Technologists drive quality in medical imaging


As a radiologist, I interpret thousands of imaging studies every year. Of the millions of medical images that have crossed my screen, they all have one thing in common. They were all acquired by a technologist in the radiology department.

Imaging technologists perform a vital role in medicine. All have specialized training that is unique and critical to patient care. Truth be told, many of them have a greater knowledge base and skill set regarding the technical components of image acquisition in their specific parts of the radiology department than I and many of my physician colleagues do.

As health care technology has evolved, physicians have become progressively more dependent on medical imaging. Radiologic studies that cost hundreds and many times thousands of dollars have become commonplace with many providers ignorant to the role that imaging appropriateness and quality have on diagnostic accuracy. A low-quality study or one ordered for the wrong reason has the potential to increase uncertainty and medical costs by generating vague information, but a high-quality examination ordered for the right reason can save a life.

Consider one of the most common diagnoses I encounter, appendicitis. When I was a child, it would have been diagnosed primarily by physical exam. The CT scanner markedly improved our diagnostic capability, but children are more sensitive to the radiation associated with such scans. Not only can a highly-trained CT technologist with the appropriate equipment reduce the radiation to the child while still providing a diagnostic image, but a skilled sonographer can avoid the costs and radiation associated with CT altogether by finding the appendix with ultrasound.

Ultrasound is the most operator-dependent modality in the radiology department. While the understanding that many patients have of ultrasound is limited to obstetrics, ultrasound evaluation plays a much greater role in the assessment of acute illness, blood vessel evaluation, and high-resolution imaging of abnormalities just below the skin than many realize. Performing an ultrasound is much more complicated than merely setting a probe on the patient and pushing a button. The sound waves have to be uniquely calibrated to each and every patient. This can only be done with precise technical coordination, knowledge of anatomy, and extensive practice. It can also be physically demanding, as sonographers must often take their imaging equipment to the patient. I should disclose that my regard for ultrasound technologists is a bit biased by my personal relationship with one. I must also admit that it was her passion for the profession, attention to detail, and concern for patient well-being that made me fall in love with her.

I read hundreds of MRIs every month, but it is the MRI technologists who manage the safety risks that come with the powerful magnetic force of the machine. With new types of MRI studies invented every year, they must constantly learn and relearn how to acquire exams while minimizing scanning time, preventing patient motion that degrades the images, and satisfying radiologists and ordering providers who have high expectations.

Medical procedures that radiologists perform can be uncomfortable and anxiety-provoking. It is the technologist who sets up the sterile environment, distracts the patient with conversation, guides the radiologist with an imaging tool, and provides essential reassurance to the patient. In this way, the technologist can have an enormous role in patient satisfaction and safety.

As Medical Ultrasound Awareness Month comes to a close and National Radiologic Technology Week approaches, I encourage patients, physicians, and nurses to take time to thank our technologists for their contributions. More importantly, please listen to them and respect their expert ability to suggest the correct exam for the clinical question asked. High-quality health care is only achievable if we work together as a team, and our technologists in the radiology department have only the best interests of patients in mind. To my technologist co-workers, I thank you on behalf of my fellow radiologists. We can’t do our job until you do yours, and it is a fantastic job that you do.

Cory Michael is a radiologist.

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