Reflections in Real Time : Radiology, News

ARDMS’s Single Physics Examination

Daniel Merton — Tue, 24 Jun 2008 13:32:00 GMT

In case you haven't heard, the American Registry for Diagnostic Medical Sonography (ARDMS) has announced that starting in Spring 2009, a new Sonography Principles and Instrumentation (SPI) examination will be made available. Before all of you who are already certified have a panic attack, I'll state up-front that active registrants who hold the RDMS, RDCS or RVT credentials do not need to take the SPI examination in order to maintain your current credentials.

In the past, there were three different physics examinations: The Ultrasound Physics and Instrumentation (UPI) exam was for applicants who wanted to earn the Registered Diagnostic Medical Sonographer (RDMS) certification; the Cardiovascular Principles & Instrumentation (CPI) exam was for people who wanted to become a Registered Diagnostic Cardiac Sonographer (RDCS) and the Vascular Physical Principles & Instrumentation (VPI) exam was required to obtain the Registered Vascular Technologist (RVT) credential. The rationale behind having three different physics and instrumentation exams was that echocardiographers and vascular technologists needed to be tested more on issues related to Doppler ultrasound and technologies used for those sub-specialties, where as general sonographers (i.e., those holding RDMS credentials) did not need to be tested too heavily on Doppler physics and instrumentation.

The new SPI exam will replace the three existing physics-related exams so that, in the future, applicants will only need to take and pass one physics exam and a specialty exam to become certified.

What the ARDMS did was to remove from the existing CPI and VPI exams any content that was specific to the RDCS and RVT credentials and place those questions on their respective specialty exams. Thus, the 2009 versions of the individual specialty examinations will include some physics and instrumentation questions that are unique to that specialty. Test items that were considered necessary for practitioners in all three credentials were incorporated into the SPI exam.

Given the fact that Doppler ultrasound is used so frequently during virtually all sonography examinations, I think having a single physics exam makes a lot of sense. Furthermore, once the SPI test is available, individuals who are new to the field will only be required to take the SPI exam as opposed to three different physics-related exams which will likely reduce their anxiety as well as save them the time required to study for and take the exam (not to mention a few bucks).

It sounds to me like a win-win situation for all, but I'd love to hear what you think about it.

To read more about the SPI exam visit the ARDMS website.

Sonographer Salaries On the Rise

Daniel Merton — Tue, 10 Jun 2008 18:53:00 GMT

I recently received the results of the Society of Diagnostic Medical Sonography's 2008 Sonographer Salary and Benefits Survey. Every few years the SDMS does a survey and provides its membership with the results---it's a nice benefit of being an SDMS member.

The results contained in the 87-page survey are rather detailed with data provided based on geographical regions, worker ages, types of compensation (hourly, salaried, per diem, etc) and other variables. In addition to compensation, the survey covers such areas as sonographer demographics, work settings, certification, education and job satisfaction. I can't go into too many details regarding the survey results, but I would like to share a little of the information. If you are an SDMS member and you have not received an email offering it to you, the complete survey can be downloaded from http://www.sdms.org/.

The survey indicates that the median salary for sonographers in 2008 is just under $67,000, having increased from about $62,000 in 2005 when the last survey was done. It probably comes as no surprise to learn that the vast majority (87%) of sonographers are female and the percentage of sonographers who are over 50 years of age is increasing.

Sonographers who are in the top salary levels tend to hold several certifications (e.g., RDMS, RVT, RDCS) than those who only hold a single certification. The survey also confirms that most sonographers are employed in hospitals, followed by physician offices (19%) with the third largest practice setting being outpatient clinics (16%). The average number of scans performed per day is 10, with the majority of respondents indicating they perform between six and 15 scans a day.

The SDMS Salary Survey is an impressive body of data that is likely to be beneficial to individual sonographers (e.g., when they want to ask for a raise), as well as to administrators that need to know how their compensation packages stack-up to other employers in their areas. The reported salary increases, job security and employment opportunities available to sonographers and vascular technologists as described in this important document will hopefully also encourage more individuals to pursue a career in DMS.

