Radiography (2005) 11, 305e306

LETTER TO THE EDITOR

Response to Letter to the Editor byBrian Tidey

Dear Editor in Chief

Thank you for inviting me to respond to theletter from Brian Tidey and in particular on whatadvice might be offered to radiographers in othercountries trying to develop advanced competen-cies? It is a difficult question especially as therewill almost certainly be different health caresystems from that of the United Kingdom. None-theless I shall try to offer some suggestions.

The situation in the United Kingdom is unique inmy view and I believe Brian has hit the nail on thehead. There is no shortage of radiologists in NewZealand, and as far as I am aware the situation isthe same in Canada and Australia. I am not sure ofthe overall position in the USA but payment ofradiologists is probably determined in a similar wayas in the other three aforementioned countries andthis is the crux of the matter. I see the majordifference between the NHS and the other coun-tries is that we have a health system funded out oftaxation; radiologists are employed by the trusts(hospitals), and are paid a salary which is notdirectly dependent on the number of examinationsor reports written. A system funded largely byprivate insurance is by its nature very different andthe volume of work will directly determine earn-ings. Then it follows that if radiographers aretaking over radiologists work then there will beless for the radiologists. Not surprisingly radiolog-ists are likely to consider very carefully a situationwhere their income is reduced. Interestingly, I amnot aware of radiographers undertaking extendedroles in the private sector in the UK, presumably forthe same reasons as stated. So as for making a starton reporting Brian is probably in a good position, itseems that he is being offered an opportunity thatis in advance of the red dot system.

Radiographers continue to advance their role inthe UK and the rate at which it has occurred overthe past decade is indicative that their perfor-

1078-8174/$ - see front matter ª 2005 The College of Radiographedoi:10.1016/j.radi.2005.05.003

mance is at the same standard as radiologists orother medical practitioners; otherwise, the devel-opments would not have been adopted and pro-gressed to the extent they have done. My latestsurvey, which has been submitted to Radiography,shows continuing adoption and diffusion of ex-tended roles since 2000. A summary of the resultsfrom this proposed article is as follows:

� RESULTS: Some177questionnaireswere returnedfrom a total of 254 dispatched giving a 70%response rate. In 166 trusts, radiographersadministered intravenous injections and per-formed barium enemas in 147 trusts and bariummeals in 19 trusts, while a red dot system was inoperation in 143 trusts. Each category showed anincrease from that reported in 2000. Likewisereportingofmedical images by radiographershadincreased since 2000. Replies indicated that at146 trusts, radiographers were reporting inultrasound; reporting of the appendicular skele-tonwas undertaken at 81 trusts and axial skeletalreporting at 70 trusts. Barium enemas werereported by radiographers in 78 trusts. Reportingwas also undertaken by radiographers on bariummeals, mammography, nuclear medicine, paedi-atric and chest radiography; and all showed anincrease in frequency since 2000. Regional differ-ences were again apparent in reporting, witha greater prevalence in the English regions, withthe exception of London, than that in NorthernIreland, Scotland and Wales. Of the sample, 59%employed assistant practitioners, 47% advancedpractitioners and 6 employed consultants. Thenumber reported in each category (excludingpractitioners) were 158 assistants, 623 advancedpractitioners and 6 consultants.

It may be worthwhile that Brian contacts theAmerican Society of Radiologic Technologists whohas been involved in the work on the radiologists’assistants, and it may be that such a system couldoperate in New Zealand. Personally, I feel that thisis not something we should pursue in the UK,where the advanced and consultant radiographer

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306 Letter to the Editor

role has much more to offer. Whether they were topursue assistant practitioners as a means of re-leasing radiographers is not something I would wishto comment upon at this stage but would dependupon the extent to which advanced roles materi-alise. Also I do not know whether there is a short-age of radiographers in New Zealand, and thiswould have a bearing on what advice could begiven on this aspect.

In conclusion, and given the likely radiologistsituation New Zealand, is difficult to see how theadvances that have been made in the UK will beachieved. There does, however, seem to be scopeto build on his ‘reporting initiative’ and if thereport can be produced immediately in an A&Esituation it will enhance team working and be ofbenefit to the patient, which in the end is whatmatters. If this proves to be successful then thereis no reason why the practice should not spreadthroughout New Zealand.

Yours Sincerely

Richard PriceSchool of Paramedic Sciences, Physiotherapy andRadiography, University of Hertfordshire, CollegeLane, Hatfield, Herts AL10 9AB, United Kingdom

Tel.: C44 1707284962; fax: C44 1707281143.E-mail address: r.c.price@herts.ac.uk

Suggested reading

1. Paterson A, Price RC, Thomas A, Nuttall L. Reporting byradiographers: a policy and practice guide. Radiography2004;10:205e12.

2. Price RC, Miller LR, Mellor F. Longitudinal changes inextended roles in radiography. Radiography 2002;8:223e34.

3. Price RC, Paterson AM. Consultant practitioners in radiog-raphy e a discussion paper. Radiography 2002;8:97e106.

4. Price RC. Radiographer reporting: origins, demise, andrevival of plain film reporting. Radiography 2001;7:105e17.

5. Price RC. Radiographers and reporting e the early years.The Journal of the Radiology History and HeritageCharitable Trust 2000;14:16e29.

6. Price RC, Miller L, Payne G. Re-engineering the softmachine: the impact of developing technology and chang-ing practice on diagnostic radiographer skill requirements.Health Services Management Research 2000;13:27e39.

7. Price RC. Longitudinal changes in extended roles in radiog-raphy. Proceedings of 23rd International Congress ofRadiology, Montreal, Canada, 25the29th June 2004. Bolo-gna: Medimond; ISBN: 88-7587-064-0.

8. Paterson A, Price RC. A tiered approach to practice: whereis the debate? Rad Magazine 2002;29(324):32.

9. Price RC, Prime N. Reading radiological images e whoseimage is it any way? Hospital Healthcare Europe 1999/2000.Camden Publishing Limited. p. DI 20e1.

10. Price R, Paterson A. Radiography an emerging profession.In: Paterson, Price R, editors. Current topics in radiogra-phy. vol. 2. London: WB Saunders; 1996. p. 1e13.