[DYSPHAGIA] Radiologist @ MBS

[Jane.Little@swchsc.on.ca (Little, Jane)]

Lindsay
We are also encountering this issue some facilities in Toronto. There is a
shortage of radiologists. 
 Also we have been told that radiologists, in particular residents,  are not
as keen to work with fluoro as the new technologies. In the past couple of
years, we have had an increasing number of days when videostudies were
cancelled when the radiologist, who usually performs the fluoro, was absent.



Jane Little, MA, Reg. CASLPO, SLP(C)
Professional Leader 
Speech-Language Pathology
Sunnybrook and Women's College Health Sciences Centre
2075 Bayview Avenue, # L102M
Toronto, Ontario   M4N 3M5
jane.little@swchsc.on.ca 


		
		--- Lindsey McLean <LMCLEAN@sbgh.mb.ca> wrote:
		> 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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