| http://www.newsobserver.com/front/digest/story/2923232p-2685783c.html
Seeing a Clear Need
North Carolina's lack of licensing for X-ray technicians
'doesn't make sense'
By SARAH AVERY, Staff Writer
Don Harrington was still in school studying radiologic technology,
but he had learned enough to know that the woman shooting his
X-ray at the podiatrist's office was taking risks.
After he demanded that she provide him a protective lead shield
-- she didn't think it was necessary -- he was shocked to see
that she wore no safeguards as she leaned within inches of his
foot and shot X-ray after X-ray. "I asked her, 'How many
of these do you do a day?' And she said, 'I do them all day,'
" said Harrington, who has since graduated and is now working
at WakeMed. "She could have easily gotten cancer or something."
The woman, it turned out, was studying to be a veterinarian
and had no formal training to take X-rays.
North Carolina is one of 17 states that does not require its
radiologic technologists to be licensed. Advocates for licensure
say the regulatory void creates problems for patients, for the
untrained people performing the procedures and for the doctors
who rely on clear images to set broken bones, diagnose lung
cancers or find stomach ulcers.
"A hairdresser has to have a license to cut hair,"
said Frances Apple, a retired radiologic technologist at Duke
who has been active in national professional groups. "The
X-ray machines we use have to be registered, but the operators
don't. Somehow that doesn't make sense."
Apple and others in the field said most North Carolina hospitals
do hire technologists who are certified through a national organization
such as the American Registry of Radiologic Technologists, which
requires at least an associate's degree from an accredited college.
But in smaller doctors' offices and urgent-care clinics, the
people taking X-rays and other images are less likely to have
had such education. Some are nurses, nurses' aides or other
staff, such as the vet student in the podiatrist's office, who
picked up some level of on-the-job training.
Apple said statewide efforts in the 1980s to require licensure
met resistance from some doctors concerned that licensed technologists
would demand higher pay. But the state could be forced to adopt
new rules if bills introduced in Congress this summer are passed.
The bills call for all states to adopt minimum standards of
education and certification for radiologic and nuclear medicine
technologists, noting that "it is in the interest of public
health and safety to minimize unnecessary or inappropriate exposure
to radiation ... by personnel lacking appropriate education
and credentials."
Apple and others said the action is long overdue, as imaging
technology grows more sophisticated and is used for a wider
variety of medical procedures. Nationally, about 300 million
imaging exams are conducted a year, according to the Senate
bill introduced this past summer.
In a recent study of the radiologic work force in North Carolina,
researchers with the Cecil G. Sheps Center for Health Services
Research at UNC-Chapel Hill found that the use of mobile magnetic
resonance imaging devices in North Carolina increased 256 percent
between 1995 and 2001; the use of PET scans, an imaging technique
that detects subtle changes in the body's chemical activities,
increased 631 percent during the same period.
"Patients make an assumption that when they go to the
doctor's office or clinic that whoever works on them is qualified
to do what they are doing," Apple said. "Most people
won't ask whether the person has been trained."
Training is offered in radiologic technology at 21 community
colleges, which offer two-year, associate's degrees; UNC-CH
offers a bachelor's degree. Additionally, 16 campuses in North
Carolina train in other types of scans, including nuclear medicine,
MRI and computerized tomography, according to the Sheps Center
study.
Anita Phillips, director of Wake Technical Community College's
radiologic sciences program, said the two-year course of study
provides an intense education that no on-the-job training situation
could match: basic anatomy and physiology, how the X-ray machines
function, how X-rays affect human cells, how to protect people
from radiation, how to position people for good images, and
how to do vital signs and monitor patients.
"It's important to have clear and accurate images,"
Phillips said. "Every time you have to repeat something
... it costs twice as much. And if you don't have good images,
the doctor might miss something because it wouldn't be clear
enough to see an abnormality."
Another problem raised by the lack of licensure in North Carolina
is the dearth of information that can be gathered about the
work force.
In the Sheps Center's analysis, researchers found that they
could not accurately count the number of practitioners nor fully
evaluate where they were working.
"It is hard to answer questions from a research standpoint
without having data," said Susan L. Dyson, lead author
of the report, which was a collaboration of the Sheps Center,
the Council for Allied Health in North Carolina and the N.C.
Area Health Education Centers.
Among the questions that the analysis sought to answer was
how well-distributed the work force is throughout the state
-- a critical piece of information for community colleges as
they seek to train enough people to meet the demands of local
hospitals and clinics.
This year, for example, Wake Tech increased enrollment in its
radiologic technologies program from 24 to 30 at the request
of area hospitals. And it could enroll dozens more; about 300
people applied to the program, and 120 met the qualifications,
Phillips said.
Harrington, who graduated from Wake Tech three years ago, said
he was hired immediately after completing his degrees -- he
sought advanced training -- and feels secure from layoffs. Like
many of his colleagues, he said he believes that only licensed
professionals should be allowed to use the technology.
"The harm that we could cause people because of the lack
of knowledge is tremendous," he said. Harrington said he
wonders about the woman who took his X-ray at the podiatrist's
office and whether she'll one day regret her cavalier attitude:
"It's like, if you don't see a danger, people don't think
there's one there."
Staff writer Sarah Avery can be reached at (919) 829-4882 or
savery@newsobserver.com
Submitted By: Susan
Dyson & David
Yoder |
