Re: sonographers right to give information to patient
From: James S Smeltzer MD (gaperina@mindspring.com)
Tue Mar 30 06:15:10 1999
Paula,
I did not look at where you are. I know the MFM sonologists at St Peters
and they are among the best in the world. With this kind of talent around,
why are the radiologists reading OB US? No wonder they have a bit of a
complex!! LOL
Jim Smeltzer MD
At 10:12 AM 3/25/1999 -0600, you wrote:
>I don't think there is a single "correct" response to this situation,
>and I don't think it is a sonographer vs. physician issue. This is a
>dilemma sonographers face when they are caught between conflicting needs
>and expectations--those of the radiologist and those of the patient.
>
>Many radiologists will only give results to the referring physician. The
>patient's own physician then discusses the report with the patient. If
>the practice in question prohits the sonographers from discussing the
>results of an abdominal sonogram with the patient, it is not
>inconsistent to prohibit sharing the results of an obstetrical exam as
>well.
>
>The difference from the obstetrical patient's perspective is that, under
>most circumstances, she comes in expecting normal results, and the lack
>of information creates anxiety. Would the radiologist be willing to
>step into the room before the patient leaves and say a few reassuring
>words before explaining that the referring physician will discuss the
>details at her next scheduled visit?
>
>Working in a perinatal practice is very different. When we introduce
>ourselves to the patient, we explain that we are sonographers, not
>doctors, and that the specialist will come in when the exam is completed
>and discuss the results with the patient. We are then free to explain
>what we are doing. When a patient asks me if everything is okay, I
>respond that I'm not the doctor, but I haven't seen anything out of the
>ordinary. However, I tell her, my opinion is not the one that
>matters--she really needs to raise these questions when the doctor comes
>in. We do tell the sex of the baby if the patient wants to know.
>
>I do not give the patient any abnormal results, but I don't lie and say
>everything is fine if I know that's not the case. Unfortunately,
>keeping quiet sometimes give the patient a false sense of security. I
>admit to feeling like I've in some way betrayed the patient after I've
>built a rapport and then the doctor comes in and drops a bombshell.
>
>What are other sonographers' experiences, from both radiology and OB
>settings?
>
>At Wed, 24 Mar 1999, roger sanders wrote:
>>
>>I just recieved this letter from a sonographer I trained. I am away from
>>my files. Can anyone help?
>>"today we were told by one of our Radiologists not to tell the patient
>>the sex of the baby. And to keep
>>our narrative while scanning the fetus VERY GENERIC. And we can't tell
>>them how far along they are, even if the measurements are equal and they
>>are intelligent people and they can read it on the screen, while we
>>measure!!!.I am having heart failure, but keeping my cool. I have to
>>present the sonographer's point of view at the next Radiologist QA
>>meeting, so Ineed ammunition. If you could just steer me to the right
>>journals for articles concerning the importance of the bonding between
>>parents and fetus and maybe an article
>>about the sonographer's role. I just haven't kept up with all the
>>journals. Is there any way you could help me??"
>
>--
>Paula S. Woletz, MPH, RDMS, RDCS
>University of Medicine and Dentistry of New Jersey/
>St. Peter's University Hospital
>New Brunswick, NJ
>woletzps@umdnj.edu
>
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