|Author: Peggy Kaplin|
|A Humanistic Approach to Ultrasonography
|Ultrasound Preceptor Amy Taylor admits that when she was in high school she hated science. She was more interested in the classes that encouraged interaction and communication between the students. "Science never interested me at all. Paradoxically, however, I really enjoy ultrasound and the area that I work in." She explains that the first time she considered a career in healthcare, namely in the radiology field, was when she accompanied her mother during an amniocentesis. As her mother was lying on the examination table awaiting the procedure, the ultrasound technologist was searching the room for a pen to make a mark on her skin.
When she was unable to locate one, Taylor watched in horror as the tech proceeded to jam her fingernail into her mother's pregnant belly. She acted as if this were not in any way inhumane or unordinary and carried on with the procedure. Even at a young age, it occurred to Taylor that there needed to be more communication involved between patient and healthcare provider. After all, if Taylor had realized quickly enough that the ultrasound tech was searching the room for a pen, she could have easily offered the one that was in her own purse.
Taylor began her career as a practicing sonographer in Australia, having acquired a Bachelor of Medical Radiation Science (with Merit) from The University of Newcastle, Australia as well as a Graduate Diploma of Health Science from The University of Sydney, Australia. The training for Australia's sonographers is completely different to that of technologists in the United States. Taylor explains, "Tertiary institutions also interested not only in science and math, but are emphasize the importance of communication in the medical industry." Taylor fit the bill perfectly because of her desire to relate to people on a human level. "I have always enjoyed communicating and working with people and have always been interested in assisting in medical diagnoses. I became fascinated by ultrasound during a work experience program at high school. I was awed by the technology and its applications. I wanted to be someone to apply the technology well in order to facilitate better, more accurate diagnoses. Moreover, I wanted to be an approachable harnesser of the technology; to be able to make ultrasound a well understood procedure."
Taylor was working as a sonographer in Sydney, Australia when a colleague undertaking an MRI fellowship at HSS at the time, Dr. Tej P. Dugal FRANCR, MBBS (Hons.), told her about advancements that were being made at The Hospital for Special Surgery in New York. Dr. Ronald Adler, PhD, MD, and the Department of Radiology and Imaging were working together in the musculoskeletal specialty area of ultrasound imaging. She says, "Being incredibly enthusiastic about such a new and dynamic area of ultrasound, as well as excited by a challenge, I contacted the department to express my interest in their work. It just so happened that the ultrasound division was in the process of expansion, and about to establish an MSK ultrasound training and education facility." With the generous sponsorship from HSS, Taylor pursued a visa and arrived in New York in November of 2005.
When asked about some of the most defining moments in her job, Taylor replies, "It is hard to think of one defining moment. It is rewarding on any occasion that someone takes you aside to thank you. I have had such lovely interactions on many occasions with patients and people that I've worked with." Based on her experiences in both fields, Taylor prefers ultrasound to X-ray partly because a rapport is more easily established. Ultrasound examinations are lengthier (they can take anywhere from 10 to 45 minutes) and as such allow plenty of time to develop a relationship between herself and the patient. To elaborate on her passion for representing human nature in what can sometimes be a sterile profession, Taylor goes on to say, "A lot of people want to have a big impact on the world by making big changes. I think the best way to achieve this is one person at a time; by making life more pleasant day to day. Small changes pave the way for larger changes; water dripping onto a flat surface over time will create indentation."
The Hospital for Special Surgery is currently working on an educational collaboration with local universities in which certain students will have access to the extremely high tech machinery that the facility houses, such as the Philips iU22 system. "It is an innovative system with brand new technologies, as well as the capacity to house the ultrasound technologies of tomorrow. Aside from the university students who attend HSS to get a taste of the procedures that are routinely done there, Taylor also assists in training her fellow radiology techs, allied health professionals and visiting physicians.
Taylor adds, "If you are looking for a profession where you are pretty much guaranteed a job, and want to use the knowledge that you have, but be able to apply it in new and different ways each day, this is a really rewarding profession to consider. It is an opportunity to use basic scientific knowledge and apply it in a very humanist way. It is really nice career choice for people who are interested in science and technology, but who are also interested in people. I think the humanist factor is something that can't be left behind. At the end of the day we really have to get communicators and people who are good with words into the field." For young professionals considering radiology as a career, it doesn't hurt to know that "ultrasound is an area that can only increase and improve in what it is capable of. In the last year or two we have only had a little taste of where ultrasound is going to be able to go in the next five to 10 years."
