How a lack of regulation is allowing unqualified people to perform ultrasounds | 7.30

Key Concepts:

• Reassurance Scans: Non-medical ultrasounds offered by private providers, often focusing on keepsake images and gender reveals.
• Medical Scans: Ultrasounds performed by qualified sonographers for diagnostic purposes, including detailed medical reports.
• Sonographer Regulation: The lack of national standards, registration, and oversight for sonographers in Australia.
• Operator Dependence: The high degree of skill and training required for accurate ultrasound interpretation.
• Misdiagnosis/Missed Diagnosis: Potential consequences of unqualified sonographers performing scans.
• AHPRA: Australian Health Practitioner Regulation Agency, the organization that registers health professionals.

1. The Problem: Lack of Regulation and Rise of Reassurance Scans

• Viv Matikas' experience highlights the issue: a rushed, unclear ultrasound scan from a private provider, no medical report sent to her obstetrician, and the need for a repeat scan costing her additional money.
• Dr. Denanisha Cot (President of the Royal Australian and New Zealand College of Obstetricians and Gynecologists) notes the increasing prevalence of "reassurance scans" offered by private providers, which may not include a proper medical assessment.
• These reassurance scans often focus on providing images and videos for parents, sometimes in 3D or 4D, but may lack the medical rigor of diagnostic ultrasounds.
• Some patients unknowingly book reassurance scans instead of medical scans, leading to potential issues if problems are detected but not properly documented or reported.
• Federal Health Minister Mark Butler has asked for a briefing and is investigating reassurance clinics.

2. Consequences of Unregulated Sonography

• Andrew Huitt (a sonographer with over 30 years of experience) emphasizes that sonography is a highly "operator dependent" profession requiring intense and lengthy training.
• He highlights the risk of misdiagnosis or missed diagnosis due to unqualified individuals performing scans, which can have "life-altering" consequences.
• Currently, anyone can purchase an ultrasound machine and offer private scanning services without needing specific qualifications, as long as they don't bill through the health system.
• There is a sonographer shortage, potentially leading to less qualified individuals entering the field to meet demand.

3. The Need for Regulation and National Standards

• The Australasian Sonographers Association has been advocating for sonographer regulation for over 2 years.
• Tony Kohl's (President of the Australasian Sonographers Association) proposes registering sonographers through the Medical Radiation Practitioners Board of Australia (under AHPRA), aligning them with other medical imaging professions like radiographers and nuclear medicine technicians.
• Currently, there is no national system for enforcing competency, quality standards, or handling complaints against sonographers.
• This lack of a central repository for complaints makes it difficult to assess the true extent of the problem.

4. Government Investigation and Potential Solutions

• Federal Health Minister Mark Butler states that a review is underway to determine whether sonography and other allied health professions should be brought under the national regulatory scheme for health professionals.
• The review is due to report to health ministers in the coming months, and sonography will be included in the report.

5. Viv Matikas' Plea and Call to Action

• Viv Matikas expresses her hope that better regulation will prevent others from experiencing similar issues.
• She advises pregnant women to thoroughly research ultrasound providers to ensure they are qualified and will provide proper medical reports.

6. Key Quotes:

• Dr. Denanisha Cot: "There are more and more providers who actually do these reassurance scans. They may not even do any medical scans at all."
• Andrew Huitt: "Synography is actually a really highly operator dependent uh profession... there's a high skill level required and it's um a critical uh diagnostic tool that a lot of the medic rely on and so we have to get it right."
• Andrew Huitt: "A misdiagnosis or or a missed um or a wrong diagnosis um you know it can be lifealtering in terms of the outcome."
• Tony Kohl's: "We'd like to see synographers registered through that board [Medical Radiation Practitioners Board of Australia] that would bring it into line with other medical imaging professions."
• Viv Matikas: "I don't want others to go through this to feel like they have no choice but to go to places like this to do their research and make sure the places are proper and that they will get their medical reports because otherwise you're left paying for it all over again because it wasn't done properly the first time."

7. Synthesis/Conclusion:

The video exposes a concerning gap in the Australian healthcare system: the lack of regulation for sonographers. This has led to a rise in private providers offering "reassurance scans" that may not meet medical standards, potentially endangering pregnant women and their unborn children. The absence of national competency standards, registration, and a complaints mechanism allows unqualified individuals to perform ultrasounds, increasing the risk of misdiagnosis and missed diagnoses. The government is currently reviewing the situation, and stakeholders are advocating for sonographers to be regulated under AHPRA, similar to other medical imaging professionals. The hope is that increased regulation will ensure quality and safety in ultrasound services for all Australians.