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Chen WT, Kang YN, Wang TC, Lin CW, Cheng CY, Suk FM, Hsu CW, Huang SK, Huang WC. Does ultrasound education improve anatomy learning? Effects of the Parallel Ultrasound Hands-on (PUSH) undergraduate medicine course. BMC MEDICAL EDUCATION 2022; 22:207. [PMID: 35346161 PMCID: PMC8962240 DOI: 10.1186/s12909-022-03255-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 03/13/2022] [Indexed: 05/25/2023]
Abstract
BACKGROUND As ultrasound has become increasingly prominent in medicine, portable ultrasound is perceived as the visual stethoscope of the twenty-first century. Many studies have shown that exposing preclinical students to ultrasound training can increase their motivation and ultrasound competency. However, few studies have discussed the effect of ultrasound training on anatomy learning. METHOD The Parallel Ultrasound Hands-on (PUSH) course was designed to investigate whether or not ultrasonography training affects anatomy knowledge acquisition. The PUSH course included anatomical structures located in the chest and abdomen (target anatomy) and was conducted in parallel to the compulsory gross anatomy course. Learners (n = 140) voluntarily participated in this elective course (learners in the course before the midterm examination (Group 1, n = 69), or after the midterm examination (Group 2, n = 71)). Anatomy examination scores (written and laboratory tests) were utilized to compare the effects of the PUSH course. RESULT Group 1 obtained significantly higher written test scores on the midterm examination (mean difference [MD] = 1.5(7.6%), P = 0.014, Cohen's d = 0.43). There was no significant difference in the final examination scores between the two groups (Written Test: MD = 0.3(1.6%), P = 0.472). In Laboratory test, both mid-term (MD:0.7(2.8%), P = 0.308) and final examination (MD:0.3(1.5%), P = 0.592) showed no significant difference between two groups. Students provided positive feedback in overall learning self-efficacy after the PUSH course (Mean = 3.68, SD = ±0.56 on a 5-point Likert scale). Learning self-efficacy in the cognitive domain was significantly higher than that in the affective domain (MD = 0.58; P < 0.001) and psychomotor domain (MD = 0.12; P = 0.011). CONCLUSION The PUSH course featured a hands-on learning design that empowered medical students to improve their anatomy learning.
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Affiliation(s)
- Wei-Ting Chen
- Department of Emergency, School of Medicine, College of Medicine, Taipei Medical University, No.111, Sec. 3, Xinglong Rd, Taipei City, 11696, Taiwan
- Department of Emergency and Critical Medicine, Taipei Municipal Wan-Fang Hospital, Taipei Medical University, Taipei City, Taiwan
| | - Yi-No Kang
- Department of Education and Humanities in Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan
- Department of Education, Taipei Municipal Wan-Fang Hospital, Taipei Medical University, Taipei City, Taiwan
- Evidence-Based Medicine Center at Taipei Medical University, Taipei City, Taiwan
| | - Ting-Cheng Wang
- Department of Emergency, School of Medicine, College of Medicine, Taipei Medical University, No.111, Sec. 3, Xinglong Rd, Taipei City, 11696, Taiwan
- Department of Emergency and Critical Medicine, Taipei Municipal Wan-Fang Hospital, Taipei Medical University, Taipei City, Taiwan
| | - Che-Wei Lin
- Department of Education and Humanities in Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan
- Department of Education, Taipei Municipal Wan-Fang Hospital, Taipei Medical University, Taipei City, Taiwan
- Center for Education in Medical Simulation, Taipei Medical University, Taipei City, Taiwan
| | - Chung-Yi Cheng
- Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan
- Division of Nephrology, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei City, Taiwan
| | - Fat-Moon Suk
- Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan
- Division of Gastroenterology, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei City, Taiwan
| | - Chin-Wang Hsu
- Department of Emergency, School of Medicine, College of Medicine, Taipei Medical University, No.111, Sec. 3, Xinglong Rd, Taipei City, 11696, Taiwan
- Department of Emergency and Critical Medicine, Taipei Municipal Wan-Fang Hospital, Taipei Medical University, Taipei City, Taiwan
| | - Sha-Ku Huang
- Research Center for Environmental Medicine, Kaohsiung Medical University, Sanmin, Kaohsiung, Taiwan
- National Institute of Environmental Health Sciences, National Health Research Institutes, Zhunan Township, Miaoli County, Taiwan
| | - Wen-Cheng Huang
- Department of Emergency, School of Medicine, College of Medicine, Taipei Medical University, No.111, Sec. 3, Xinglong Rd, Taipei City, 11696, Taiwan.
