News from WFUMB: Ultrasound physician extenders lend hand to busy radiologists
When several offsite ultrasound rooms opened simultaneously, the caseload for radiologists at the University of Michigan, Ann Arbor became too burdensome to manage. They trained two experienced sonographers as physician assistants, or ultrasound practitioners, to triage and dictate cases from the main hospital site.
The success of the first year of the program exceeded expectations: Most dictated reports were completely acceptable, with a negligible incidence of patient callbacks, according to lead investigator Dr. Ronald O. Bude, a radiologist at UM.
?The ultrasound practitioners allowed us to increase radiologist productivity in a manageable way, with existing staff,? Bude said at the 10th Congress of the World Federation for Ultrasound in Medicine and Biology in Montreal on Monday.
Training included one week of observation only and four weeks on the job in close proximity to the radiologist. Trainees also underwent a mock oral board exam, scoring a mean of 70.8, better than 25% of residents, Bude said.
One ultrasound practitioner per day autonomously monitors hourly cases from three to four offsite technologists via a PACS, requesting additional images and video clips as needed to ensure a complete examination. Ultrasound practitioners do not give autonomous verbal reports to be acted on medically, and a radiologist is always available for consultation as needed.
The practitioner dictates provisional reports using voice recognition equipment. At day?s end, a radiologist comes in to review all cases, which usually takes about an hour, Bude said.
?It?s like internal moonlighting,? he said.
Radiologists also graded each dictated report: · A: completely acceptable · B: minor change required, not affecting patient care · C: moderate change required, affecting patient care · D: major change required, substantially affecting patient care
For the study duration of 36 weeks, the mean number of patient exams triaged per day was 19.2 (3396 patients/177 days). Nearly 95% of dictated reports were category A, 4.9% category B, 0.4% category C, and none were category D.
Only one patient callback was required to satisfactorily complete a study.
?I'd pick an ultrasound practitioner over our best resident any day,? Bude said.
The pay is 10% more than the highest paid sonographer, according to ultrasound practitioner Teena Hayes.
?I know it?s not much, but it?s what I want to do,? she said.
