Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Article Comments

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*

You may also like these posts

    None Found

Read comments »

Comments are closed.

Return to article »

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

See all book reviews »

Commented - Most Popular Articles