The lead article in this issue of the JDMS is the culmination of the work of an intersocietal task force, with representatives from 16 organizations, which led to the revision of the “Scope of Practice and Clinical Standards for the Diagnostic Medical Sonographer.” The last revision of the scope of practice, endorsed by 5 organizations, was approved by the Sonography Coalition in 2000. Since that time, sonography has undergone significant changes that have affected that scope. In 2000, medical sonographer was not a recognized profession; the scope of practice was written for the “diagnostic ultrasound professional.” Technologic improvements in ultrasound equipment have dramatically enhanced image quality and workflow. The breadth of the contributing organizations shows how much more widespread the applications of sonography are. Users of the equipment have expanded from the traditional sonographer to almost all medical specialties and specialists, who provide focused examinations for specific diagnoses. Indications for sonography have also expanded, as it has become a primary diagnostic imaging modality and is now the first choice of imaging for a variety of diagnoses. Keeping up with these changes and appropriately reflecting today’s community standards of care has necessitated this revision of the professional scope of practice and clinical standards.
While the general outline of the document has not changed significantly, the content has. The description of the profession has been expanded to reflect current practice; it notes that the diagnostic medical sonographer is not an independent practitioner but the “delegated agent of the physician”; and it specifically mentions the ALARA principle (“as low as reasonably achievable”). Increased emphasis has been placed on the need for demonstrating competence through appropriate certification. Patient evaluation and assessment provide specific practice standards to be met. Quality of care and quality improvement measures are all in their own section. Sonographer self-assessment and education are addressed in section 3, and section 4, ethics, has been added as a separate section. The appendix provides formal definitions of the terms used in the document. What has not changed in 15 years is the overriding role of the diagnostic medical sonographer to act in the best interest of the patient at all times. I hope that you will take some time to read this new “Scope of Practice and Clinical Standards,” become familiar with it, and incorporate it into your daily routine and clinical practice.
Phillip J. Bendick, PhD, RVT, FSDMSEditor in Chief, Journal of Diagnostic Medical Sonography
