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Re: FW: ULTRASOUND digest 2879From: Terry DuBose (terrydubose@sbcglobal.net)Sat Apr 11 20:46:15 2009
From: Joan P Baker <jbakerbaker@comcast.net> Subject: FW: ULTRASOUND digest 2879 To: "Terry DuBose" <terrydubose@sbcglobal.net> Date: Saturday, April 11, 2009, 5:49 PM I do not know if this made it Terry but you can post it if it did not Joan -----Original Message----- From: Joan P Baker [mailto:jbakerbaker@comcast.net] Sent: Saturday, April 11, 2009 3:47 PM To: ultrasound@obgyn.net; 'Multiple recipients of list ULTRASOUND' Cc: DuboseTerryJ@uams.edu; DuboseTerryJ@exchange.uams.edu Subject: Re: ULTRASOUND digest 2879 Few understand how we got here in the first place. Around 1973 I went to the United States Office of Education (USOE) to create the Diagnostic Medical Sonographer. The first step in this process was to approach the Council Allied Health Education and Accreditation (CAHEA) which at the time was a branch of the AMA. A branch of this was the Manpower Division and they had the responsibility for approving the creation of occupations in AH and determining the requirements to enter a new field AH. AT this time they were about to be dissolved and did not want to create any new occupations and in fact were ordered/decided that new occupations had to be put under existing occupations. Sonography was to be put under radiology.. Ultrasound turf wars were at their height at the time. Dr.Gil Baum was AIUM president and an ophthalmologist he played a key role in making it possible for me to get into the hallowed halls of the AMA since I was not an MD. At the same time junior or community colleges had just been formed and were hurting for offerings and programs. So a deal was struck in return for us being formed under a community college system we got to have a separate occupation. It was not an automatic. We had a lot of hoops to jump through and no promises were made to us, although we had to be willing to make them. Dr. Ralph Kuhli was the head of CAHEA (predecessor to CAHHEP). Interesting there was one other group trying to ride our coat tails and they were the "Pump Techs" A.K.A perfusionists (open heart surgery). I took a moment to look them up on the CAHHEP web site. It was interesting to see they have not made much progress either in changing their educational requirements, especially when you realize the patient's life is in their hands while they have the heart stopped. The trials and tribulations JRC DMS experienced recently when they considered leaving CAHHEP is an illustration of the vice grip and difficulty that AH has in doing what they want and feel is right for their Profession. Everything has a price that must be paid, just like Art Fougner, MD said "No good deed goes unpunished". SO this was not failure of Sonography or myself to understand or want it to be a profession, it was a situation that I had very little control over. I either played my cards and take advantage of a situation that Dr Gil Baum made possible or walk away with nothing and an uncertain future for Sonography as we know it today. The likely future would have been to become a sonographer you would have to be an RT first and they are still trying to get the CARE bill passed. So I look at all these developments with some interest and amusement as to how they are interpreted. Some like to be a Monday morning quarter backs or you can say hindsight is always 20/20. You should have been there, the presentation to USOE put 10 years on my life. I felt the weight of responsibility on my shoulders, to get funding so that students could get loans to go to school to learn ultrasound. (the main reason for accreditation) If you had asked me in 1974 if Sonography would not be licensed or require a BS degree I would have laughed at you, I was so certain it would be, but here we are no or only a little further ahead. YES we need to celebrate NM and try to make more states write GOOD bills but not x-ray machine operator bills like the RT's have to live with. There is nothing worse than a bad Bill. Even no Bill at all is better than a bad one.. Joan Baker Perfusionist Occupational description A perfusionist operates extracorporeal circulation and autotransfusion equipment during any medical situation where it is necessary to support or temporarily replace the patient’s circulatory or respiratory function. The perfusionist is knowledgeable concerning the variety of equipment available to perform extracorporeal circulation functions and is responsible, in consultation with the physician, for selecting the appropriate equipment and techniques to be used. Job description Perfusionists conduct extracorporeal circulation and ensure the safe management of physiologic functions by monitoring the necessary variables. Perfusion (extracorporeal circulation) procedures involve specialized instrumentation and/or advanced life-support techniques and may include a variety of related functions. The perfusionist provides consultation to the physician in the selection of the appropriate equipment and techniques to be used during extracorporeal circulation. During cardiopulmonary bypass, the perfusionist may administer blood products, anesthetic agents, or drugs through the extracorporeal circuit on prescription and/or appropriate