While the growth of this profession is something to be optimistic about, Taylor warns that it can also be a cause for some concern. "As the worldwide population ages, the pressure is continually increasing on the radiology profession. Concurrently, the amazing advancements being made in radiological technology is something that the profession needs to stay abreast of. Whilst these two factors are, in my opinion, overridingly positive for the profession in the long term, the pressures in the short term may be challenging to manage."
Another concern facing radiology professionals is the high number of workplace injuries that occur in the field. According to a conclusive survey done by the SDMS website in response to overwhelming complaints regarding workplace injuries, "More than 80% of sonographers are scanning in pain and 20% of these professionals eventually experience a career-ending injury. On average, within five years of entering the profession, sonographers experience pain while scanning. The increasing loss of sonographers due to WRMSDs exacerbates the existing shortage of sonographers in the workplace and decreases patient access to this important healthcare service." Taylor adds that another alarming fact is "sonographers and nurses are one of the highest injured careers in the workplace." A common cause of injury for ultrasound technologists is called repetitive micro-trauma. "Repetitive micro-trauma is something a phenomenon in which you do a little movement that is not particularly stressful but over and over again for eight hours a day for five to six days a week. Over time, using the same tendons and ligaments weakens them."
Because the Hospital for Special Surgery is so unique in its technology and knowledge of musculoskeletal injuries, they have often treated some high profile patients. This is partly because "musculoskeletal ultrasound is relatively new and can be a difficult area of ultrasound to understand and interpret. We treat a lot of exclusive patients with very specific sport injuries." Players from such teams as the New York Giants and Knicks have been known to pass through their facility on more than a few occasions. Taylor has treated some of these exclusive patients herself, and she claims, "I am able to scan the high profile patients because, not being American, I don't necessarily know who they are and thus am perfect to walk in there and act normally. Particularly the football and baseball players because those sports aren't as popular in Australia, so I don't even know the rules let alone who the players are!"
That is not the only instance in which Taylor's background has proved useful at work. Her charming Australian accent has also come in handy from time to time. "My accent has proved useful in our waiting area, which at times can be very busy. I have been called upon by my colleagues on several occasions to make announcements because when people hear my voice, they stop to listen."
Taylor emphasizes that the need for communication and education in her field is as important as the application itself. The newly established Academic Center for Musculoskeletal Ultrasound was the reason that she had originally decided to come to the United States and HSS. She explains, "The Academic Center is a unique and exciting resource which has been established by HSS with collaboration with Philips Medical Systems. Cameras have been connected within the ultrasound procedure room for the visualization and interactive discussion of the dedicated MSK procedures performed by Dr. Adler. The System has been configured to specially capture procedures in a digital format for real time visualization, or for on-demand recall. A large library is thus being gathered of procedures and protocols of musculoskeletal ultrasound within a dedicated facility. The information contained in this library is a wonderful resource for ultrasound technologists, radiologists and medical specialists of all denominations to learn about dedicated musculoskeletal ultrasound for diagnoses and therapeutic purposes."
Despite all of the technological developments, Taylor does not believe that treatment can be properly carried out when there is a lack of communication between patient and doctor. "I think the common thread when I talk about my profession is emphasizing how important it is to communicate with people. It can be such a small gesture. Having someone come in and taking the five seconds to say ‘My name is... and this is what I'm going to do' really makes a difference to people. When people can have a name that they can hold on to, at least you can relate to them on a human level. If we can just take time to slow down and communicate with our patients, I think radiology would be a much better field."
Amy Taylor earned her Bachelor's of Medical Radiation Science (Diagnostic Radiography) with Merit from the University of Newcastle in Australia and her Graduate Diploma in Health Science (Medical Sonography) from the University of Sydney, Australia. Taylor would like to thank Dr. Helene Pavlov, Dr. Ronald Adler and the team at The Hospital for Special Surgery Radiology and Imaging for all their help and support of her Australian/United States visa sponsorship.
Anyone seeking information on Musculoskeletal Ultrasound should feel welcome to contact Amy Taylor at email@example.com or her department at the Hospital for Special Surgery.
Peggy Kaplin is a freelance writer from the Philadelphia area and is on the NEWS-Line for Radiology Professionals staff.