Bubbles are Back!

Daniel Merton — Fri, 16 May 2008 12:41:00 GMT

A change in the labeling of Definity and Optison is the direct result of concerted efforts by the echocardiology community.

Chalk one up for the good guys! In a rare move, the United States Food and Drug Administration (FDA) has agreed to relax its warning about the possible risks of the two commercially available ultrasound contrast agents, Definity and Optison. In October, 2007 the FDA required the agents to carry a "Black Box Warning" which placed significant restrictions on the use of the agents. Many members of the ultrasound community, particularly cardiologists, questioned the validity of the FDA's decision and felt that the restrictions were not warranted.

Thus, a concerted movement was initiated to objectively assess the safety of contrast. One study, which was presented at this year's meeting of the American College of Cardiology, compared the outcomes of patients who received contrast-enhanced echocardiography studies to patients who did not need to receive contrast. Of the nearly 18,000 individuals who received contrast injections, none experienced an adverse event within 30 minutes. Another compelling report was published in the March issue of the Journal of the American College of Cardiology: "Acute Mortality in Hospitalized Patients Undergoing Echocardiography With and Without an Ultrasound Contrast Agent".

Although the product's package inserts will still have black box warnings, the FDA has eliminated a ban on giving the agents to acutely ill patients, such as those with congestive heart failure (many of which are the very patients that need contrast-echocardiography studies the most). The Feds also changed the requirements for monitoring patients that receive contrast. The previous warning had called for monitoring all patients for 30 minutes after they received contrast, but the new warning only requires monitoring of patients with pulmonary hypertension or unstable cardiopulmonary disease.

The cardiology community should be applauded for their successful efforts to convince the FDA to relax its restrictions. Furthermore, the FDA should be praised for its willingness to right a wrong. Both of these actions will now allow cardiology professionals to resume performing contrast-echocardiograms and enhance (pun intended) the care of cardiac patients.

Lantheus Medical Imaging is the distributor of Definity. Read more about the FDA's labeling requirement here: Lantheus Medical Imaging, Inc.,

Minimally Trained but Maximally Utilized

Daniel Merton — Tue, 13 May 2008 20:18:00 GMT

At this year's Annual American Institute of Ultrasound in Medicine conference, Dr. Brian Garra of the University of Vermont School of Medicine and long-time sonographer advocate made scientific a presentation entitled "Scan Protocols for Use by Nonmedical Personnel in Developing Countries: Organ Visibility and Reproducibility Evaluation."

It described preliminary work that involved the use of volume sonography performed by minimally trained individuals. The concept of the study was that a "non-imaging person" could be trained to perform screening volume scans on low-cost equipment.

To test this idea the researchers developed four scanning protocols (thyroid, gallbladder, renal, and female transabdominal pelvis) that consisted of 4 to 6 volume sweeps. Individuals who had no imaging experience received a 20-minute training session on each protocol and then they scanned each other using surface anatomy to guide where they placed the transducers. The scans were then evaluated by a panel of sonologists to determine the completeness of the scans in terms of organ visualization and for image quality.

What Dr. Garra's group found was that organ visibility was excellent for the thyroid and gallbladder scans but visualization was less optimal but usually adequate for renal diagnoses. Visibility of pelvic organs was good, but (as might be expected) it was dependent on the degree of bladder distension.

The conclusion of the study was that individuals who only received minimal training could perform screening sonography scans.

For very practical purposes this model could be used in rural areas of the world where the availability of sonography services (or any diagnostic imaging services for that matter) is severely limited. The volume scan data could be sent via teleradiology for interpretation and a report could be issued back to the provider who, in turn, might be asked to obtain additional images or provide the patient with medical advice.

This is clearly an untraditional method of providing medical diagnoses and the concept was not embraced (to put it mildly) by some in the medical community. I suspect some sonography professionals feel threatened by the idea of having any Manny, Moe and Jack perform scans, and I do not blame them for feeling that way. A majority of sonographers take their responsibilities very seriously and have devoted a lot of time and expense to become skilled.

