that ultrasound techs have much more responsibility as compared to other techs in healthcare. But the answer is not a higher salary. To me personally, it is a physicians job. Because it is "while" scanning that you make a diagnosis, not after. It is unfair to ask a person of less than physicians status to comment on lesions and appearances that he has not had enough teaching on. And it frustrates me even more when I see that most radiologists just counter-sign the statement prepared by sonographers. Best regards Haider On 4/28/06, Joe <forcep@intercom.net> wrote: Any good suggestion? Why yes , have them read about the fall of the Roman Empiure and other great past nations. Joe C
NOWELL ONA wrote:
> True, new generation have different ethics and more patients that they
> any difficult ultrasound exams.
>>forget the "generation factor". Current generation has difference
>>>have noticed and heard the decline of quality in sonographers. I'd
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