Running Head: EXPERIENTIAL EXERCISE CHAPTER 4
Experiential Exercise Chapter 4
Vickie Delaney
Siena Heights University
January 22, 2014
LDR 625: Human Resources
John Fick, ACHE
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EXPERIENTIAL EXERCISE CHAPTER 4
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Abstract
This paper will explore the healthcare profession of Diagnostic Medical Sonography. This is a
field that requires knowledge of anatomy and physiology as well as disease processes.
Sonographers play a major role in aiding the physician in diagnosis and treatment of illness.
Keywords: sonography, disease, diagnosis
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Diagnostic Medical Sonographers
Diagnostic medical sonographers perform imaging of various body parts using high
frequency sound or ultrasound. “The images and test results help physicians assess and diagnose
medical conditions. Some technologists assist physicians and surgeons during surgical
procedures” (US Dept of Labor, 2014).
Knowledge Base
Diagnostic medical sonographers (DMS) are highly skilled professionals with an
extensive knowledge of anatomy and physiology of the various organs in the body as well as the
vascular system. Sonographers also must understand the use of highly technical ultrasound
imaging equipment to produce high quality images for interpretation by a physician
The professional responsibilities include, but are not limited, to:

obtaining and recording an accurate patient history

performing diagnostic procedures and obtaining diagnostic images

analyzing technical information

using independent judgement [sic] in recognizing the need to extend the scope of
the procedure according to the diagnostic findings

providing an oral or written summary of the technical findings to the physician for
medical diagnosis