However, what the study described above is really proposing is not to replace or obviate the need for skilled sonographers to perform focused diagnostic examinations, but to expand the availability of services into areas that are in dire need (at least for now) of screening purposes.

For these applications I believe the time is right and the concept noble. After all, expanding the utilization of sonography to improve healthcare for everyone on the planet is what it's all about. Considering the recent disasters in Asia, the need for sonography services performed in this fashion may be more important and vital than ever.

A New Electronic Leash

Daniel Merton — Tue, 29 Apr 2008 14:56:00 GMT

Remember the days when the sonographer could go off on portables (toting a bundle of film cassettes) taking their own sweet time to wander around the hospital, do a few cases in the intensive care units, chat with the floor nurses and colleagues they met in the hallway or admire the view from the top floor of the hospital (at least that's what I've heard other people did...).

Then came healthcare reform and budget cuts, which forced all of us to do more with less staff, not to mention the dreaded pagers the schedulers could use to track us down and tell us there was another portable case added on. Those pagers were the first generation of "electronic leashes" that could yank us back to our responsibilities.

Later, cell phones were implemented to summon the stray sonographer. Fortunately, caller ID allowed us to choose which calls we decided to answer, but by and large the cell phone enhanced communication between the base station (sonography lab) and the roaming professionals both within as well as outside the hospital setting (e.g., on-call).

Now, there are new tracking tools, and the damn things are turning our very own beloved technology against us!

They're called ultrasound positioning systems. These tracking devices can be utilized in hospitals to monitor the locations, in real-time, of patients (so the nursing station would know when Mr. Jones is on his way back to the unit) as well as medical equipment (i.e., ultrasound scanners being used for portable procedures). Obviously they have other uses outside of medicine too.

The Sonitor system uses wireless detectors and "tags" that are linked to a digital file containing all vital statistics and information about the device or person being monitored. The tag uses ultrasound waves to transmit a unique identification signal to detector. The detectors transmit signals over an existing local area network (LAN) to a central computer that stores the information about the tag's location and the time of receipt of the signal. The system is reported to be 100 percent reliable in its ability to track the location of equipment and people (patients or professionals).

Oh well, no more lally-gagging when you're out on those portables. But just think of how useful a tracking system like this could be to monitor where your teenagers are going and how long they spend at the party on a Saturday night!

See why ultrasound is used and how theses systems can be utilized in a hospital environment here: Why Ultrasound for Indoor Positioning Systems?

The AIUM's EER Issues an RFP to Help Professionals Help Patients

Daniel Merton — Thu, 17 Apr 2008 19:50:00 GMT

As sonographers and vascular technologists, it is in our interest for the medical community (as well as the general public) to recognize the benefits of our examinations. This includes the potential and real benefits diagnostic sonography offers as compared to other more costly imaging modalities such as CT or MRI and/or modalities that utilize ionizing radiation like X-ray, nuclear medicine and angiography.

Thus, I was very happy to learn that the American Institute of Ultrasound in Medicine's Endowment for Education and Research (EER) has issued a Request for Proposals (RFP) for investigations into the costs, accuracy, risks and benefits of sonography compared to other imaging modalities. This is, to my knowledge, the first targeted initiative that the EER has ever undertaken.

In case you are not familiar with the EER, it is an AIUM member-funded endowment designed to support critical research in the field of ultrasound imaging. According to the AIUM's web site, "The fund provides investigators from all disciplines of diagnostic ultrasound with an opportunity to further their professional development and secure the most promising future for ultrasound in medicine."

Each year the EER awards up to $10,000 to four individual projects. Since its inception in 2001, nearly $300,000 has been awarded by the EER for ultrasound education and research.

The new EER RFP is called "Study of Ultrasound Compared to Other Imaging Modalities," and has a deadline for submissions of July 1, 2008.

