Radiographers -v- 'Techs'?

[Gunny]

I've been wondering about the role of the 'techs' in radiology deparments in the US and Canada? Here in the UK, they:

• Are referred to as radiographers - 'tech' seems a bit degrading!
• Go to university for four years to obtain their qualification, with extensive classes in Anatomy and Pathology, among others.
• Are a critical part of the healthcare team, along with for example nurses and physiotherapists. No radiographers=no exams!
• Have a statutory duty to control the amount of radiation the general population is exposed to, and thus have the capacity to reject procedure requests that they deem unnnecessary. Many times have I seen the radiographer ring an intern to inform him/her that the procedure the requested is unnecessary - e.g. a chest x-ray for a minor rib fracture, or an Abdo X-ray following a CT - and that they won't be proceeding with it. A friend of mine who worked for a while as a 'tech' (and boy how she hated that term!) in Bermuda told me that this doesn't happen in routine practice in North America.

Is this true in your experience? What's your view on the roles of the radiographer? Any comments/observations? Seems like they have a bit of a raw deal in North America!!

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[f_w]

> # Are referred to as radiographers - 'tech' seems a bit degrading!

Well, the 'tech' doesn't stand for technician, it stands for 'technologist'. This denotes the scientific foundation of their work (at least in the eyes of their credentialing organization, the ARRT).

> # Go to university for four years to obtain their qualification, with
> extensive classes in Anatomy and Pathology, among others.

Most RT's (in the US) today get their degree to my knowledge in 2 year associate programs. Some get a 4 year bachelors of radiological science. The bachelors doesn't help too much with a regular tech job, it is however very useful if one desires a career in managing a department or plans to go to graduate school (e.g. to become a physicians assistant).

> # Are a critical part of the healthcare team, along with for example
> nurses and physiotherapists. No radiographers=no exams!

Same here. Unfortunately, they often don't get the credit they deserve.

> # Have a statutory duty to control the amount of radiation the
> general population is exposed to, and thus have the capacity
> to reject procedure requests that they deem unnnecessary.

Well, they have the duty to perform the requested study at the lowest reasonably achievable dose.
Their role to curb unneccessary utilization is limited to bringing unreasonable requests to the attention of the radiologist in charge. It is up to the radiologist to duke it out with the referrer (given the economics of radiology and the litigious environment of care in this country, there is however very limited incentive to refuse studies. If an RT brings another particularly bizarre request to the rads attention, they will often hear 'just do it' and give up on it for the future). The pain threshold is reached when the wrong interventional procedure is ordered. While you can consider the unneccessary application of ionizing radiation a crime in its own right, the moment you stick a sharp instrument into your patient you are really charged with making sure it is for a good reason.

Note: In some states in the US we have no licensing or certification for radiographers. Anyone who feels qualified can push the button. In other states, we have an 'x-ray operator' who sort of functions below an RT. They are typically nurses at rural clinics (too small to employ an RT) who will be able to take CXR's or simple extremity films under supervision of the clinics physician.

 

[f_w]

> What's your view on the roles of the radiographer?

Couldn't work without them. As any group of professionals they come in all shades and variations. From qualified professionals held in high regard by the other members of the healthcare team, to unmotivated and uncaring 'button-pushers' dreaded by everyone in the hospital.


> Seems like they have a bit of a raw deal in North America!!

Actually, they don't.
At least they make decent money. I keep telling high-school kids that if they are looking for an associate level job allowing them to feed a family, RT is one to consider.
And while many techs do this as a career, there are are opportunities to advance. Just recently, the 'radiology assistant' pathway has been kicked off. Similar to the 'reporting radiographer' in the UK, these 'super-techs' are expected to take a more active role in the imaging sector (officially they are not to interpret studies, but I would be suprised if they didn't gain that priviledge after a couple of years). Also, the scheduling of techs is very flexible. Many hospitals look for 'third shift' (overnight) or 'per diem' techs at very favourable pay. Some techs will use such a 'per diem' job as a means to work their way through college (e.g. to become a certified public accountant like one of our techs just did).