The role of the sonologist in a sonographer-based practice

In many foetal medicine units and private practices, sonographers have gained considerable responsibility and independence. Still, there is a wide divergence of opinion as to their proper role, and to the role of the reporting doctor. The present study examines the role of the sonologist in three sonographer-based obstetric and gynaecological ultrasound practices. During a 25-day period, 14 sonographers filled out a questionnaire for each patient they scanned. Questions included indication for scan, whether or not and why the patient was scanned and/or seen by a sonologist, and abnormalities found. Information regarding 700 patients was obtained. Forty-eight patients were excluded because they were also booked to see a doctor. Of the remaining 652 patients, 74.5% had obstetric indications and 25.5% had gynaecological indications. Ten per cent of all patients scheduled to be scanned only by a sonographer also needed to be scanned by a sonologist, and 34.5% of all patients had contact with a doctor unexpectedly, most commonly to explain findings or arrange treatment and tests. In conclusion, in a sonographer-based practice the sonologist is often required to provide direct patient care beyond simple report writing. Therefore optimal patient management would require an on-site sonologist.