Radiologist assistant..heard of it?

[nev]

Has anyone heard about a the new program called a Radiologist Assistant?
It requires a B.S in radiography (I think) as one of the pre-reqs. I know about one colleg offering this course...it is in Midwestern State University , Wichita Falls,Texas.

Tell me what u guys think about it.

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[deleted6669]

See Similar Thread Over At Physicianassociate.com
The Short Answer Is That They Can Only Practice In Ny State So It Is A Waste Of Time And Money.

 

[cdcd67]

Have you guys heard about Radiologist practitioner assistant? They are different from RA and require education. I was wondering if any of you knew in what states RPA are allowed to practice.

 

[Taurus]

Have you guys heard about Radiologist practitioner assistant? They are different from RA and require education. I was wondering if any of you knew in what states RPA are allowed to practice.

RPA's and RA's have been discussed ad nauseum over on auntminnie.com

Here are some threads on the topic:

http://www.auntminnie.com/forum/tm.aspx?m=84190
http://www.auntminnie.com/forum/tm.aspx?m=87767
http://www.auntminnie.com/forum/tm.aspx?m=89514
http://www.auntminnie.com/forum/tm.aspx?m=96681
http://www.auntminnie.com/forum/tm.aspx?m=132262
http://www.auntminnie.com/forum/tm.aspx?m=85054

It seems to me that the RPA's will eventually get phased out. I don't know how much longer Weber State can continue to offer the program when the RA movement is making so much progress in terms of programs offered and the number of states that have approved RA legislation.

Personally, I don't know why anybody would become an RA. Being a PA is much more versatile and PA's are increasingly being utilized in radiology.

 

[meister]

I had never heard of PAs being used in this capacity. What sort of things would a PA do in radiology? Do they read MRIs?

 

[deleted6669]

I had never heard of PAs being used in this capacity. What sort of things would a PA do in radiology? Do they read MRIs?

mostly interventional stuff like difficult line placement, lp's/abscess drainage with fluoro, etc
I don't know of pa's reading diagnostic studies anywhere as their primary job function although all pa's read plain films in the general course of their day to day practice in em, fp, etc.

 

[Taurus]

I had never heard of PAs being used in this capacity. What sort of things would a PA do in radiology? Do they read MRIs?

Some radiology groups use RA/RPA's and PA's and sometimes NP's to do the routine interventional work that can get monotonous. You can do only so many PICC lines before you want to hurl. The really interesting or complex interventional cases are done by the radiologists.

RA's do not interpret images at all. The radiologists were very emphatic about that when they designed the RA. The RPA's wanted to basically do everything that a radiologists did, including procedures and image interpretation and without direct radiologist supervision. You can read more about it here.

However, my feeling is that we're opening a Pandora's box. First, we let RA's do the simple cases, but it's just a matter of time before they ask and lobby for more. Radiologists need to stop being so lazy. Do you ever see surgeons allowing an RNFA or PA do the surgery while they're drinking coffee in the next room? Overall, I'm not worried about the RA's. It was a compromise to fend off the RPA's. In addition, there's nothing special about the RA that a senior RT tech, PA, or even NP couldn't do.

There's a very interesting history behind the RA and RPA. The radiologists basically took what could have been a serious problem, ie, CRNA's and NP's, and squashed it like a bug. The rest of medicine has much to learn from this.

 

[RPA]

