Sonography In The XXI Century

Reframing the sonographers role, from the perspective of technologist to "Practitioner", in the presence of busy Sonologists and the costs of the health care system, is an issue many of us want to address and define.

The events that developed with the idea of “The Sonographer Practitioner”, have redesigned and reoriented our current position in the health care priorities. This poses significant challenges for our newly emerging classification as a direct care provider. This leaves us with the question -- Quo vadis? -- Where we are going and how we get there depends a great deal, on how we define our leadership, its challenges, its proposed destination, and ultimately what we intend to achieve. We might best understand our destination as a horizon, visible as a guidepost but never removing the need for continued selected leadership and teamwork across the nation.

We have been struck in the last couple of decades with the intense demand of practicing at higher levels, more than just an image generator. In reality, the role of our position is in crisis in the work place. What is the nature of this conflict? What are our goals and how are they going to contribute to the diagnostic field? Who are we, and what are we up to? Interpretations and answers to these questions frame and justify the strategy and response to a well prepared group of health care providers. This process of building a shared meaning side by side with the Sonologists is so intense and controversial, precisely because we are dealing with a phenomenon that does not fit the modern health care working environment, particularly as prescribed in politics, plutocracy and legalities.

I have observed in our newly emerging role to engage the phenomenon we wish to address, which is practicing sonography under a new scope. Sonographer Practitioners working by definition with Sonologists to mentor us, complete the team effort in diagnostic medical sonography. When we address complexity through simple causal equation, particularly with the lack of Sonographers to populate the demand of the market without the need of struggle, reducing the challenge to a more manageable working and professional conditions, this can be done without the cost of ignoring important dimensions of our dedication and obligation to the community.

Accordingly, we should attempt to comprehend, or see together, the various facets of the reality we face as we develop and assess our position with our role in the diagnostic imaging departments of health care facilities. We must develop a greater capacity to think in paradoxes and dilemmas, wherein multiple resolution in conflict, even when they appear contradictory on the surface. The three paradoxes that I think of, appear frequently in our current role and speculate on their implications for strategy and action are:

Accountability and Systemic Prevention of Unpreparedness - Much of the debate on our response to knowledge, morals and ethics fall along two lines of thinking, posed as contradictions representing incompatible points of view with the medical community and our own past perspective.

Prevent Pursuits of only false recognition - Let us consider a second paradox, the hedonistic syndrome the medical community has assumed for certain categories. This paradox poses the question: What category do we fit in this new century?

Engagement of administration and legal transformation from within the practice - A third question emerges in the recent metaphor that our profession has strengthened not only the technical aspect but also the harmony and performance with the Sonologists. The health care system must now address the issue and promote change in the medical community. This question asks us how we understand change. Again, we find two distinct voices. The Hedonistic and the Altruistic.

With well-qualified Sonographers, sonography is significantly more than images and equipment. If higher quality of diagnostic sonography continue to attract only a small group, there will not only be a shortage of Sonographers, but the Sonographers available may not have the best qualifications. Our role then, will continue to be of a picture taker. If our image suffers, our future will suffer.

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