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Nova Scotia Ultrasound provides answers to frequently asked questions. We have received many questions about the regulation of the profession of diagnostic medical ultrasound in Nova Scotia and we have provided answers here. If you have questions about any aspect of the profession of diagnostic medical ultrasound, please send them to the executive. You can contact the executive on the Contact Us page.

Would you suggest maintaining our memberships with Sonography Canada and ARDMS?

What are the benefits to being self regulated?

What are the cons to being self regulated?

What is the committee proposing for the wording of our scope of practice?



Would you suggest maintaining our membership with Sonography Canada and ARDMS?

The best way to answer this question is to take a look at each one and see what each one provides you.

Sonography Canada: At this point, the legislation committee is recommending Sonography Canada as the prerequisite for qualification for your license. This is comparable with NSAMRT requiring that a candidate have their CAMRT. Therefore, you will need Sonography Canada.

Sonography Canada provides you with CME opportunities. These will be required by the college each year to renew your license. Of course, there are other avenues that you can pursue to acquire your CMEs.

Sonography Canada also provides personal liability insurance specific to sonographers. You are probably aware that you can be a member of Sonography Canada but opt out of the insurance and save a considerable amount. If you are a member of CAMRT you are covered under their insurance policy if you are ARDMS registered. For more information on the insurance offered by Sonography Canada, you can visit their web site. See the link on the LINKS page of this site.

You are covered by your employer's insurance policy. However, it is our understanding that if you are found to be negligent, the employer can then sue you to recoup their loses. It is therefore highly recommended by the Legislation Committee that make sure you have personal liability insurance.

ARDMS: Some employers in Nova Scotia may require that you have ARDMS as a prerequisite for employment. You will need to check with your employer on this. You could request that this requirement be changed to CARDUP now. After the legislation is passed you would also need your license from the college. At that point, you may check with your employer to see if they still require ARDMS.

Also, ARDMS is recognized throughout the world. If you plan to ever practice outside the province you may need ARDMS.

It will be a personal decision on your part whether you want to maintain your membership with all these registries and societies. However, we highly recommend that you maintain CSDMS with liability insurance. CARDUP will be a requirement.

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What are the benefits to being self regulated?

The first benefit is to the public. If we become self regulated with the NSAMRT then everyone practicing diagnostic sonography in Nova Scoita will need to be licensed. The license will be granted by the college only to those who meet the criteria set out in the regulations of the college. Your legislation committee is recommending that the criteria are CARDUP or ARDMS with CARDUP clinical competency testing.

Another benefit to being a self regulated profession is equal status with other regulated health professions. Sonographers in Nova Scotia have been overlooked as stakeholders for some very important health care decisions in the past. This is not unique to Nova Scotia. Sonographers across Canada have been overlooked on many occasions. For instance, sonographers were not consulted in Ontario when proposed changes to the nurses' scope of practice was to include performing ultrasound. A recent example here in Nova Scotia was failure to include sonography in the proposed Health Information legislation. Other examples exist and perhaps some sonographers remember being misrepresented as to the amount of expertise and education involved with sonography when the Hay Report was released. Sonographers were said to have only one year of training and so the recommendation for our pay was very low compared to radiography.

As a regulated health profession sonography will be regarded in the same light as nursing, respiratory therapy and other health professions when important decisions are being made in health care. Sonographers will be invited to the table as an equal stakeholder when health care decisions are being made.

Self regulation incorporates title protection. This means that only those holding an active license to practice diagnostic ultrasound can declare themselves to the public as a sonographer. Other titles will also be protected such as ultrasound technologist, and diagnostic ultrasound professional.

Practice protection is also incorporated with self regulation. The scope of practice for diagnostic medical sonography will be legislated and no one else can perform our functions. There will however be some exemptions such as those who are "duly qualified medical practitioners under the Medical Act". There may be other exemptions and the legislation committee is investigating who may be declared as exempted. There are always allowances for overlapping scopes of practice in any legislation of this type. We will keep you posted on what exemptions are ultimately determined.

Self regulation will also provide clarity of a number of processes, specifically, licensing criteria including continuing education and patient complaints processes. This process of handling complaints increases public confidence in the profession and its practitioners.

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What are the cons to becoming a self regulated profession?

Once regulated the profession falls under the control of the Department of Health to some extent and also to cabinet which is most always made up of members of the House of Assembly. If, for example, we as a profession felt that we needed to make a change to the regulations of the college, we would need approval of cabinet.

The most important con to becoming self regulated is cost. There are many costs associated with the process. The initial cost of setting up a college is substantial. This involves many hours in lawyers' fees because it is a legal process. Of course, increased numbers reduces the cost. The legislation committee recommends joining the NSAMRT for this and other reasons.

There are also ongoing costs of running a college on a day to day basis. These costs are associated with needing to pay a part time registrar, and operating a "store front". All self regulating health professions need to have an address where a people can call or present themselves in person to get information about the college or to lodge a complaint.

In addition to the initial set up and ongoing running of the college there are unknown and potentially substantial costs to being self regulated. These unknown costs are the costs of resolving complaints. There can be large lawyer fees if a complaint is deemed to be real by the board of the college. These costs can run into tens of thousands of dollars.

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What is the committee proposing for the wording of our scope of practice?

The committee proposes the following:

Diagnostic Ultrasound Sonography means:

- The examination of patients using high frequency sound waves and the production of diagnostic images
- The application of knowledge of anatomy, anatomic variants, physiology and pathophysiology in the evaluation and interpretation of diagnostic images to distinguish normal and abnormal findings specific to pathological processes during ultrasound examinations
- The application of ultrasound physics to distinguish artifact from pathological process during ultrasound examinations
- The communication of sonographic findings to the reporting physician
- The application of ultrasound field safety in the protection of patients
- The provision of care to patients during ultrasound examinations
- The education of patients regarding sonography
- Such other practices and procedures within the scope of practice of diagnostic ultrasound technology as taught in diagnostic ultrasound technology education programs

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