For this special project, the EER will award up to $50,000 for investigators to evaluate the costs, accuracy, risks and benefits of ultrasound compared to other imaging modalities. Proposals are expected to address decision analyses regarding a specific disease entity, body region or patient symptom. In addition to the potential cost benefits of sonography, radiation exposure (or lack there of) can also be addressed.

Basically, the purpose of the EER's RFP is to encourage investigators to evaluate and uncover the potential costs and/or safety benefits of sonography for use in initial evaluations or follow-up of patients with specific indications.

Examples of possible projects would be:

To compare the use of ultrasound-guided breast biopsies to needle localizations using mammography.
To compare the use of musculoskeletal sonography to MRI for rotator cuff tears.
To determine if intra-operative ultrasound imaging can reduce the need for pre-operative CT for patients with liver metastases.

The results of projects such as these will not only demonstrate how sonography can be employed more cost effectively, but also to expand the use of the modality to the point that its use becomes the standard of care. When and if that happens it will enhance sonography's standing as a diagnostic modality, save valuable healthcare funds and ultimately improve patient care. After all, that's what it's really all about.

More information including a list of criteria and submission forms can be found on the AIUM's EER website.

[Full Disclosure: I received an EER award in 2006 for my project "Enhancing Awareness of the Diagnostic Medical Sonography Professions: A High School Outreach Program." I am also a member of the AIUM's EER Committee and am on the AIUM Board of Governors.]

CARE Bill is Making Progress

Daniel Merton — Fri, 04 Apr 2008 13:03:00 GMT

The Society of Diagnostic Medical Sonography recently announced that the "Consistency, Accuracy, Responsibility and Excellence in Medical Imaging and Radiation Therapy" (CARE bill; Senate 1042) recently passed the Senate Health, Education, Labor and Pension (HELP) Committee. This step is an important milestone in the SDMS' effort to pass this major legislation.

The specific wording of the CARE bill states:

"To amend the Public Health Service Act to make the provision of technical services for medical imaging examinations and radiation therapy treatments safer, more accurate, and less costly."

I have written before about the CARE bill in a previous blog. According to recent SDMS news release, the Senate Finance Committee has expressed interest in the bill's provisions because of the potential cost savings from a reduction in repeated studies. The bill is expected to not only reduce the cost of medical services by reducing the number of repeat examinations, but it is also expected to require credentialing and education standards for sonographers and other imaging professionals.

Thus, it would likely improve the overall quality of care. That can only mean good things for patients, as well for as those sonography providers who are fulfilling their roles in terms of delivering high-quality patient care. Meanwhile, those providers doing sub-standard services may be looking at problems down the road. I'll keep you updated as the CARE Bill advances through the oh-so-sluggish legal process.

Click here to read more details about the CARE bill.

A Valuable Web-based Tool For Us All

Daniel Merton — Mon, 31 Mar 2008 14:11:00 GMT

Several years ago the topic of one of my ADVANCE for Imaging and Radiation Therapy Professionals articles was a hypothetical "eBay for Healthcare." In that column I described how potentially useful a feedback feature would be for patients to be able to learn about how previous patients were treated by a particular healthcare facility or provider.

Here is a snippet of what I wrote:

One of the most useful aspects of the auction site... is the "feedback" section. Here, buyers and sellers can indicate, in 80 characters or less, their experience with a deal. For example, sellers can indicate how quickly the payment was received and buyers can indicate if the item was accurately described in the listing. Also, before placing a bid on an item, prospective bidders can review the seller's feedback left by previous buyers to determine if the seller has a good or bad track record. ... The feedback component contributes to each party being held accountable for their actions on the auction site.

Well, it appears that the hypothetical scenario I described back in 2003 has become a reality. The federal government recently launched the Hospital Compare Website where patients can describe their hospital experiences and read about the experiences of others. The site is designed to help patients compare the quality of care hospitals provide and empower them to make educated decisions.

