As the term point-of-care ultrasound becomes part of popular vernacular to those of us in the medical community, it's important to consider what the phrase really means and how it is shaping the way physicians practice medicine. Portable or compact ultrasound systems are becoming smaller and the technological improvements are awe-inspiring, the industry has grown tremendously since the day of the clunky Siemens Elegra™ or refrigerator-sized Acuson 128/XP™, both of which can be found as refurbished ultrasound equipment, but just because the new systems are smaller and simpler to use, can any health care provider really be trained on ultrasound technology, how to scan, and most importantly how to decipher anatomy and pathology in just a few weeks?
Ultrasonographers attend several years of school to learn ultrasound physics and anatomy, interpret ultrasound artifact from anomalies and study the technologies offered on various ultrasound systems. After their initial schooling the advanced sonographers sit for boards and specialize in areas of cardiology, vascular, breast, etc. As point-of-care ultrasound increases there are unanswered questions: Who is responsible for this training? Who is monitoring their core competencies? Who is liable for a misdiagnosis?
According to the AIUM guidelines for physicians who use and interpret ultrasound, clinicians must have experience with at least 300 ultrasound cases within three years to become proficient in discerning anatomy, be versed in ultrasound technology, and gain experience in what is normal versus pathology. In addition, they must demonstrate one of the following:
- Completion of a residency program with three months of ultrasound training
- Certification in breast ultrasound by the American Society of Breast Surgeons
- Successful completion of the Endocrine Certification in Neck Ultrasound (ECNU)
- Completion of training in "Focused Assessment with Sonography for Trauma (FAST)" as recommended by the American College of Emergency Physicians (ACEP
- Successful completion of one criteria in "Training Guidelines for the Performance of the Musculoskeletal Ultrasound Examination"
- Successful completion of one criteria in "Training Guidelines for the Performance of Ultrasound Examinations in the Practice of Urology
There is a complete list of AIUM guidelines for ultrasound that were approved November 5, 2011. For health care providers who are currently proficient with ultrasound you can contact United Medical Instruments, Inc. for refresher courses on your existing ultrasound system, to train a new staff member who is a licensed sonographer, or to purchase ultrasound equipment.