- Department of Emergency and Critical Medicine, Taipei Municipal Wan-Fang Hospital, Taipei Medical University, Taipei City, Taiwan.
- Department of Education and Humanities in Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan.
- Department of Education, Taipei Municipal Wan-Fang Hospital, Taipei Medical University, Taipei City, Taiwan.
- Center for Education in Medical Simulation, Taipei Medical University, Taipei City, Taiwan.
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Importance of Ultrasound Education in Undergraduate Medical Curriculum: A Survey Study Based on First-Year Medical Students' Perception of the 6-Year Doctor of Medicine Program of the University of Nicosia Medical School in Cyprus. Ultrasound Q 2020; 36:328-332. [PMID: 33136934 DOI: 10.1097/ruq.0000000000000540] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Ultrasound imaging modality is a tool used in clinical practice and is being introduced gradually in the undergraduate curriculum of several medical schools worldwide. This study aims to assess medical students' perception regarding the integration of ultrasound training as part of undergraduate education. A questionnaire was given to first-year medical students after a 2-hour-long session, which was developed to introduce them in the fundamental physics theory and function of ultrasound equipment in the clinical practice. Analysis of the results indicated that students acknowledged that ultrasound training would improve their knowledge of internal medicine (P = 0.027) and of different diagnostic modalities (P = 0.019), and enhance their medical decision making (P = 0.0004). Moreover, students found beneficial the ultrasound education regarding correlating clinical knowledge with basic sciences (P = 0.0004). The study pointed out that the majority of first-year students have the opinion that the integration of ultrasound training in the medical program is valuable in medical education and patient care. However, work is needed to determine how to provide an optimal learning environment and to assess the competency of the training sessions.
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Davis JJ, Wessner CE, Potts J, Au AK, Pohl CA, Fields JM. Ultrasonography in Undergraduate Medical Education: A Systematic Review. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2018; 37:2667-2679. [PMID: 29708268 DOI: 10.1002/jum.14628] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 02/18/2018] [Indexed: 05/14/2023]
Abstract
OBJECTIVES The purpose of this study was to conduct a systematic review of the evidence of educational outcomes associated with teaching ultrasonography (US) to medical students. METHODS A review of databases through 2016 was conducted for research studies that reported data on teaching US to medical students. Each title and abstract were reviewed by teams of 2 independent abstractors to determine whether the article would be ordered for full-text review and subsequently by 2 independent authors for inclusion. Data were abstracted with a form developed a priori by the authors. RESULTS Ninety-five relevant unique articles were included (of 6936 identified in the databases). Survey data showed that students enjoyed the US courses and desired more US training. Of the studies that assessed US-related knowledge and skill, most of the results were either positive (16 of 25 for knowledge and 24 of 58 for skill) or lacked a control (8 of 25 for knowledge and 27 of 58 for skill). The limited evidence (14 of 95 studies) of the effect of US training on non-US knowledge and skill (eg, anatomy knowledge or physical examination skill) was mixed. CONCLUSIONS There is ample evidence that students can learn US knowledge and skills and that they enjoy and want US training in medical school. The evidence for the effect of US on external outcomes is limited, and there is insufficient evidence to recommend it for this purpose at this time.