I am a Radiology Practitioner Assistant who graduated from Weber State University. Unless a PA is a Rad Tech they are not legally able to use a fluoroscopy unit, which is used in Radiology to do procedures. To my understanding PAs are not trained in radiation protection and radiation physics like the RPAs and RTs are. I am a registered RT, who is certified in Radiology, MRI and Mammography (and soon to be CT and US). I am able to assist the Radiologists as well as the technologists in almost all aspects of their work. I have been in the field of Radiology since 1994. With all of the experience that goes along with being dedicated to one field (Radiology) I feel that this makes a specialist a specialist. The program at Weber State can not compare to the RA programs. Weber state has been in existence much longer than the RA programs and has their curriculum down to a science. In speaking with some of the RA students from the other schools they are just beginning and with anything new there has to be time to work out the quirks. I feel that there is a definite and positive role in radiology for all of us. It just depends on the site as to what they wish to accomplish. As far as reading films, that job should be left to the Radiologist with 12+ years of schooling. Anyone can see a gross fx or a normal from abnormal film but it should be left to the Radiologist to use all of their experience and schooling to come up with the differentials and diagnosis. The Radiologists of today are not being lazy sitting back drinking coffee. They are overworked because of the shortage of people wanting to become Radiologists due to the litigious society that we live in. As the baby boomers get older you will see how important it is to have as much help as possible. To have anyone who is passionate about their job enough to want to go back to school to learn more is a person I would want taking care of me.

 

[howelljolly]

I am a Radiology Practitioner Assistant who graduated from Weber State University. Unless a PA is a Rad Tech they are not legally able to use a fluoroscopy unit, which is used in Radiology to do procedures. To my understanding PAs are not trained in radiation protection and radiation physics like the RPAs and RTs are. I am a registered RT, who is certified in Radiology, MRI and Mammography (and soon to be CT and US). I am able to assist the Radiologists as well as the technologists in almost all aspects of their work. I have been in the field of Radiology since 1994. With all of the experience that goes along with being dedicated to one field (Radiology) I feel that this makes a specialist a specialist. The program at Weber State can not compare to the RA programs. Weber state has been in existence much longer than the RA programs and has their curriculum down to a science. In speaking with some of the RA students from the other schools they are just beginning and with anything new there has to be time to work out the quirks. I feel that there is a definite and positive role in radiology for all of us. It just depends on the site as to what they wish to accomplish. As far as reading films, that job should be left to the Radiologist with 12+ years of schooling. Anyone can see a gross fx or a normal from abnormal film but it should be left to the Radiologist to use all of their experience and schooling to come up with the differentials and diagnosis. The Radiologists of today are not being lazy sitting back drinking coffee. They are overworked because of the shortage of people wanting to become Radiologists due to the litigious society that we live in. As the baby boomers get older you will see how important it is to have as much help as possible. To have anyone who is passionate about their job enough to want to go back to school to learn more is a person I would want taking care of me.

I know a few med students who would give their left thumb to be a radiologist.

 

[Taurus]

I am a Radiology Practitioner Assistant who graduated from Weber State University. Unless a PA is a Rad Tech they are not legally able to use a fluoroscopy unit, which is used in Radiology to do procedures. To my understanding PAs are not trained in radiation protection and radiation physics like the RPAs and RTs are. I am a registered RT, who is certified in Radiology, MRI and Mammography (and soon to be CT and US). I am able to assist the Radiologists as well as the technologists in almost all aspects of their work. I have been in the field of Radiology since 1994. With all of the experience that goes along with being dedicated to one field (Radiology) I feel that this makes a specialist a specialist. The program at Weber State can not compare to the RA programs. Weber state has been in existence much longer than the RA programs and has their curriculum down to a science. In speaking with some of the RA students from the other schools they are just beginning and with anything new there has to be time to work out the quirks. I feel that there is a definite and positive role in radiology for all of us. It just depends on the site as to what they wish to accomplish. As far as reading films, that job should be left to the Radiologist with 12+ years of schooling. Anyone can see a gross fx or a normal from abnormal film but it should be left to the Radiologist to use all of their experience and schooling to come up with the differentials and diagnosis. The Radiologists of today are not being lazy sitting back drinking coffee. They are overworked because of the shortage of people wanting to become Radiologists due to the litigious society that we live in. As the baby boomers get older you will see how important it is to have as much help as possible. To have anyone who is passionate about their job enough to want to go back to school to learn more is a person I would want taking care of me.