protocol. The perfusionist is responsible for the monitoring of blood gases and the adequate anticoagulation of the patient, induction of hypothermia, hemodilution, and other duties, when prescribed. Perfusionists may be administratively responsible for purchasing supplies and equipment, as well as for personnel and departmental management. Final medical responsibility for extracorporeal perfusion rests with the surgeon in charge. Employment characteristics Perfusionists may be employed in hospitals, by surgeons, and as employees of a group practice. They typically work during the week and are frequently on call for emergency procedures on weekends and nights. They also may work in an on-call system, depending on the number of perfusionists employed by the institution. According to the American Society of Extra-Corporeal Technology (AmSECT) , the average base salary for a recently graduated perfusionist is $50,000 to $63,000; for a certified perfusionist with 2 to 5 years experience, $65,000 to $75,000; 6 to 10 years experience, $69,000 to $90,000; and chief perfusionist, $80,000 to $100,000. Educational programs Length. Programs are generally 1 to 4 years in length, depending on the program design, objectives, prerequisites, and student qualifications. Certificate programs require that applicants have a bachelor’s degree. Prerequisites. Prerequisites vary depending on the length and design of the program. Most programs require college-level science and mathematics. A background in medical technology, respiratory therapy, or nursing is suggested for some programs. Curriculum. Curricula of accredited programs include courses covering heart-lung bypass for adult, pediatric, and infant patients undergoing heart surgery; long-term supportive extracorporeal circulation; monitoring of the patient undergoing extracorporeal circulation; autotransfusion; and special applications of the technology. Curricula include clinical experience that incorporates and requires performance of an adequate number and variety of circulation procedures. This can only be a good thing. I have heard some people get upset about this. Their attitude seems to be: How dare ANYONE require that I actually be regulated to perform this intricate and difficult exam! I've been doing this X years and that is just good enough. Who needs education? A degree doesn't make me scan better. Who needs lab accreditation? Being credentialed doesn't make me Scan better. Who needs anyone saying anything about anyone? Pooh, we don't need no stinking oversight! I just laugh because to me it shows the limitations in thinking. When we limit ourselves we deny ourselves the ability to advance and provide choices for our future. Instead of flying, we'll be stuck toadding along in the dark. Unfortunately because sonographers have failed to demand national education and credentialing requiremenets we have abdicated the responsibility to others. We have no one to blame but ourselves. I feel that if we, as sonographers, don't start stepping up to the plate and regulating ourselves to a high standard, 4 year education and credentialing, we will stay right where we are. The Advance Practice Sonographer is still a bit of a joke, in my opinion. The same discussions are being held today as they were 10-15 years ago. Nothing much new or different there. Why? Because many experienced sonographers refuse to admit that a bachelor degree is important for recognition in the greater world. People seem to be looking out for themselves only and not the future profession. There comes a time when either you must change or the world will change without you. Be part of the solution or part of the problem. If you don't want to work for change, or actively work against the change, then get out of the way and let people who will get on with the work. At least the SDMS saw that they MUST change their official stance or once again be left behind in the process. Audrey Fleming BHSc, RT (R), RDMS, RVS
"DuBose, Terry" <DuboseTerryJ@uams.edu> 04/07 6:28 AM wrote:
> ------------------------------ I recommend that you become part of the solution then by actively ------------------------------ participating in the development of the future Sonography requirements. Be -- ------------------------------ aware that there have been some very educated and dedicated people working on these issues for some time. It won;t happen overnight and you must take into consideration the entire group of individual Sonographers in their current educational status as well as those who may join us in the future. Does the profession of Sonography require a BS degree in terms of knowledge to perform the required exams...and does having a BS degree help you scan patients better if you not have the eye/hand/brain coordination to perform these scans? Will having the BS as a requirement for the future help to elevate the profession in the eyes of government regulators/MD's/Insurance payors....Yes. Let's do it in a way that protects all Sonographers who are currently Registered through grandfathering and continuing educational requirements. Consider that in m! any states basic nursing does not require a BS or continuing educational standadrs to practice. Good luck from a Sonographer of 37 years.
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