Expanding radiographer role ‘could put patients at risk’

Interpreting scans goes 'significantly beyond' their training, radiologist college warns

Asking radiographers to interpret scans instead of just administering them could compromise patient care, a body representing radiologists has warned.

The Medical Radiation Practice Board wants to expand radiographers’ minimum scope of practice to include evaluating images and making recommendations about whether scans are necessary for each patient.

In a consultation paper published earlier this year, the board argued technological developments were making it possible for radiographers to take on new roles, including work traditionally only performed by doctors.

It also said there had been “changes to the scope and role of medical radiation practitioners” in the past five years, meaning radiographers should be able to take on complex tasks such as:

  • Assessing imaging requests or referrals and suggesting alternatives;
  • Evaluating medical images;
  • Applying knowledge of safe and effective use of medicines (other than IV contrast and medications used for image-guided injections);
  • Interpreting and communicating examination findings; and
  • Providing medical information to patients and their family and carers.

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But the Royal Australian and New Zealand College of Radiologists (RANZCR) knocked back many of the suggestions, arguing they went “significantly beyond” the training of radiographers and required “rigorous undergraduate medical and post-graduate specialist training and expertise”.

“Radiographers are not trained as medical practitioners and do not study in-depth the nature, management and prognosis of disease nor the capacity of different imaging techniques to demonstrate disease processes,” the college wrote in its submission.

It also pointed out the draft document failed to mention that a radiographer always worked under the supervision of a radiologist. This meant all concerns should be referred to the supervising radiologist.

The college said role extension for radiographers had only occurred in one notable country, the UK, and this was because of a chronic shortage of clinical radiologists rather than from any desire to improve patient care.

But Australia had no such problem, it said.

Clinical Associate Professor Sanjay Jeganathan, dean of the college’s faculty of clinical radiology, stressed that radiographers were highly valued members of the imaging team.

But safe, high-quality patient care could only be delivered by the appropriately skilled professionals, he said.

“There are significant risks to a patient if their doctor makes treatment decisions based on information provided by a radiographer that is incomplete, incorrect or lacking clinical context,” he said.

“The draft competencies lack clarity and are open to wide-ranging interpretation. We would like to see clarification of these points to ensure that there are no unintended consequences from misrepresentation.”

The AMA echoed the college’s concerns in its own submission to the Medical Radiation Practice Board.

While the board cannot independently make changes to scope of practice, it does work in an advisory capacity to the Ministerial Council of the Council of Australian Governments.

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