Let's All Jump on the Ultrasound Bandwagon: Further Debate on the Use of Ultrasound

Abstract

No imaging technique is more popular or more in demand than ultrasound. But should it be considered a specialist technique to be employed only by highly trained professionals or as a readily available tool to be used by many? This paper will discuss some of the implications of having ultrasound performed by a range of individuals and will emphasize the importance of training and regulation.

The long and winding road to achieving professional registration for sonographers

“…As a radiography-allied specialty, sonography practice was the pioneer of roleextension, particularly in its reporting role (4,12,17). Although the SCoR and the RCR were still having problems as late as 1998 with independent reporting (18), widespread sonographer reporting was adopted despite this.…”

“…In the UK ultrasound investigations now comprise over twenty two percent of all diagnostic imaging examinations (1). Despite the large number of scans performed each year, there remains no statutory regulation of the practice of sonography in the UK, and although there are many practitioners who are regulated as professionals in their primary area of practice, there are others who are not (3,4,24). Many in the field consider that this should change, and are working to obtain professional status for the practice of sonography (2,3,4,5).…”

“…Hevey (29) further argues that individuals or groups can often have the characteristics of professionalism without the formal recognition and identity of a profession. Some consider that sonography practice in the UK is in this position, particularly as in several countries such as the United States of America (USA), sonography practice is a regulated profession (3,4). This is a complex area with many issues involved, but arguably the reasons for this would appear to be, as Hevey discusses in relation to professionalisation generally, rooted more in historical, organisational and political contexts, rather than in any tangible defining characteristics (29).…”

“…As a relatively new area of medical diagnosis, the practice of sonography falls into this specialist category, with unsuccessful attempts to obtain recognition as a profession in an area where a variety of groups of established professionals are already using the technique as a diagnostic tool. In addition to core imaging specialists, sonography is practised widely by clinicians and healthcare professionals with the skills to perform ultrasound examinations in order to provide answers to specific clinical questions and expedite patient treatment (4,32). These professionals would not perceive any advantages to limiting the practice of ultrasound to a defined group of registered sonographers, and may have concerns that their scanning could be curtailed (3).…”

“…This raises concerns as to whether the public is appropriately protected (2). Whilst the person performing the scan may be registered as a professional in another field, and working within their own scope of practice, this registering body may not have confirmed the individual's level of training or competence to perform an ultrasound scan, because it is not necessarily part of the remit of that professional registering body (4,37). Alternatively, the person performing the scan may not be registered with any regulatory body, as is the case with many vascular technicians, echocardiographers, and science graduates who have directly entered their working life as a sonographer.…”