If you read the auntminnie recently about the job market, people are noticing a sharp decline.

Here's something else I didn't realize until I studied this issue more. Most RPA's don't even have college degrees. How would you like somebody who does interventional procedures on you without direct physician supervision and that person is not even a college grad? That's scary to me. To be certified as RA's, the RPA's are being required to get college degrees.

 

[foreverLaur]

The PA that I shadowed in thoracic oncology read all the scans... particularly PET scans in this case.

I'm sure a radiologist had comments on the PET scan, but for the most part, the PA read it, decided, and then went in to talk to the patient.

 

[howelljolly]

The PA that I shadowed in thoracic oncology read all the scans... particularly PET scans in this case.

I'm sure a radiologist had comments on the PET scan, but for the most part, the PA read it, decided, and then went in to talk to the patient.

I think PAs can read whatever they want, and act on it... but the official read still needs to come from a radiologist. The PA or MD clinician run the same risk of acting on their own misdiagnosis.... though thats probably rare.

 

[Taurus]

The PA that I shadowed in thoracic oncology read all the scans... particularly PET scans in this case.

I'm sure a radiologist had comments on the PET scan, but for the most part, the PA read it, decided, and then went in to talk to the patient.

If this is true, I wouldn't want to be the supervising physician of this PA. It's just another lawsuit waiting to happen.

 

[foreverLaur]

Well for starts, a radiologist reads it before the PA ever sees it. So it isn't like the PA is pulling a diagnoses from a PET scan out of thin air.

The doctor isn't going to operate without looking at the PET scan himself and he also sees all patients before surgery.

The doctor and PA have been working together for 23 years. I'm also pretty sure a PA is legally allowed to do anything their PS can do. The only legal issues come up if/when the PA "screws up" but a missed diagnoses would be at the fault of the radiologist who missed it, not the PA who followed the radiologists findings and the doctor who followed up on the patients the PA saw.

So, where is this 20+ year lawsuit waiting to happen?

 

[deleted6669]

The doctor and PA have been working together for 23 years. I'm also pretty sure a PA is legally allowed to do anything their PS can do.

a pa can do anything their sponsoring physician delegates to them. this may not include tasks the sp themselves can not perform. an experienced pa may have a scope of practice very similar to their sp but they don't "automatically" get credentialed for anything the sp can do. in most states and at most facilities there is a defined scope of practice for pa's in each specialty and if you want to exceed that you need to demonstrate training and experience in those areas to the satisfaction of the credentialing committee. for example I just started a new per diem job and had to apply for specific credentialing to do LP's, procedural sedation, fx reduction, regional anesthesia blocks, etc because these are not in the basic scope of practice description.
these were not "automatic" even though my sp there is a residency trained em md. they can do trauma thoracotomies for example and I'm not credentialed for those although I have 1st assisted a bunch.
in primary care the scope of a pa is basically the scope of their sp but in many specialties this is not the case.

 

[XRAYMAN2008]

except fluoro guided procedures. In the state of IL there have been heavy fines for PAsthat use fluoro.

 

[deleted6669]

except fluoro guided procedures. In the state of IL there have been heavy fines for PAsthat use fluoro.

if it's in their written state scope of practice they can do it.
I use bedside flouro all the time....
From the state of illinois medical board site:
http://www.ilga.gov/commission/jcar/admincode/068/068013500000900R.html

Section 1350.90 Scope and Function

a) A physician assistant may provide medical/surgical services delegated to him/her by the supervising physician(s) when such services are within his/her skills and within the current scope of practice of the supervising physician/alternate supervising physician and are provided under the supervision and direction of the supervising physician/alternate supervising physician.

b) The physician/physician assistant team shall establish written guidelines that are individual to the physician assistant in the practice setting and keep those guidelines current and available in the supervising physician's office or location where the physician assistant is practicing.