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Affiliation(s)
- Joshua J Davis
- Department of Emergency Medicine, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Corinne E Wessner
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA
| | - Jacqueline Potts
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Arthur K Au
- Department of Emergency Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Charles A Pohl
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - J Matthew Fields
- Department of Emergency Medicine, Kaiser Permanente San Diego, San Diego, California, USA
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Hall MK, Hall J, Gross CP, Harish NJ, Liu R, Maroongroge S, Moore CL, Raio CC, Taylor RA. Use of Point-of-Care Ultrasound in the Emergency Department: Insights From the 2012 Medicare National Payment Data Set. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2016; 35:2467-2474. [PMID: 27698180 DOI: 10.7863/ultra.16.01041] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 02/06/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES Point-of-care ultrasound is a valuable tool with potential to expedite diagnoses and improve patient outcomes in the emergency department. However, little is known about national patterns of adoption. This study examined nationwide point-of-care ultrasound reimbursement among emergency medicine (EM) practitioners and examined regional and practitioner level variations. METHODS Data from the 2012 Center for Medicare and Medicaid Services Fee-for-Service Provider Utilization and Payment Data include all practitioners who received more than 10 Medicare Part B fee-for-service reimbursements for any Healthcare Common Procedure Coding System code in 2012. Odds ratios (ORs) and descriptive statistics were calculated to assess relationships between ultrasound reimbursement and practice location, nearby presence of an EM residency, and time elapsed since practitioner graduation. RESULTS Of 52,928 unique EM practitioners, 391 (0.7%) received limited ultrasound reimbursements for a total of 16,389 scans in 2012. Urban counties had an OR of 5.4 (95% confidence interval, 3.8-7.8) for receiving point-of-care ultrasound reimbursements compared to rural counties. Counties with an EM residency had an OR of 84.7 (95% confidence interval, 42.6-178.8) for reimbursement compared to counties without. The OR for receiving reimbursement was independent of medical school graduation year (P = .83); however, recent graduates performed more scans (P = .02). CONCLUSIONS A small minority of EM practitioners received reimbursements for point-of-care ultrasound from Medicare beneficiaries. These practitioners were more likely to reside in urban and academic settings. Future efforts should assess the degree to which our findings reflect either low point-of-care ultrasound use or low rates of billing for ultrasound examinations that are performed.
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Affiliation(s)
- M Kennedy Hall
- Division of Emergency Medicine, University of Washington School of Medicine, Seattle, Washington USA
- Department of Emergency Medicine, Yale University School of Medicine, New Haven, Connecticut USA
| | - Jane Hall
- Cancer Outcomes, Public Policy, and Effectiveness Research Center, Yale Cancer Center, and Yale University School of Medicine, Section of General Internal Medicine, Department of Internal Medicine, Yale University, New Haven, Connecticut USA
| | - Cary P Gross
- Cancer Outcomes, Public Policy, and Effectiveness Research Center, Yale Cancer Center, and Yale University School of Medicine, Section of General Internal Medicine, Department of Internal Medicine, Yale University, New Haven, Connecticut USA
| | - Nir J Harish
- Department of Emergency Medicine, Yale University School of Medicine, New Haven, Connecticut USA
| | - Rachel Liu
- Department of Emergency Medicine, Yale University School of Medicine, New Haven, Connecticut USA
| | - Sean Maroongroge
- Cancer Outcomes, Public Policy, and Effectiveness Research Center, Yale Cancer Center, and Yale University School of Medicine, Section of General Internal Medicine, Department of Internal Medicine, Yale University, New Haven, Connecticut USA
| | - Christopher L Moore
- Department of Emergency Medicine, Yale University School of Medicine, New Haven, Connecticut USA
| | | | - R Andrew Taylor
- Department of Emergency Medicine, Yale University School of Medicine, New Haven, Connecticut USA
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Decker SJ, Grajo JR, Hazelton TR, Hoang KN, McDonald JS, Otero HJ, Patel MJ, Prober AS, Retrouvey M, Rosenkrantz AB, Roth CG, Ward RJ. Research Challenges and Opportunities for Clinically Oriented Academic Radiology Departments. Acad Radiol 2016; 23:43-52. [PMID: 26598485 DOI: 10.1016/j.acra.2015.10.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 10/13/2015] [Accepted: 10/14/2015] [Indexed: 12/26/2022]
Abstract
Between 2004 and 2012, US funding for the biomedical sciences decreased to historic lows. Health-related research was crippled by receiving only 1/20th of overall federal scientific funding. Despite the current funding climate, there is increased pressure on academic radiology programs to establish productive research programs. Whereas larger programs have resources that can be utilized at their institutions, small to medium-sized programs often struggle with lack of infrastructure and support. To address these concerns, the Association of University Radiologists' Radiology Research Alliance developed a task force to explore any untapped research productivity potential in these smaller radiology departments. We conducted an online survey of faculty at smaller clinically funded programs and found that while they were interested in doing research and felt it was important to the success of the field, barriers such as lack of resources and time were proving difficult to overcome. One potential solution proposed by this task force is a collaborative structured research model in which multiple participants from multiple institutions come together in well-defined roles that allow for an equitable distribution of research tasks and pooling of resources and expertise. Under this model, smaller programs will have an opportunity to share their unique perspective on how to address research topics and make a measureable impact on the field of radiology as a whole. Through a health services focus, projects are more likely to succeed in the context of limited funding and infrastructure while simultaneously providing value to the field.
