Owner, Director, Caregiver: A Sonographer’s Dream
Source: Michael Samsot
She has a background of over 30 years in the medical field, and she had practiced for a number of years as a Licensed Practical Nurse. But Rose Gozdowski says that there came a point when she realized that she wanted to get out of nursing, but stay in medicine — and her goal, in the end, was to help people and own her own business.
Today, Gozdowski is the owner and director of Sylvania Ultrasound Institute and Men's Health Center in Sylvania, Ohio. It focuses mainly on obstetrical, abdominal, gynecological, vascular, urological, small parts, and musculoskeletal imaging — and, "It is the only free-standing [and non-affiliated] facility of this kind in our area,"Gozdowski says. "When I first learned about the … program of ultrasound, I investigated it and decided that it would allow me to still care for patients, yet explore different avenues that involved ultrasound, such as sales, applications, etc.
"I opened my business in August, 1994, with the intent of doing only obstetric ultrasound. When that concept didn't take off," however, she says, "I decided to expand my services, and I have grown my business to what it is today. We have a 3000-square-foot facility, and we dedicate our time to patient needs. I wanted a facility where patients could enter and be treated truly as patients, not just numbers; and I wanted the facility to be relaxing. I feel that I have accomplished both goals."
Besides the services already mentioned, Gozdowski also has a General Operator's License to perform DEXA scans for osteoporosis. "I am also interested in mammography, and would like to incorporate it at some point, so we could be an all-encompassing women's center, too. I also may, in the future, add cardiac imaging."
Gozdowski says that while it has been an uphill battle to gain acceptance by the area's referring physicians, that acceptance has been growing, and she now receives numerous referrals. In addition, she says, patients who are aware of the services her facility offers, will ask their primary care physicians to send them to Sylvania Ultrasound because of its reputation for getting reports to physicians quickly, for treating patients with care and respect, and for the quality of their work.
"Years ago," she says, "there were no formal programs in ultrasound, and radiology techs were cross-trained in the field of ultrasound, but many have now gone on to become registered in the field, have taken their boards, and have become Registered Diagnostic Medical Sonographers."
As for Gozdowski, herself, she says, "Ultrasound is my specialty; it's what I am educated to do." At the center, she has "two registered sonographers, plus myself, three students who work here part-time as receptionists, and one marketing director. And I have physicians — radiologists — who consult for me," she adds. "There are two groups that I pay to consult for us. With our reporting system, we are able to get reports on the films back to the physicians within 10 to 24 hours, with, of course, STATs being reported much faster.
"What credits our business," Gozdowski says, "is that we treat our patients in a timely and respectful fashion. We are a more personalized and confidential service than patients might find in a larger facility. We are very confidential, which is important to some patients." One of the areas in which this might carry more weight is the group's Men's Health Center, "which allows a gentleman to seek confidential and private counseling for impotence. The patient is seen here by a Board Certified urologist, and can be diagnosed and often treated here. We perform Duplex Doppler studies of the penis, which can provide a definitive diagnosis of the cause of the impotence, so that the most suitable treatment plan can be [devised] without guessing."
A large number of the center's other clients, Gozdowski says, are obstetric and abdominal patients. "Many doctors will order a 20-week scan to check the growth of the fetus, check the fetal well-being, and rule out any anomalies. This is a big part of our practice; we see about 250 patients a month, and about 60%-65% of them are obstetric.
"With the type of scan we do," she continues, "if we find anything wrong, we report it immediately to the physician so that if treatment is possible, it can be started. Sometimes, even when a medical scan is not originally ordered by the doctor, a patient will want one performed and will pay for it out-of-pocket. However, this can be done only with a referral from the patient's physician. We had one obstetric patient who did this — there was no medical reason to order the test, but she just wanted to be reassured that, 'yes, the baby did have all its parts,' and 'no, there wasn't anything obviously wrong with the baby.' "
Other obstetric patients come on their own because they want to know the sex of the child, and, "of course," Gozdowski says, "we wouldn't want the patient's insurance, or Medicaid, to have to pay for this — but the patient herself is willing to pay, and we think it's important to offer this service. Last November, in fact, there was a Medicaid patient who came here and paid out of her own pocket because she wanted to know the sex of her baby, and it was a self-pay situation. When we did the scan, though, we saw something in the baby's stomach that was abnormal and that we thought would require treatment. The woman's doctor called and berated me, saying that we should not have reported the findings to him, as now he had to deal with it.
