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Ultrasound Isn’t All That Useful In The ER

What Shari Welch Said.

Ultrasound is a neat toy, and I’m all about toys.  I found two opportunities to play with enhance patient care with our ultrasound today on my shift.  But it doesn’t have the bang for the buck that the enthusiasts think it does.   It has very narrow, but real, utility, and does nothing to generate revenue.  It does in some cases enhance patient turnaround, and it certainly enhances patient satisfaction (they love cool toys as much as we do — and extra face time with the doctor to boot!).  But that’s a small return on a machine costing tens of thousands of dollars.

But what Dr Welch is griping about is not just the cost of the machine (after all, the hospital pays for that), but about the hassle and time required to generate a professional bill for ED ultrasounds.  The rules are fairly clear — you need to archive the images, you need to generate a report comparable to that which a radiologist would have done (which is not to say that you need to perform a complete exam; the “limited” disclaimer will exempt you from the requirements for a complete exam, though you will bill out at a lower code as a result), and you need to perform regular Quality Assurance.  It’s a big commitment, and if you are really going to comply with these rules it will take a lot of administrative time, and will certainly slow down a busy ER doc trying to, um, move the meat.  As an entrepreneur, I’m all about trying to maximize the income stream.   Is there potential revenue in ultrsound?  Yeah, sure, some.  Not a lot, and definitely less than the opportunity lost in the time required to realize that revenue.

I kinda hate to be a wet blanket on this point.  I mean, it’s a gadget!  How can I *not* be insanely enthusiastic about it?  Turns out it’s kinda like my old Palm Pilot (yes, I am old enough to remember when it was called the Pilot).  I was the early adopter, got one as soon as they hit the market.  Showed everyone how cool it was and evangelized about how it was going to change the way doctors interacted with patient data.  Slowly it started to get used less and less till it ended up in my desk drawer.  The ultrasound’s not relegated to that ignominious fate and I doubt it will be.  But neither will it ever be one of those “I don’t know how I ever got by without it” things.

*This blog post was originally published at Movin' Meat*


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