Scope of Practice FAQs

• To whom should the sonographer provide the preliminary report/sonographer findings?

  The short answer is: it depends! The Scope of Practice and Clinical Standards for the Diagnostic Medical Sonographer was written ​with the recognition that there are many different medical specialties and practice settings. And depending on the facility, the sonographer may be dealing with variations of ​different physician roles (i.e., referring, interpreting, and supervising).
  
  The glossary found at the end of the Scope of Practice provides three definitions for ​some common roles that physicians serve in sonography.  
  
  

  1. Interpreting Physician: The physician (e.g., radiologist, cardiologist, gynecologist, obstetrician, vascular surgeon, etc.) who evaluates the results of the diagnostic examination and provides the final report of the findings that is included in the patient’s medical record. 
  2. Referring Physician: A physician who orders a diagnostic examination or refers the patient to a specialized facility for a diagnostic examination. In some clinical environments, the referring and supervising physician may be the same person.
  3. Supervising Physician: A physician who provides overall medical direction of the sonographer but whose physical presence may not necessarily be required during the performance of a diagnostic examination. The supervising physician is available to review examination procedures and to offer direction and feedback. In some clinical environments, the supervising and interpreting physician may be the same person.

  Because sonographers are only licensed in a few states, they are generally considered to be performing sonographic procedures as an extension of a supervising physician. In a single physician OB office, this might be the obstetrician; in a vascular lab, it is often the designated "medical director"; in a hospital, this might be the ​radiologist in charge of the radiology department. 
  
  If the facility is accredited in ultrasound (e.g., American College of Radiology, American Institute of Ultrasound in Medicine, Intersociety Accreditation Commission), the accreditation standards may also provide guidance (or requirements) on how sonographic procedures are to be performed​, supervised, and interpreted.
  
  As a result, facility policy (​e.g., in writing and approved by the appropriate facility authority, e.g. medical staff board, etc.) will play a significant role in who can: (a) refer a patient to the facility for a sonographic procedure; (b) order a sonographic procedure at the facility; (c) perform a sonographic procedure in the facility; (d) supervise the sonographer performing the sonographic procedure; (​​e) interpret the sonographer's images and preliminary report/findings ​and then make the diagnosis, (​f) bill for the technical component (actual performance of the procedure); and (g) bill for the professional component (physician interpretation of the procedure). 

  Other Resources:
  
  American College of Radiology Ultrasonography Practice Parameters and Technical Standards
  http://www.acr.org/Quality-Safety/Standards-Guidelines/Practice-Guidelines-by-Modality/Ultrasound
  
  American College of Emergency Physicians
  https://www.acep.org/Physician-Resources/Practice-Resources/Administration/Financial-Issues-/-Reimbursement/Ultrasound-FAQs/

• Other Common or Emerging Roles for Sonographers

  The Scope of Practice sets forth the standards in major areas of the diagnostic medical sonographer’s responsibilities. It does not cover all areas or topics that may  present themselves in actual practice. In addition, technological changes or changes in medical practice may require modification of the standards.
  
  The SDMS Board of Directors has approved two position statements related to sonographer tasks/roles not specifically addressed in the Scope of Practice:

  • Physician Orders and the Sonographer Scope of Practice
  • 3D Models from Sonographic Images

  NOTE: The SDMS Position Statements have not been reviewed or approved by the endorsing or supporting organizations; therefore, they should only be considered official statements ​of the SDMS.