Guidelines for Qualifications of Neurodiagnostic Personnel: A Joint Position Statement of the American Clinical Neurophysiology Society, the American Association of Neuromuscular & Electrodiagnostic Medicine, the American Society of Neurophysiological Monitoring, and ASET – The Neurodiagnostic Society

Response to Letters to the Editor by Gregory J, Rice K, McCarthy K, et al. 2023 Regarding: “Guidelines for Qualifications of Neurodiagnostic Personnel: A Joint Position Statement of the American Clinical Neurophysiology Society, the American Association of Neuromuscular & Electrodiagnostic Medicine, the American Society of Neurophysiological Monitoring, and ASET—The Neurodiagnostic Society”

“…We read with interest the comments by Gregory et al Letter to the Editor 1 regarding the Guidelines for Qualifications of Neurodiagnostic Personnel (GQNP). 2 We recognize that Gregory et al 1 may not be aware that the process to produce the GQNP was long and involved the active and dedicated participation by many very experienced members of four Clinical Neurophysiology societies. Many extensive meetings occurred over several years with continual input by each society's representatives and required approval of the final document by each society's governing body before publication.…”

“…In the summary, we state our intentions: "This document suggests job titles, associated job responsibilities, and the recommended levels of education, certification, experience, and ongoing education appropriate for each job." 2 We also state that "The quality of patient care is optimized when neurophysiologic procedures are performed and interpreted by appropriately trained and qualified practitioners at every level. ", 2 clearly identifying the intended audience.…”

“…However, this is designed to be a trainee position and therefore requires a higher degree of supervision as listed in the original document, 2 whereas the Neurodiagnostic Technology Specialist I IONM performs many of the same tasks with less supervision needed because of the attainment of their credential and experience as is the case for all of the Specialist level positions included in the GQNP document. 2 In developing these guidelines, we recognized that a variety of practices exist; thus, our general approach was to develop these with a generous degree of flexibility. We also understand that guidelines are recommendations intended to optimize patient care.…”

“…In addition, under "Experience," we state that "Before practicing independently, this physician should have completed the number of studies outlined below under supervision for which privileges are being requested," which is 100 for IONM. 2 The IONM field has advanced sufficiently, especially in remote monitoring and supervision that these recommendations are reasonable and attainable. This is well within the AMA policy that IONM "constitutes the practice of medicine" and that it be performed by a physician "trained in, or who has demonstrated competence in, neurophysiologic techniques and is available to interpret the studies and advise the surgeon during the surgical procedures."…”

“…Neurodiagnostic Job Descriptions and Competencies for intraoperative neuromonitoring (IONM) were last published by ASET in 2016. 2 Those descriptions are cumbersome in…”