Radiologists, Develop Point-of-Care Ultrasound Training

CHICAGO - Point-of-care ultrasound has become ubiquitous in medicine, from emergency departments to OB and trauma surgery. But that doesn’t mean it’s taking the modality away from radiologists.

In fact, radiologists should be the ones guiding its training and promotion – not bemoaning and pushing back on the trend.

“Radiologists are not involved in ultrasound education and promoting its use in point of care or elsewhere, but it would be nice to have more involvement,” Michael Blaivas, MD, an emergency medicine physician and past chair of the American College of Emergency Physicians ultrasound section, said during a presentation at RSNA 2012 this week. “It’s better to be seen as proponents of an application, guide it, and help with it, especially an application that is seen as critical at the bedside.”

Radiologists are the ultrasound imaging experts, Blaivas said, and should be the first to share their expertise. The specialties shouldn’t be fighting each other, he said, but working to make sure the modality thrives for all clinicians. If radiologists were more involved in teaching, they could ensure quality in its use.

“There really is a need for ultrasound education, and this is somewhere we can meet,” he said.

Five years ago, radiologists were less concerned about other specialties moving in on the ultrasound turf. There was a shortage of radiologists, perhaps too few to do ultrasound, and the focus was on high-end imaging like CT and MRI where reimbursement was higher, noted John Cronan, MD, FACR, chair of the department of diagnostic imaging at Brown University School of Medicine.

Today, he said, radiologists are “working feverishly to protect our income,” and the profession faces threats of commoditization with the rise of teleradiology and service-live imaging.

Although ultrasound is likened to the stethoscope in its extension of the physical exam, Cronan noted, it’s used by many, understood by few.

Developing a curriculum to teach ultrasound to medical students is challenging, said John Pellerito, MD, North Shore University Hospital in Manhasset, NY. Detractors say there’s a lack of appropriate training, standards and documentation. Plus, radiologists are busy and don’t have time to teach ultrasound to medical students.

But ultrasound skills can provide great benefits to medical students, Pellerito said. It allows them to really explore and reinforce concepts in anatomy and physiology and enhances the physical examination. It’s considered a core clinical skill across many specialties.

“There should be standardized curriculum, and radiology should be involved in developing it for medical schools,” he said.