Apocalypse Now! Nonradiologists performing most US-guided procedures

The Increasing Role of Nonradiologists in Performing Ultrasound-Guided Invasive Procedures

Journal of the American College of Radiology (November 2013), 10 (11), Complete, pg. 859-863

Richard E. Sharpe; Levon N. Nazarian; David C. Levin; Laurence Parker; Vijay M. Rao

In this American study, data shows that as of 2010 non-radiologists were doing more ultrasound guided procedures than radiologists.  The decreasing cost, increasing resolution, and better portability of US machines has made POCUS available to almost all areas of clinical medicine.  (Hello psychiatrists!  Have you tried transcranial doppler on your patients yet?)

In Canada there has been ferocious opposition to some clinical specialties using POCUS, particularly in the emergency department.  This is a bit of a surprise to our American colleagues where radiologists have been more accepting or at least apathetic about ED docs messing with sound waves.  Fair remuneration from insurers is the bigger obstacle South of the 49th.

This article makes it clear that the horse is out of the barn.  It’s time to stop the blind opposition to POCUS use and develop a more collaborative relationship where we can benefit from each other’s knowledge and resources.  There is plenty of room to better integrate POCUS and other diagnostic investigations to complement each other.

As an aside, we ED docs really need to let go of our inferiority complexes. The terms “formal ultrasound”, “comprehensive ultrasound” are really misnomers when distinguishing POCUS from radiology department scans.  POCUS is not informal nor is it not comprehensive for the clinical question it addresses.
 
Click here for more on procedures at EM Cases: Jamie Blicker on Emergency Procedures