There are several useful sections on the site, including a survey results section where patients can read what other patients say about the care they received in a hospital. There are also dedicated sections that describe patients' rights and a "Hospital Checklist" that includes questions that prospective patients should consider before they go to the hospital. Other areas provide information that hospitals voluntarily submit from their own medical records about the treatments their patients received. You can search for and compare hospitals based on certain conditions or procedures, as well as by geographical locations.

Hospital Compare was created through the efforts of the Centers for Medicare & Medicaid Services (CMS) and the Hospital Quality Alliance (HQA). It includes data that was collected by hospitals from a random sample of patients between October 2006 and June 2007. The amount of data provided is quite impressive, and it can take some time to navigate through it all to in order to get the answers you are seeking. This isn't surprising given that the site was developed by the federal government (if you've ever tried to obtain information about government grants or visited other ".gov" sites you'll know what I mean).

While I would like to take credit for coming up with the concept of such a patient-advocate site (do you think some CMS bureaucrat read my eBay article in ‘03?), I suspect it was born as a logical and worthwhile tool to allow the public to determine how well a particular hospital is doing and to enable them to make educated healthcare choices.

An obvious additional benefit to us all (as former or future patients) is that hospitals will need to constantly improve their quality of care or risk receiving "bad feedback" and lose both their reputation within the community as well as future patients' business. I would encourage you to take a look at the website--if not now--then definitely when you or a loved one needs to choose a hospital.

Personal Laptop or Sonography Scanner?

Daniel Merton — Wed, 26 Mar 2008 16:41:00 GMT

"Simply attach the probe to your laptop computer using a standard USB cable, install the software and you're ready to scan."

That's the latest approach to providing highly affordable sonography scanners; ones that convert any personal laptop into a diagnostic sonography system by having all the necessary hardware in the probe itself. The hardware, which is supplied with the required software and usually operates on any PC, only costs a few thousand dollars.

The concept of the personal laptop computer-based scanner dates back to the year 2000, when Terason introduced its first commercially available system utilizing "ultrasound-system-on-a-chip" technology. Since then, thousands of their scanners have been shipped throughout the world.

More recently, an Apple MacBook Pro laptop has been the foundation for Siemens Medical Solutions' own version of the ultra-portable, battery-operated scanner. The Acuson P50, as its called, has a number of proprietary echocardiography and vascular calculation capabilities as well as an integrated stress echo package. Thus, the system can be used for not only the usual diagnostic exams but even for more advanced applications, which would make it attractive to a wide range of users. However, the P50's ultrasound hardware cannot be removed from the laptop, which makes the overall size of the system significantly larger and more expensive than a standard laptop system.

The latest versions are virtually indistinguishable from your run-of-the mill laptop computer (except for the transducer attached via the USB port) and a lot less expensive than previous versions. The systems don't require any super-computer capabilities. In fact, I've heard that, in some cases, any device that has a USB port can be used as a scanner.

There are probes for all typical sonography applications including vascular, echo, abdominal, endovaginal and endorectal scanning, as well as probes with biopsy guidance capabilities. Units that are currently available have all the usual modes of operation and other features you expect to find on a diagnostic scanner, including color and spectral Doppler, tissue harmonics, calculation packages and memory for image storage.

The obvious advantages to these are that you can choose to use your laptop for all the usual reasons (ie, word processing, Web browsing, emails, presentations, etc) and, when necessary, plug in the transducer and scan away.

Of course, this does raise some concerns over who will have access to the technology. However, aside from the relative low-cost of this approach, this isn't necessarily any worse than what's happening with other hand-carried scanners or even the 4D ultrasound units used for keepsake purposes. It will remain to be seen how the FDA regulates the sale of these systems.

There are several manufacturers producing this type of equipment. For more information, click on any of the links listed below.

MUSL Laboratories

Ardent Sound, Inc.