 

[core0]

if it's in their written state scope of practice they can do it.
I use bedside flouro all the time....
From the state of illinois medical board site:
http://www.ilga.gov/commission/jcar/admincode/068/068013500000900R.html

Section 1350.90 Scope and Function

a) A physician assistant may provide medical/surgical services delegated to him/her by the supervising physician(s) when such services are within his/her skills and within the current scope of practice of the supervising physician/alternate supervising physician and are provided under the supervision and direction of the supervising physician/alternate supervising physician.

b) The physician/physician assistant team shall establish written guidelines that are individual to the physician assistant in the practice setting and keep those guidelines current and available in the supervising physician's office or location where the physician assistant is practicing.

Its under the radiation safety laws. In Illinois PAs can take X-rays but not utilize fluoroscopy:
http://www.aaspa.com/pdfs/2008 X-ray Provileges by State for PAs.pdf

David Carpenter, PA-C

 

[deleted6669]

Its under the radiation safety laws. In Illinois PAs can take X-rays but not utilize fluoroscopy:
http://www.aaspa.com/pdfs/2008 X-ray Provileges by State for PAs.pdf

David Carpenter, PA-C

thanks for the reference.
seems like a silly law, bedside fluoro is easier than plain film radiology to perform....
apparently my state would allow me to take xrays which I have no desire to ever do.
I have a buddy who works in alaska who is not an xray tech who works in a very rural setting and has to take his own films. he got a 1 day crash course from the off going pa and did a lot of self study and does ok...

 

[RPA1]

Just to chime in, first of all, all RPAs have degrees. It is a requirement to be a Registered Technologist (RT) with five years experience before applying to the RPA program. The program currently consist of many of its course hours on a graduate level. Upon completion, only the research portion is left to acquire the Masters. RRAs (Registered Radiologist Assistants) are all on BS levels with a few Masters programs.
RPA/RAs have over 1800 hours of time spent with their radiologists during interpretation and procedures (diagnostic and interventional) throughout the duration of the program. For other midlevels downing the profession I find it unprofessional and imature. We are a young profession of 10 years and are taking our place in Radiology where we belong. The RPA curriculum was based on the NP course work for the general med portion which includes patient care and assesment, pharmacology, patho, medical ethics and law, etc. Then we cover how patho relates to every imaging modality and (i.e. Ultrasound, CT, MR, etc.) As a RPA Intern, all of the NP and PA students come through our department for their brief rotations. NPs spend 16 hours and PAs spend maybe 50 hours if they elect to even have a Rad rotation. By the way, the local NP and PA program here if you view the curriculum, there is NOT 1 HOUR of formal radiology coursework. I have 10 years of Interventional experience as a Vascular Interventional specialist, a member of the Society of Interventional Radiology, Association of Vascular and Interventional Radiographers, Certified RA (CBRPA), and will take my boards for the RPA and RRA this summer and take my place with my Radiologist's group with some physicians who have practiced for over 30 years because they have seen how RPA/RAs perform exams and take care of their patients and would not even consider a NP or PA since they would have to be taught on the job and is a big liability. So what we can't write a prescription. Who writes scripts in Radiology anyway? We can administer conscious sedation and order additional imaging studies if needed. We are taught how to do an H&P but do not need to perform these since H&Ps are provided by the referring anyway! RPAs are recognized by CMS and have a taxonomy code and billing is in the future. So once again, I'm not here to slam any profession. Just providing factual information. We all have to work together as a team in my perspective and every memeber of the team has a place and purpose. If anyone has questions about the RPA/RA profession, ask a RPA/RA. Now, who would you want to perform your invasive radiology procedure other than a Radiologist?

 

[RPA1]

How much formal education do you have in Radiology (radiation safety)?

 

[Taurus]

As a RPA Intern

This reminds of the time when a 2nd year RA student introduced himself to me as, "Hi, I'm XXX. I'm a radiology assistant resident." It took all the will power in me to not crack out laughing.

