Bill seeks to reduce errors in medical radiology

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By Annika McGinnis, McClatchy Newspapers (June 8, 2012)

— A bipartisan bill working its way through the House of Representatives would create a set of uniform standards for the radiologic technicians who treat patients with cancer and illnesses.

Right now, 11 states and the District of Columbia only have voluntary education and training standards for the technicians who handle medical imaging equipment.

In another 16 states, inexperienced people can administer the radiation therapy that treats cancer, according to the American Society of Radiologic Technologists, which testified at a House hearing Friday.

“This is sadly more like Russian roulette than personalized care,” said Rebecca Smith-Bindman, a radiologist and professor at the University of California, San Francisco, School of Medicine, who also testified.

In the hearing Friday, the health subcommittee of the House Energy and Commerce Committee discussed a bill that would create a set of uniform standards for radiologic technicians.

The bill can’t come too soon, according to Leonard Gunderson, chairman of the board of directors of the American Society for Radiation Oncology.

“Everybody here has a family member who’s had cancer,” Gunderson said. “Would you want them to have radiation therapy by somebody that hasn’t been properly trained? No way!”

Such inexperience often leads to misdiagnoses, a terrifying prospect for patients facing cancer or other life-threatening illnesses, according to Sal Martino, chief executive officer of the American Society of Radiologic Technologists.

“An X-ray won’t reveal a broken bone and a CT won’t find a growing tumor if the person using the equipment doesn’t know the basics of anatomy, exposure and technique,” Martino wrote in his testimony.

Just a little too much radiation can cause cancer, skin burns and birth defects, according to Martino. If the equipment isn’t used correctly, patients can be injured or killed. And errors in tests forcing patients to have repeated exams cost Medicare billions of dollars a year, he said.

Smith-Bindman spoke about the dangers of inexperience in performing computed tomography tests, a type of X-ray widely used to generate the images of internal organs used to diagnose patients. Under such a test, a patient receives an extremely high dose of radiation, akin to about 200,000 airport X-ray screens, Smith-Bindman said. She said the equipment is very difficult to use.

A technologist cannot just “press a button” to work the scanner but must make many complex decisions on his or her own judgment, Smith-Bindman said.

The bill, called the CARE Act, would require personnel who administer imaging and radiation therapy to have certain qualifications, including graduating from a formal program and passing a national exam.

The bill was first introduced to Congress in 2000 and has been introduced in every subsequent session, according to Martino. Now, however, the bill enjoys bipartisan support: 25 Republicans and 53 Democrats, from 26 states and the District of Columbia.

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