"My point of view was that when the patient had had her first ultrasound, eight weeks earlier, it probably was too early for this problem to have been picked up. But the fact that it was picked up — even though it was in a scan for a non-medical reason—was something the doctor should have thanked us for, instead of resenting it; but I looked at it, thinking that if the condition was treatable, then the earlier it was caught, the better for both the mother and the baby."
With obstetric patients, there's another service offered by Sylvania Ultrasound that's a little out of the ordinary. The center makes videotapes of the ultrasound scans of the fetus, and it makes them available to the parents. For a while, Gozdowski says, "we had some objections from the FDA, which said that if we did videotapes, we were misusing our equipment for entertainment purposes. My question, though, is, 'What's the difference between a still picture [from the ultrasound] that you give to the parents, and a video that you give them?'"
She adds that the center did one video of a fetus that was particularly rewarding. "It was done of the baby being carried by a surrogate mother, and was done in order to prove the health of the baby to the parents who would care for the baby. Both mothers thought it would be a good idea to give the adoptive mother a copy of the tape, to make her feel more a part of the birth process. This was a couple of years ago, and everything turned out fine for everybody."
The vascular scanning that Gozdowski's center does includes Doppler scans of the penis — to diagnose impotence; scans of the carotid arteries — looking for plaque build-up and for pattern of blood flow to the brain; and arterial and venous scans of the extremities — looking for poor circulation. We can even test the digits — fingers and toes — to see if they've got good circulation," she says.
Checking the circulation of the extremities is often indicated when a patient walks a short distance and then experiences pain in the legs. "We're then looking at the possibility of arterial insufficiency of the legs," Gozdowski says. "We put blood pressure cuffs on the legs, check pressure at various levels, and run the scan. It's a little like an EKG pattern; we look at it and determine whether the pattern is good or bad."
When there is a possible diagnosis of male impotence, "we are looking for the reason for that impotence," she continues. "It could be a result of Peyroni's plaque, which a man frequently doesn't realize he has, but which we can see on an ultrasound. It could be from a venous leak, in which the gentleman has a sufficient blood supply, but the venous system takes the blood right back out of the penis, like a leaky-pail effect, and the components for erection are not working properly. It could also be due to arterial insufficiency — not enough blood coming into the penis; and we can detect that with Doppler.
"Unfortunately, there's not much that can be done to treat Peyroni's plaque, but with the venous leak, the most common successful treatment is with an implant. If the cause of impotence is arterial insufficiency, the patient can have injection therapy, in which he injects himself with a medication that brings a temporary increased blood supply to the penis," Gozdowski explains.
Without an ultrasound, the doctors must make their best guess as to what the cause is, she adds, "and since all of the treatments for impotence are expensive, you want to make sure that you get the right diagnosis. We're the only place in the city of Toledo that does this type of testing. Since seeking treatment for this problem can be a difficult thing for a man to do, it's very gratifying when he or his partner (and we encourage the partners to come with the patient for diagnosis and treatment) call back and say, 'Thank you so much; you've made things so much better.'"
Gozdowski recalls another gratifying case. The husband of a friend of hers had been to his family physician and to a specialist, both of whom had looked at something on his leg that appeared to be a cyst. Gozdowski's friend, a nurse, wasn't so sure, though, and she asked Gozdowski if she would scan the area. "I didn't like the looks of it," she says. "I could tell that it wasn't a cyst, because it was solid. We recommended that he seek treatment, and we encouraged him to have the lump removed. Surgery was performed in January. It did turn out to be malignant, a very rare malignancy, and he's receiving follow-up treatment now. My friend tells me that we probably saved his life.
Being a business owner can bring numerous rewards, "but it's also filled with problems to be solved," Gozdowski notes. "It's when you get that call or that letter, saying, 'Thank you, you saved my life,' that you realize all the headaches of the business are worth it."
Rose Gozdowski is a Registered Diagnostic Medical Sonographer and a Licensed Practical Nurse. She earned her Associates Degree of Science, with a major in Ultrasound, in 1985, through Owens Technical College, Perrysburg, OH. She earned her Diploma in Nursing, in 1971, from Northwest Ohio Practical Nurse Training Center in Toledo. She is a member of the American Institute of Ultrasound in Medicine, and of the Society of Diagnostic Medical Sonographers.
Michael Samsot is a freelance writer in Fairfax City, VA. She is on the Editorial Staff of NEWS-Line for Radiology Professionals.
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