There's no disputing the impact ultrasound is making in primary care. A growing number of general practitioners (GPs) are embracing different types of ultrasound systems to augment their patient care, grow their practices, and provide a better patient experience.[1]
Practices may see patients affected by abdominal pain, thyroid, cardiac and vascular issues, or aging populations at increased risk for musculoskeletal issues.[2] Fortunately, ultrasound is emerging as a way to help primary care meet these challenges.
Despite its increasing importance for GPs,[3] barriers persist in the application of primary care ultrasound. This reluctance stems from training and education as well as resource allocation and shifting organizational priorities.
Let's examine the obstacles that are preventing GPs from adopting ultrasound and how implementing the right system is a viable remedy.
What prevents general practitioners from adopting primary care ultrasound?
1. Lack of education and training
Whether real or perceived, steep learning curves have long kept many GPs from taking the leap and integrating ultrasound into their services. Recent data published in the American Journal of Medicine indicates that a lack of trained providers and funding for training were among the most common impediments to primary care ultrasound adaptation.[4]
Other education-related obstacles include lack of direct supervision for successful application, lack of time to perform scans, and lack of quality assurance processes to ensure compliance and correct utilization.[5]
Some GPs do not have the time or bandwidth to learn a new ultrasound system, regardless of ultrasound's incrementally common application. Training would be helpful to grow their practice and improve the quality of care for their patients. The right ultrasound system can help clinicians overcome these barriers with intuitive features, robust training and education, and ongoing support.
Features like scan coaching, AI-enabled assistance tools, and image-optimization can help even the least experienced users get the most accurate and reliable scans. Additionally, vendor training and support options can ensure maximum proficiency of use. This would include initial training and set up, subsequent online operational and clinical education, and comprehensive guidance in the event of any issues.
2. Initial cost of implementation
All general practices and primary care organizations have to consider the cost and long-term financial impact of their procurement decisions. In a landscape where many clinicians and administrators battle resource scarcity, ultrasound can be regarded as "too expensive" or a technology unable to deliver the right return on investment to justify the purchase. Many practices simply don't feel they have the up-front capital to purchase an entire system, despite their increasing affordability.[6]
With comparatively lower price points, flexible financing options, and comprehensive extended warranties, it's getting increasingly easier for primary care physicians to embrace ultrasound for a minimal up-front investment. These options help offset financial concerns and allow even the most intuitive and dynamic systems to be integrated more affordably than ever.
To further assuage economic worries, GPs new to ultrasound can immediately use it as a means to explore new revenue opportunities as they grow their practices, offer their current patients more comprehensive care, and treat new populations.[7]
3. Ongoing costs of scalability
Many GPs continue to voice concern about the future costs of upgrades, the possibility of premature obsolescence of technology, and how a system will fit into their future needs and growth objectives. Will the functionality and capabilities be adequate a year from now? Will upgrades be costly?
The right systems can help you scale up or down to meet your organization's shifting objectives and ambitions. They offer easy, remote, software-based upgrades and condition-specific probes to help you treat more conditions to meet your patients' evolving needs.
4. Spatial limitations
In addition to financial resources, space continues to be at a premium for many GPs. Whether it's a single-location practice or a hospital system with multiple facilities, there is hesitation that larger systems could require too much space.
In response to these concerns, the right primary care ultrasound unit offers maximum performance and versatility in a lightweight or portable package. Systems are available that are lightweight and easily maneuverable from room to room as well as smaller in overall size to better fit into office spaces. This not only simplifies life for clinicians but expands ultrasound access to more patients in need.
5. Repair, maintenance, and operability
Ultrasound and similar diagnostic technology need to consistently operate at optimal capacity and performance. But a fear of the system "breaking" keeps some practices from bringing ultrasound into their scope of services.
Clinicians need freedom to focus on patient care without the burden of navigating technical challenges related to their ultrasound equipment. The right system should offer comprehensive and prompt help. Routine maintenance and a dedicated team for service allows clinicians to continue providing the best patient care.
6. Diagnostic confidence and image clarity
One of the most pervasive barriers to primary care ultrasound is the notion that imaging specialists are more proficient. While ultrasound is a valuable diagnostic tool, primary care providers may need to weigh the benefits of having an in-house machine against the expertise of specialized imaging centers that focus solely on diagnostic imaging.
Like the obstacles listed above, this culture of skepticism can be laid to rest with the right system possessing features that deliver optimal clarity, user-friendly functionality, and premium training and support. Current technology allows GPs to perform scans with confidence and proficiency while achieving quicker diagnosis, greater speed of care, and—most importantly—a better experience for patients.
If you are a primary care physician considering in-office ultrasound, the right system allows you to "have it all" by eliminating many of yesterday's barriers.
Resources:
1. Touhami, D., Merlo, C., Hohmann, J., & Essig, S. (2020). The use of ultrasound in primary care: longitudinal billing and cross-sectional survey study in Switzerland. BMC Family Practice, 21(1). https://doi.org/10.1186/s12875-020-01209-7
2. Can, B., Kara, M., Kara, Ö., Ülger, Z., Frontera, W. R., & Özçakar, L. (2017). The value of musculoskeletal ultrasound in geriatric care and rehabilitation. International Journal of Rehabilitation Research, 40(4), 285–296. https://doi.org/10.1097/mrr.0000000000000239
3. Andersen, C. A., Holden, S., Vela, J., Rathleff, M. S., & Jensen, M. B. (2019). Point-of-Care Ultrasound in General Practice: A Systematic Review. Annals of family medicine, 17(1), 61–69. https://doi.org/10.1370/afm.2330
4. Nathanson, MD, R., Williams, MD, J., Gupta, N., Rescop, MD, D., Lucas, MD, MS, B., & Soni, MD, MS, N. (2023). Current Use and Barriers to Point-of-Care Ultrasound in Primary Care: A National Survey of VA Medical Centers. The American Journal of Medicine, 136(6). https://www.amjmed.com/article/S0002-9343(23)00108-0/fulltext#%20
5. Wong, J., Montague, S., Wallace, P., Negishi, K., Liteplo, A. S., Ringrose, J., Dversdal, R. K., Buchanan, B., Desy, J., & Irene, W. Y. (2020). Barriers to learning and using point-of-care ultrasound: a survey of practicing internists in six North American institutions. The Ultrasound Journal, 12(1). https://doi.org/10.1186/s13089-020-00167-6
6. Shen-Wagner, J., & Deutchman, M. (2020, November 15). Point-of-Care Ultrasound: a practical guide for primary care. AAFP. https://www.aafp.org/pubs/fpm/issues/2020/1100/p33.html
7. Mclaughlin, A., RN. (2020, November 15). Patient-Centric Revenue Sources: Ultrasound for your Medical Practice. Physicians Practice. https://www.physicianspractice.com/view/patient-centric-revenue-sources-ultrasound-your-medical-practice