Direct Medical Systems

Laborie Medical Technologies

And You Thought You Were Finished Taking Tests…

Daniel Merton — Tue, 26 Feb 2008 13:07:00 GMT

The American Registry for Diagnostic Medical Sonography (ARDMS) has recently announced that they are in the early stages of developing a recertification process for its registrants. In other words, sonography professionals that are ARDMS registered will, at some point in the future, be required to "...demonstrate continuing competency..." over and above just obtaining the requisite CMEs as we do now. Yes--to answer the question that immediately comes to mind--in all likelihood this means that we'll have to take some type of recertification examination, or two or three.

A major factor in this decision was the need for the ARDMS to meet the expectations of the accrediting organizations who's standards the Registry is expected to maintain [i.e., the International Standards Organization (ISO) and the National Commission for Credentialing Agencies (NCCA)]. Then, of course, there is the issue of patient care.

The primary goals of recertification for medical professionals are to improve patient care, to set standards of practice, to encourage continued education and to reassure patients and the public that we remain competent throughout our careers. We're all aware of the current rate of advances in technology and practice of sonography. Thus, as painful as becoming recertified in the future may be (and we do not know what exactly the process will involve), I must admit that it is not only appropriate for sonographers, but necessary to ensure that those who are certified are, in deed, competent to be doing sonographic examinations. But that recognition will not be the Novocain we need to take away the sting of having to continuously prove our competencies in the future.

There are many recertification models utilized for medical professionals. In some cases there are "grandfather clauses" while other models offer "limited recertification" to those who do not deal directly with patients (e.g., educators, administrators). Thus, it would be premature for us to conclude that the process developed and implemented by the ARDMS will necessarily be a "one-size-fits-all," painful and expensive endeavor.

We'll just have to see what they propose and voice our legitimate concerns when the opportunity is provided (which, knowing how the ARDMS conducts business, I am sure will happen). Furthermore, recertification is not going to happen over night so there is always the possibility that we'll reach retirement before its enacted!

I could regurgitate what the ARDMS has disclosed in their recent communications but it's easier to just let you read it for yourselves. You can read the latest ARDMS press release, available on the ARDMS homepage.

Only in the Movies?

Daniel Merton — Tue, 05 Feb 2008 18:00:00 GMT

The new comedy "Juno" about a young woman with an unplanned pregnancy has been the recent focus of several on-line discussions in several sonography forums for its apparently negative depiction of an "ultrasound technician." Some sonographers have suggested we launch a letter-writing campaign in protest.

I'll confess that I haven't seen the movie and probably won't, but word has it that it was nominated for three Golden Globes and four Academy Awards. Not paying much attention to the GGs, AAs or any other pat-ourselves-on-the-back movie award ceremonies, I haven't a clue as to whether it has already (or will in the future) win anything, and I don't personally care. Can you tell I'm not much for movies? I spend enough screen-time in front of a computer or ultrasound scanner to want to do more in my free time. But I digress...

For those who haven't heard about or seen the movie, the basic premise is that 16-year-old Juno MacGuff, a virgin, gets pregnant the first time she has sex with her boyfriend (also a virgin). The couple weigh their options; but, eventually, unable to go through with an abortion, Juno decides to give the baby up for adoption. She finds a couple who cannot conceive through the want ads. As Juno spends more time with the adoptive parents-to-be, she realizes that their marriage isn't quite as picture-perfect as it first appeared.

Based on the movie reviews, there are many portrayals which will likely make pro-choice advocates cringe. The scene where Juno gets a sonogram conveys it as a bonding experience and adoption is depicted as "the heroic option."

So now to the issues that Juno presents in terms of the portrayal of "ultrasound techs":

As one forum poster noted:

"First off, they used the word ‘technician'---I don't know about anyone else, but that term makes me crazy!!! Secondly, the sonographer is cold and judgmental. They could have portrayed the sonographer as compassionate and used the opportunity to show what an amazing experience the exam can be for the expectant mom and her family."

