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Re: Endovaginal in 1st trimester _ Janet's commentsFrom: J. L. Tomko RDMS (buddy@redrose.net)Mon Mar 9 09:39:59 1998
>QUESTION: If we start all TVS at the perineum & insert ourselves, we see >the urethra go into the bladder & theoretically would not miss this >particular problem. Could TVS be superior in this case of a large simple >cyst. Makes sense in a doctor scanning atmosphere but in a sonography clinic and or radiology setting this is havoc on a schedule in event full bladder views needed. Time contraints alone make it easier to start with T/A and follow through with T/V. BTW all our gyn obtain T/V as part of the study unless virginal, under 18 and parent not aware of sexual activity and cases of geriatric severe atrophic vaginitis where transperineal is attempted. In thinking this recent thread through [IMHO] radiology/sonography oriented labs are more fearful of litigation and in event of a lawsuit not performing both might be construed by a jury as lack of care. My hospital job has this too...the radiologists are usually second guessing everything in more of a legal sense and run-on dictations of all possible differentials end up on the final report. Obviously frustrates the referring doctor when 8 differentials are included. Kind of toss the ball to the next player scenerio. In my other work situation (non-supervised but all video) I document and over-scan as if each case would be going to court. Also more written documentation in event of technical limitations such as stated above. Makes one a tad neurotic. I will attempt to find a recent article of a sonographer that has become an expert legal witness and her thoughts on the litigation issue. It is enlightening to see I am not alone in this TA/TV dilemma. If the ob/gyn is doing the scanning there is a personal relationship from repeat patient visits that is not as likely with radiology/sonography labs and might make a legal case less likely. Fodder for thought.
Janet
> Agree!
-- Ephrata Community Hospital National Imaging Systems, INC 717.390.5212
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