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Bahner DP, Goldman E, Way D, Royall NA, Liu YT. The state of ultrasound education in U.S. medical schools: results of a national survey. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2014; 89:1681-6. [PMID: 25099238 DOI: 10.1097/acm.0000000000000414] [Citation(s) in RCA: 214] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
PURPOSE To determine the state of ultrasound education in U.S. medical schools and assess curricular administrators' opinions on its integration in undergraduate medical education (UME). METHOD In 2012, curricular administrators at 134 U.S. MD-granting medical schools were surveyed concerning the nature of ultrasound education in medical school. The questionnaire sought ultrasound education program characteristics, structures, and objectives. It also sought respondents' opinions on the role of ultrasound education in UME and barriers to its integration. Frequency and distribution analyses were conducted for survey responses; Rasch analysis was performed for barrier responses. RESULTS Responses were received from 82 (61.2%) medical schools; these institutions were representative of the U.S. medical school population. Fifty-one respondents (62.2%) reported ultrasound training was integrated into their UME curriculum. Ultrasound was most commonly taught in the third year (38/82; 46.3%), and the purpose of training varied by curricular year. There was agreement that ultrasound should be part of the UME curriculum (56/71; 78.9%), but few respondents reported it was a priority at their institution (13/70; 18.6%). Respondents perceived lack of space in the curriculum (logit = +0.49; standard error [SE] = 0.11) and lack of financial support (logit = +0.42; SE = 0.11) as the most significant barriers to integration. CONCLUSIONS Despite a general consensus that ultrasound is an important skill to teach in medical school, the integration of ultrasound education in U.S. schools is highly variable. This study indicates a need for national standards to guide the integration of ultrasound education into U.S. medical school curricula.
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Affiliation(s)
- David P Bahner
- Dr. Bahner is professor, director of ultrasound, and emergency medicine ultrasound fellowship director, Department of Emergency Medicine, Ohio State University College of Medicine, Columbus, Ohio. Dr. Goldman is associate professor, Department of Human and Organizational Learning, and director, Master Teacher Leadership Development Program for the School of Medicine and Health Sciences, George Washington University, Washington, DC. Mr. Way is senior research associate, Ohio State University College of Medicine, Columbus, Ohio. Dr. Royall is a fourth-year resident in surgery, Department of Surgery, Orlando Health, Orlando, Florida. He holds a joint appointment as resident instructor, Department of Clinical Sciences, University of Central Florida College of Medicine, Orlando, Florida. Dr. Liu is assistant professor and emergency medicine ultrasound fellowship director, Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC
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Bahner DP, Adkins EJ, Hughes D, Barrie M, Boulger CT, Royall NA. Integrated medical school ultrasound: development of an ultrasound vertical curriculum. Crit Ultrasound J 2013; 5:6. [PMID: 23819896 PMCID: PMC3701608 DOI: 10.1186/2036-7902-5-6] [Citation(s) in RCA: 142] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Accepted: 01/31/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Physician-performed focused ultrasonography is a rapidly growing field with numerous clinical applications. Focused ultrasound is a clinically useful tool with relevant applications across most specialties. Ultrasound technology has outpaced the education, necessitating an early introduction to the technology within the medical education system. There are many challenges to integrating ultrasound into medical education including identifying appropriately trained faculty, access to adequate resources, and appropriate integration into existing medical education curricula. As focused ultrasonography increasingly penetrates academic and community practices, access to ultrasound equipment and trained faculty is improving. However, there has remained the major challenge of determining at which level is integrating ultrasound training within the medical training paradigm most appropriate. METHODS The Ohio State University College of