[DYSPHAGIA] Radiologist @ MBS

[kgoertz@pahd.sk.ca (Clarke-Goertz, Kim (PAHD))]

I'm experiencing something similar here with an even larger obstacle being,
I am trying to set up VFSS at my hospital.  Even the rad tech's are brushing
me off b/c it means adding to their workload.  The radiologists are far from
interested in pursuing this as a service in our district.

Kim

Kim Clarke-Goertz CCC-SLP (C)


-----Original Message-----
From: Lindsey McLean [mailto:LMCLEAN@sbgh.mb.ca]
Sent: Wednesday December 12, 2001 14:29
To: Shindi44@aol.com; dysphagia@medonline.com; eripley@yahoo.com
Subject: Re: [DYSPHAGIA] Radiologist @ MBS


I've read through the CARJ standards (current) and they seem clear to me
that a radiologist needs to be present or at least is held responsible.
However, what happens when you come up against a city of radiologists who
say that as a region they are not interested in fluorography?  Only select
radiologists even feel like participating anymore.
Lindsey

Lindsey McLean, MS, CCC-SLP
Speech-Language Pathologist/Orthophoniste
l'hôpital général St Boniface General Hospital

>>> Irene Campbell-Taylor <eripley@yahoo.com> 12/12/01 11:37am >>>
The standards for the American College of Radiology
seems pretty clear on this point.
They can be found at:
http://www.acr.org/cgi-bin/fr?tmpl:standards00,pdf:pdf/adult_esophograms_upp
er_gi.pdf 

ACR (American College of Radiology) Standard for the
performance of esophagrams and upper gastrointestinal
examination in adults.

Some extracts:
"Examination must be performed by or under the direct
supervision of a licensed physician at the site and
interpreted by a physician with the following
qualifications*"

"The ACR approves the practice of certified and/or
licensed technologists performing fluoroscopy only as
a positioning or localizing procedure and then, only
if monitored by a supervising physician who is
personally and immediately available and the
positioning*must have prior written approval by the
medical director of the radiology
department/service*."

"If the patient has symptoms suggesting problems with
the pharynx or cervical esophagus, the examination
should be modified to include rapid-sequence
radiographs or video recording of the pharynx and
cervical esophagus, if available".
It would seem clear that the guidelines,(and standards
are only that, but are to be taken seriously) do not
imply that a physician need not be present nor that a
technician alone can perform examinations.
The Canadian Association of Radiology is in the
process of updating its standards that have not been
changed since 1991 but are very similar.
I can't imagine why anyone would want to perform such
studies without a radiologist. Who carries the
responsibility for, say, a missed cancer or
misinterpretation of a sideropenic web etc. etc.?
I certainly don't and I have trained radiologists in
VFSS.
Irene.


--- Shindi44@aol.com wrote:
> Does anyone know for certain whether it is
> absolutely necessary for a radiologist to be present
> at an MBS? Would it be legal/ethical for the study
> to be "read" at a later time like some other
> radiologic procedures? Perhaps like many of you,
> staffing issues with the radiologists limit
> scheduling of MBS(s).  Thank you for your replies.
>
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