providing quality patient care

collaborating with physicians and other members of the health care team. (SDMS,
2014, para. 5)
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Technical standards include: ability to lift 50 pounds, bend and stoop, full use of hands,
adequate vision and hearing, stand for long periods, be compassionate and caring, communicate
effectively and be organized (SDMS, 2014).
Collective Goals
It is important in any work setting to have a team of players. In a hospital setting, the
ultrasound imaging department may consist of two to ten sonographers with a team leader and a
department manager. Leadership needs to define roles and responsibilities, formulate operating
procedures and create a collaborative environment (Six Sigma, 2014). The goal in the
sonography laboratory is to do these things efficiently and accurately to promote the health and
well-being of the patient through effective diagnostic testing.
Because of ever-changing technology and medical breakthroughs, lifelong learning is
also important. Management and team leaders will continually ensure that the sonographers are
kept up to date on changes through various educational opportunities such as webinars and
conferences.
Training and Licensure
The Society of Diagnostic Medical Sonographers (SDMS) conducts a periodic survey of
its members. The most recent survey showed that almost 40% of sonographers hold an associate
in science degree; approximately 30% have a bachelor degree. The graph below depicts the
breakdown of sonographer education.
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High School Diploma/ GED( 4.5)
Certificate (17.1)
Associate's (38.8)
Bachelor's (31.3)
Master's (3.2)
Doctorate (1.1)
Other (4)
Figure 1. Sonographer Education. Adapted from “Sonographer Salary Survey” by the
SDMS, 2013.
In the early years of ultrasound testing many sonographers were trained on the job.
Today, to become a credentialed sonographer you must have, at minimum, a certificate from an
accredited program in sonography or an associate’s degree in allied health and at least 1,000
hours of clinical experience. Accreditation of ultrasound training programs comes through the
Commission on Accreditation of Allied Health Programs (CAAHEP). Accredited programs
require programs include hands on clinical experience with real patients with real disease.
Only four states require a license to practice sonography: Oregon, New Mexico, West
Virginia and New Jersey. Many institutions required sonographers to be registered through the
American Registry of Diagnostic Medical Sonographers (ARDMS) or the American Registry of
Radiologic Technologists (ARRT). The ARDMS credential is the preferred credential. Newly
hired technologists may be granted a period of time in which to become registered. The registry
process includes passing a national board exam.
Registrants through the ARDMS may hold Registered Diagnostic Cardiac Sonographer,
Registered Vascular Technologist or Registered Diagnostic Medical Sonographer titles.
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Sonographers can hold credentials in specific areas such as cardiac, vascular or fetal ultrasound.
This indicates that they have passed an exam that covers specific content on that subject.
Number of Professionals
According to the Bureau of Labor Statistics (2014), there were 110,400 people employed
as diagnostic medical sonographers, cardiovascular technologists and vascular technologists in
2012. The ARDMS has 82,131active members (ARDMS, 2014). The breakdown, by type of
credential held, is shown in the table below and was found through the ARDMS website
(ARDMS). Sonographers may hold more than one credential.
Credential
Active Members
Registered Diagnostic Medical Sonographer
57,951
Registered Diagnostic Cardiac Sonographer
21,538
Registered Vascular Technologist
26,242
Registered in Musculoskeletal sonography
400
Sonographers may work in hospitals, outpatient clinics, private physician offices, or for
ultrasound supply companies. The graph below shows primary job settings as reported in the
SDMS Sonographer Salary Survey Report (SDMS, 2013).
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Primary Job Setting
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Hospital/Med Ctr (53.6)
Outpatient Clinic (18.8)
Freestandng Imaging Ctr (5.2)
Physician Office (16.5)
Mobile Service (3.0)
Ultrasound Equipment Co.
(0.5)
Figure 2. Primary Job Setting. Adapted from “Sonographer Salary Survey” by the SDMS, 2013.
History and Evolution of Sonography
In the 1970’s ultrasound was beginning to gain ground as an indirect method of
visualizing structures within the body. Physicians initially performed the testing but soon
radiologists began the practice. In the late 1970’s into the 1980’s and even 1990’s, nurses or
other medical professionals were taught by a physician or through on the job training by another
sonographer. As the technology improved so did the diagnostic capability. Because it is a fairly
inexpensive, non-invasive testing modality, the number of tests being ordered by physicians
began to increase. This prompted colleges and technology institutes to start developing
educational programs in Diagnostic Medical Sonography. Hospitals also offered programs in
ultrasonography.
The curriculum was developed by a number of professional organizations including the
Joint Review Committee on Education in Diagnostic Medical Sonography (JRC-DMS), the
American College of Cardiology, American College of Radiology, American College of
Obstetricians and Gynecologists, American Institute of Ultrasound in Medicine, American
Society of Echocardiography, American Society of Radiologic Technologists, Society of
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Diagnostic Medical Sonography, Society for Vascular Surgery, and the Society for Vascular
Ultrasound the American Medical Association(CAAHEP, 2013).
As the field has evolved, so has credentialing of sonographers. Sonographers are highly
respected by patients, physicians and other technology based healthcare professionals. They play
an important role in the diagnosis and treatment of patients. As this recognition increased, so has
the need for credentials and an increase pay rate. The median hourly pay for a credentialed
sonographer in the United States is $33.30 (SDMS, 2014). Hospitals generally require
sonographers to be registered technologists and to maintain this credential.
Professional Societies
There are several professional societies that sonographers can join. The Society of
Diagnostic Medical Sonographers is the largest. Others are the Society for Vascular Ultrasound
(SVU) and the American Society of Echocardiography (ASE). All offer continuing education
courses and provide support for Medicare and Medicaid reimbursement issues. They also
provide employment resources. Joining a professional organization shows your commitment to
excellence in the field. The above mentioned societies also provide the experienced technologist
a way to be recognized for their years of service and accomplishments by providing them with
the status of “fellow” following review of their career and letters of recommendation.
Competitor Professions
All radiological technology has evolved. At one time ultrasound imaging was the only
non-radiating imaging technique that gave you live, real-time pictures. Now Computed
Tomography (CT) and Magnetic Resonance Imaging (MRI) have evolved to produce moving
images. There was some concern from the ultrasound professionals that CT and MRI would take
over from ultrasound imaging but these methods are not portable and are two to three times as
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expensive to perform as ultrasound imaging. As the costs of healthcare have skyrocketed,
insurance companies look for ways to save on expenses and one way is to limit expensive
testing. This has helped keep ultrasound in the forefront of medical imaging.
Strategic issues
As the United States government works to reduce healthcare costs it has begun to seek
reductions in Medicare reimbursement. For example, reduction in reimbursement for
echocardiograms has been almost constant over the last ten years. Because of this, there has
been a reduction in staffing, even as the number of patients has increased. Strategic planning
involves cutting work hours, hiring only contingent or part-time employees and monitoring the
number of studies performed by each technologist in the laboratory.
There is a predicted shortage of sonographers and in some parts of the country, qualified
applicants are in short supply. If hospitals are going to decrease spending by hiring part-time
and contingent technologists, they are going to need a larger workforce. In some smaller
hospitals they are beginning to cross-train sonographers into the cardiac and vascular sonography
departments.
Conclusion
Diagnostic medical sonographers play an important role on the healthcare team. Their
knowledge and skills are a benefit to a health system and must be recognized in the overall
strategy of human resources management.
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References
ARDMS. (2014). Directory of registrants. Retrieved from
www.ardms.org/registrant_resources/id_cards_status_verification1/status_verification/ar
dms_directory_of_registrants
CAAHEP (2011). Standards and guidelines for the accreditation of educational programs in
diagnostic medical sonography. Retrieved from
http://www.caahep.org/documents/file/For-Program-Directors/DMSStandards.pdf
SDMS. (2013). Sonographer salary and benefit survey report. Retrieved from
http://www.sdms.org/members/salary.asp.
SDMS. (2014). So you want to be a sonographer…Retrieved from
http://www.sdms.org/career/career.asp
Six Sigma. (2014). Accomplishing collective goals through effective business teamwork.
Retrieved from http://www.sixsigmaonline.org/six-sigma-training-certificationinformation/accomplishing-collective-goals-through-effective-business-teamwork.html
U.S. Department of Labor, Bureau of Labor Statistics. (2014). Diagnostic medical sonographers
and cardiovascular technologists and technicians, including vascular technologists,
Occupational Outlook Handbook, 2014-15 Edition. Retrieved from
http://www.bls.gov/ooh/healthcare/diagnostic-medical-sonographers.htm