From: [EMAIL PROTECTED] Dear David,
Good to see the all thoughtful accounts around this subject. Firstly, let me say that I am a strong proponent of professional development. I agree about the need for registration. My concern is how to gain it without falling into the political traps for the unwary. I will try to keep my response brief. 1. "solid answers" There were no facts presented in the previous argument, thats what I am asking for, since registration has been legislated in various states. By whom & on what grounds? What are the benefits & limitations ? 2."chicken or egg...registration or accountability". The EPA license is our most powerful tool. It requires certain elements to be granted, it USED TO BE independent of radiologists The liability law we operate under is the same as everyone, public & professional liability. We all have insurance whether directly, under AIR or employer. 3.'other "Registered medical professionals"'. Registration is a club, it is a political tool held & used by "COLLEGES" who have the power to define & exercise that power. Registration does not grant power to self determination. As I understand it is not administered by radiation scientists. For example, a if person doing a 5 day radiation science course is granted registration to practice then that defines our "profession". Simply, the nurses RB & state MB's are in fact controlled by the nurses & doctors political lobbies (COLLEGES), something we don't have. COLLEGES are national & control NRB's & MB's which are state, under the constitution. 4. "nurse practitioners" My position is the same as the AMA. 1. Nurses are not trained to practice medicine. 2. If they want to practice medicine they are free to complete the medical degree. 3. NP is a direct result of applied political force, nothing else. 4. There are over 2000 doctors unemployed in this country but NP's are cheaper. 5. The NP creation is primarily based on the political decision to cut health spending & limit doctor numbers. This is strictly a political workforce, not community, issue. It is win/win for the nurses & government. 5. "ASA ASUM etc". There is less sonographer independence & professional standing as a result of registration. HIC deems registration a prerequisite for benefits. Outside of HIC it has zero value. The only benefit is to radiologists who now monopolize the market. It is dominated by the direct "supervision rule". This is an example of people seeking registration without planning, forethought & the power to make it work. Sonographers have zero professional independence with patients, they get to put their name on the report after "close supervision" by a radiologist before HIC benefit is payable. 6. "reports". In my experience radiation scientists are specifically enjoined from expressing an opinion in hospitals. Sure you give them to Jr MD's etc but you may not talk to the patient. I believe it is critical to establish the reporting precedent BEFORE pushing for registration. If we are registered now it will change nothing for the good & will lead to further "supervision", the legislated kind. Our competency is guaranteed by tertiary training & our credentials, which at this point are controlled by the AIR directly & indirectly. I was not referring to legal risk from reporting, I was referring to professional & public liability. It does not change under registration. Your employer still has the power to compromise you legally, every day, Your option is to accede or leave because you do not have the legal or political power to balance the employer or radiologist. Conclusion: It is erroneous to use the NRB as an example for registration. The nurses spent 20 years becoming a formidable political force before they created the NRBs which they control. It is a serious mistake to think that medical imaging practitioners can achieve this without FIRST defining themselves politically. My personal opinion is that our greatest precedent would be to use the radiologist shortage to gain limtied reporting rights at the level of the non- specialist doctor. I believe this is achievable. What we need is the establishment of an independent political wing that is attractive to the MIP community & negotiate our way to political power by controlling access to the market. That is, we need to put enough power together to force both the health departments & private practices to agree to reasonable demands in the establishment of professional identity & autonomy. Political power is about perception, projection & timing. We do NOT need registration until we have the power to define & control it. Imagine what could happen if every radiation scientist in the country acted in unison one time. Ron > From: "David Leslie" <[EMAIL PROTECTED]> > > Hi Ron and all, > no Ron not having a go at you at all. Your posting was the last in the line > which prompted my contribution. > I thought the answers were solid enough. It may be a bit of chicken or egg, > which came first, registration or accountability. I see both as being > complimentary. The issue may be somewhat legal, but without a registration > process, then accountability and independance cannot be had. > > Under current law, radiation licences can only control use of radiation. > They cannot be accounting for issues involving ethics, liability, or braoder > professional conduct. They only cover use of ionising radiation, so are not > even a prerequisite for practicing U.S. or MRI. That's a significant legal > reason why our professional control cannot rely on radiation licencing > alone. > > If registration does more harm than good, then I do not hear this from the > other "Registered medical professionals" which I listed. Each state has > it's Medical Board, Nurses Board, etc which regulates the professions to > ensure protection of public and ensure levels of competency. In the > Australian Constitution health is a matter for State jurisdiction, not > Federal,so unfortunately I see National registration as a legal furfy for > now, unless the Constitution is changed. We are in the same boat as any > other profession and will have to live with the legal anomalies of our > Constitution. I do not know what standing the national registration of > sonographers, which contributors have referred to, means. If it is simply a > list of people who hold a qualification in ultrasound which the ASUM or AIR > deem as appropriate, then the so called national registration may have no > legal standing what so ever. More feedback please from those involved. > > Until we are a registered and accountable profession then our actions will > always be deemed to be supervised by some one else, exactly your point about > compromising our position under the direction of an employer. I don�t see > that this compromises us legally at all because we are not in a position to > hold an independant professional opinion about the management of patients. > We can give as many opinions or "reports� to junior, senior doctors or > nursing staff as we like, but at the moment it is up to THEM not us what > they do with the information. Why? Because it is them, not us who, as the > registered professional, is responsible for the management of that case. > Sure, I know of radiographers who have been prosecuted for things like > fraud, or assault, or even the wrong examination i.e. not following > direction, but I don�t know of any radiographer who has been sued for > damages because of their independant patient management or interpretation of > results. > > This brings me to the nursing profession which I think offers a good analogy > to our own development as a profession. Nursing is a registered profession > which has undergone large changes in the last twenty years, from a > supporting arm of the medical profession working under the direction of > doctors, to an independent profession with its own legal standing, > independence and growing expertise eg Nurse Practitioners. Opposition to > this role development seems at odds with our own aspirations in e.g. > providing radiographic reporting. I was involved in the development of the > Nurse Practitioner role in SA and saw then how being a registered profession > gave "clout" to the role development in the face of medical opposition. Also > how having a Nurses Registration Board, who could give legal standing to new > roles and responsibilities, could facilitate the role development process > whilst safeguarding the expectations of patients. There was immediate > control of the professional boundaries and consequential action could be > taken by the Board to ensure standards of practice. > > I would therefore argue that we will have no legal right to perform limited > reporting or other independant, unsupervised activities where our opinion as > professionals counts, until we have the legal standing and professional > control that is provided by being a registered profession. > > Thank you for persevering with the long contribution. > Regards, > David Leslie. +=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+= This message is being broadcast by AIRNEWS, the Australian Institute of Radiography list Server Send messages to [EMAIL PROTECTED] For assistance send mail to [EMAIL PROTECTED] Commands should be sent to [EMAIL PROTECTED] Opinions expressed on this list are not necessarily those of the moderator, his assistants or those of the A.I.R.