Someone else who posted on the forum found the script of the sonogram scene at www.imdb.com. I'll include it here so you can draw your own conclusions before I give you mine. BTW---Leah is Juno's best friend and Bren is her stepmother:

Ultrasound Technician: Well, there it is. Would you like to know the sex of your baby?
Leah: Yes!
Juno: No!
Leah: Pllleease!
Ultrasound Technician: Plenty to be surprised about when you deliver.
Juno: Well, you know, I want Mark and Vanessa to be surprised, and if you tell me, I'll just like, totally ruin it.
Ultrasound Technician: Are Mark and Vanessa your friends at school?
Juno: No, they're the adoptive parents.
Ultrasound Technician: Oh. Well thank God for that.
Bren: What's that supposed to mean?
Ultrasound Technician: Well, it's just that I see a lot of young mothers come through here, it's obviously a poisonous environment for a baby.
Juno: Wait a minute! How do you know it'll be such a poisonous environment! How do you know Mark and Vanessa wont be some, crazy, whacked out pedophiles or something?
Leah: Or stage parents?
Bren: They could be utterly incompetent. There's no guarantee they'll do a better job raising this child than my dumbass step-daughter will... What is your job title?
Ultrasound Technician: I'm an ultrasound technician.
Bren: Oh yeah? Well I'm a nail technician and I think we both ought to just stick to what we know.
Ultrasound Technician: Excuse me?
Bren: Oh, you think you're hot *** 'cause you get to sit over there and play pictionary, well guess what? My five-year-old daughter could do that and let me tell you, she's not the brightest bulb in the tanning bed. So until you have your own kid, why don't you just go back to night-school in Manteno and get a real job.
Juno: ...Whoa Bren!

Not such a "positive bonding experience" if you ask me!

Another post on a sonographer forum read:

"It's a movie. As long as sonography is unregulated then we have no basis for complaint. Anyone can buy a machine and set up as a fun for-profit business with little or no medical oversight. A nail technician has more legal requirements for being able to practice than an ultrasound technician in most places. I have seen and worked with horrific ultrasound technicians who often did insult patients. Whether they were aware of their poor communication skills is another topic. It's called life."

Sad but true. Without knowing the full context of the script or having seen the movie what bothers me about the exchange above (besides the "technician" label) is that the healthcare worker (to use the term loosely) is interjecting her own personal values on the patient's situation.

Having worked in a fertility office for many years, I learned to recognize the fact that what some patients want to do (not to mention the types of patients we saw) often didn't match what I felt was "right." Many of us find ourselves in similar situations where we have to scan a patient that drank themselves into such a severe liver disease state that they now need a liver transplant, or there's the vain patient with breast implants who complains about all medical professionals being "incompetent" because she's sprung a leak. However, when I encounter patients whose beliefs don't match my own, I don't let it change how I treat them or what I say to them. They have their own reasons for wanting an abortion, a child or an implant and I respect that.

I believe one characteristic of a true professional---which by definition sonographers are not but I think we should at least play the part (pun intended)---is having the ability to separate personal values and attitudes from our responsibility to provide proper and optimal care for all patients regardless of their economic status, looks, race, age, gender, sexual orientation, attitudes, etc., etc., etc.---but that's just me.

What do you think?

I Need a New Job

Daniel Merton — Fri, 11 Jan 2008 21:43:00 GMT

There have been a lot of discussions on various sonography forums and sites about sonographers and sonography students looking for ways to find a job. Fortunately, the current employment situation is favorable, and sonography professionals can pick and choose from a wide variety of locations and working environments (hospitals, free standing clinics or ultrasound system manufacturers to name a few). Choices range from exotic foreign countries and popular vacation spots like Hawaii to the hospital in their own home town. Furthermore, for those willing (or desiring) to travel, there are always opportunities to work for temporary employment agencies.

Wherever you would like to work, one of the easiest ways to search for a job is no further away than your computer terminal. Of course, if you are reading this you are already on a computer, but perhaps you don't know where to begin your search.

A quick internet search will undoubtedly yield a large number of sites where you can find lists of employment opportunities. A good place to start would be ADVANCE's Careers section: http://health-care-jobs.advanceweb.com/main.aspx

You can also access websites of specific hospitals, corporations and other places of employment which often will include their own lists of job openings. Good luck in your search!