Preparing for an ultrasound exam – How can GPs and sonographers work together to provide a mutually understood service for patients?
Preparing for an ultrasound exam – How can GPs and sonographers work together to provide a mutually understood service for patients?
Patients and clinicians, rightly so, place a huge responsibility on radiological imaging to provide answers for abnormal laboratory tests or symptomology. Imaging and ultrasound in particular play massive roles in patient pathways, but as with all medical tests, ultrasound is subject to its own limitations. As sonographers, we encounter patients with a range of emotions within our clinics. What a patient is told during their GP consultation can influence how well an individual complies with or tolerates an ultrasound examination.
The NHS is a busy place, getting busier, and it is becoming increasingly difficult to manage the expectations of the people we see encountering our services. So from the perspective of a sonographer, what do we feel that a general practitioner can do to help us manage these expectations in the ultrasound department?
- Sometimes we can’t just “check that area as well”. Whilst it can be very reassuring for a patient to have their region of pain or lump examined during in a scan which was for symptoms that they have not initially presented with, it can also throw up conundrums. Ultrasound has multiple sub-specialities and assessing areas of anatomy that are not our usual forte can lead to false reassurance for both the clinician and the patient, but also could increase anxiety when uncertain (but probably benign) findings are found.
- Radiological tests, and ultrasound in particular, cannot always answer the question! Patients arrive to examinations hopeful, as they have been led down a path that an ultrasound will answer all of their questions. However patients need to understand that like any other medical test, an ultrasound examination is used to gather evidence to rule in or rule out a clinical suspicion, not always to be definitive.
- For gynaecological examinations, more often than not we may need to do an internal examination. If during a consultation a patient is explicit that they do not want an internal examination, or a male sonographer, please make it clear on the referral. Transabdominal procedures require patients to attend with a full bladder and therefore a different appointment letter.
- Ultrasound examinations have no diagnostic value in assessing the architecture of the prostate and are inaccurate for quantifying prostate volume. Whilst an ultrasound scan can show if a prostate is enlarged, it has no value for determining infective or malignant change.
- Being open, honest and transparent is absolutely important, however a scan becomes very difficult to perform if a patient is told that the scan is “looking for cancer”. Their anxiety can result in their scans being suboptimal and difficult to perform.
Article by Shaunna Smith, Sonographer at Hull University Teaching Hospitals NHS Trust