 

[core0]

This reminds of the time when a 2nd year RA student introduced himself to me as, "Hi, I'm XXX. I'm a radiology assistant resident." It took all the will power in me to not crack out laughing.

How about this:
"The MSU Bachelor of Science in Radiologic Science (BSRS) degree is ENTIRELY available through distance education, so students NEVER have to come to the MSU campus to earn this degree.

All courses in the BSRS program are offered as Internet courses. Instructors are available by phone and/or email. Course content is based on standard textbooks and the on-line course instructions guide students through every step of the material. Courses are usually divided into several individual units or modules with accompanying assignments or quizzes submitted for grading. Specific instructions for assignments, quizzes, projects, online discussion boards, and exams are provided in each course syllabus. Students take exams at approved proctored sites."

 

[DCWVU]

How about this:
"The MSU Bachelor of Science in Radiologic Science (BSRS) degree is ENTIRELY available through distance education, so students NEVER have to come to the MSU campus to earn this degree.

All courses in the BSRS program are offered as Internet courses. Instructors are available by phone and/or email. Course content is based on standard textbooks and the on-line course instructions guide students through every step of the material. Courses are usually divided into several individual units or modules with accompanying assignments or quizzes submitted for grading. Specific instructions for assignments, quizzes, projects, online discussion boards, and exams are provided in each course syllabus. Students take exams at approved proctored sites."

The didactics are online, but the clinical portions have to be done at a facility near the students home.

 

[PHealthMan]

listen to the Paul Revere of Medicine ... as a medical student he has much experience in health profession policy and trending as well as research in these areas. I like how he calls for increased research, yet probably would falter in true debate on the literature of PA and NP competency and use. Wake up and take your PA and NP questions to message boards where people with credence in these areas post. (PA Forum, Nursing Forum)

 

[jeffreyfrog]

Of course it's a real job. A radiologist is a physican who specializes in the interpretation of medical images such as MRI scans, CT scans, x-rays, nuclear medicine scans, mammograms and sonograms. They are specially trained to identify injury and disease in each of the body's systems, whether bone, tissue, organs or blood vessels. Radiologists may specialize in fields such as neuroradiology, angiography, cardiovascular-interventional radiology, pediatric radiology or nuclear medicine. Pleasanton Radiation Oncologist.

 

[howelljolly]

thanks for the update

 

[RRA1]

The didactics are online, but the clinical portions have to be done at a facility near the students home.

Hello,
I must correct these comments. The BSRS courses at MSU are online but the RA program (which is a Master's degree) require students to attend classes on campus twice a semester. While the RA students are on campus, they participate in extensive labs, lectures, hot seat, and case studies. The RA students do perform online quizzes and projects. They perform their clinical experience and competencies under the supervision of a radiologist preceptor that has agreed to participate in their training. The MSU instructors perform clinical site visits to ensure the student is performing up to standards.

Thank You.

 

[cecilia]

In California we can do Fluoro now.


Hooray! Congratulations!...AB 356 (Fletcher)
Signed into Law by the Governor!
by Beth Grivett, PA-C
Legislative Affairs Coordinator

Those of you working in interventional radiology, orthopedics and pain management are one step closer to a better practice environment. AB 356 (Fletcher) was signed by the Governor on October 11, 2009. A few amendments have been taken to clarify language and the bill is very specific to fluoroscopy. Effective January 1, 2010, PAs who wish to obtain a fluoroscopy permit will need to take a 40 hour course in fluoroscopy radiation safety and pass an exam administered by the Radiologic Health Branch in order to be licensed to use fluoroscopy during procedures in the State of California. Our thanks go out to Assemblyman Fletcher and his staff for working so diligently on this bill and to the Radiologic Health Branch and the Radiation Technologists for taking the time to learn more about the PA profession and to understand our partnership with physicians especially at it relates to interventional radiology. With their help and the work of our lobbyist, Bryce Docherty, we have made tremendous gains toward knocking down yet another barrier to practice as we get closer to an ideal practice environment for PAs in California.