Medicine has developed a novel vertical curriculum for focused ultrasonography which is concordant with the 4-year medical school curriculum. Given current evidenced-based practices, a curriculum was developed which provides medical students an exposure in focused ultrasonography. The curriculum utilizes focused ultrasonography as a teaching aid for students to gain a more thorough understanding of basic and clinical science within the medical school curriculum. The objectives of the course are to develop student understanding in indications for use, acquisition of images, interpretation of an ultrasound examination, and appropriate decision-making of ultrasound findings. RESULTS Preliminary data indicate that a vertical ultrasound curriculum is a feasible and effective means of teaching focused ultrasonography. The foreseeable limitations include faculty skill level and training, initial cost of equipment, and incorporating additional information into an already saturated medical school curriculum. CONCLUSIONS Focused ultrasonography is an evolving concept in medicine. It has been shown to improve education and patient care. The indications for and implementation of focused ultrasound is rapidly expanding in all levels of medicine. The ideal method for teaching ultrasound has yet to be established. The vertical curriculum in ultrasound at The Ohio State University College of Medicine is a novel evidenced-based training regimen at the medical school level which integrates ultrasound training into medical education and serves as a model for future integrated ultrasound curricula.
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Affiliation(s)
- David P Bahner
- Department of Emergency Medicine, The Ohio State University College of Medicine, 750 Prior Hall, 376 W 10th Avenue, Columbus, OH 43210, USA.
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Bedside pediatric emergency evaluation through ultrasonography. Pediatr Radiol 2008; 38 Suppl 4:S679-84. [PMID: 18810417 DOI: 10.1007/s00247-008-0890-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2008] [Accepted: 04/23/2008] [Indexed: 10/21/2022]
Abstract
Bedside US has emerged as a valuable technology for the emergency department physician. It impacts clinical decision-making and the safety of procedures, and it decreases the time and increases the efficiency for completion of procedures. The portability, accuracy and noninvasive nature of US make it an ideal tool for the trained clinician. Bedside US can improve clinical decision-making for the pediatric patient by helping the clinician to identify critical pathology, direct therapeutic maneuvers and determine the futility of resuscitations. Many pediatric procedures, such as vascular access, lumbar puncture and bladder catheterization, are typically performed blindly. Bedside US enhances the success of procedures, minimizes complications and limits the number of attempts necessary to complete a procedure. Bedside US can be a valuable adjunct for complicated and time-sensitive disease processes such as ectopic pregnancy, testicular torsion and hypovolemia by providing information to guide diagnostic and therapeutic interventions that subsequently improve outcomes.
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Derchi LE, Claudon M. Ultrasound: a strategic issue for radiology? Eur Radiol 2008; 19:1-6; discussion 7-8. [PMID: 18704435 DOI: 10.1007/s00330-008-1125-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2008] [Revised: 06/17/2008] [Accepted: 06/30/2008] [Indexed: 12/21/2022]
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Levin DC, Rao VM. Turf wars in radiology: Emergency department ultrasound and radiography. J Am Coll Radiol 2005; 2:271-3. [PMID: 17411810 DOI: 10.1016/j.jacr.2004.09.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2004] [Indexed: 11/17/2022]
Abstract
In recent years, emergency medicine physicians have made strenuous efforts to take over responsibility for interpreting and billing for ultrasound and conventional x-ray studies performed in emergency departments. This is a battle that radiologists have largely won. The authors explore some of the history of this controversy and the reasons why radiologists still control emergency department imaging.
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Affiliation(s)
- David C Levin
- Department of Radiology, Thomas Jefferson University Hospital and Jefferson Medical College, Philadelphia, Pennsylvania 19107, USA.
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