Demand for temp techs hints at growing turf battle

An increased demand for vascular ultrasound technologists and interventional technologists parallels an increase in the number of peripheral vascular disease cases and minimally invasive procedures. It could also signal a growing turf battle among radiologists, cardiologists, and vascular surgeons.

In 2003, the demand for ultrasound/vascular technologists at Med Travelers, a temporary staffing agency based in Irving, TX, was 11%. Just three years later, that figure rose to 22%. Even more dramatic was an increase in the need for interventional techs, going from 1% in 2003 to 19% last year. All the while, the demand for x-ray techs has dropped, decreasing from 29% in 2003 to 13% last year.

"There has been increasing interest in the diagnosis and treatment of peripheral vascular disease," said Dr. Mario J. Garcia, director of noninvasive cardiology at the Cardiovascular Institute at Mount Sinai Hospital, NY.

Garcia noted several trends that contribute to the increased interest in PVD:

• Clinicians are treating PVD much more aggressively today than in the past, when they would treat only those with severe symptoms.

• CT has the ability to define the disease much better.

• The tools to treat PVD are more effective, including revascularization through mechanical devices, stents, and bypasses.

• More physicians are capable of treating the condition.

It's the last trend that leads Dr. Levon Nazarian, an associate professor of radiology at Thomas Jefferson University, to label the widespread interest in PVD as a turf battle. Peripheral interventions traditionally have been done by radiologists. But now more cardiologists and vascular surgeons are creating their own vascular labs, and performing the imaging and interventions, Nazarian said.

"As imaging looks more attractive to support one's income, it comes down to turf," he said. "I'd be surprised if it weren't the primary reason for the increased demand for vascular and interventional techs."

Few technical barriers exist to doing vascular ultrasound. Many ultrasound machines can be retooled to perform vascular studies, and echocardiography techs can be cross-trained to perform vascular studies. A lab needs only one vascular tech to be accredited, according to Larry D. Waldroup, a registered technologist and manager of the Jefferson Ultrasound Research and Education Institute.

While vascular ultrasound may be the first imaging test for peripheral vascular disease, patients generally go on to have CT scans. A complete vascular study can be performed quickly with a relatively small amount of contrast and interpreted in 3D reconstructed images.

In the Med Travelers survey, the number of temporary CT techs in demand has been erratic over the last four years, going from 16% in 2003 to 8% to 7% and finally rising again last year to 10%. While the overall use of CT in radiology has risen considerably, more and more cardiology practices are also getting into CT imaging, Garcia said.