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The Progression of the Advanced Practice Levels of RPA-RAs (CBRPA)
The Progression of the Advanced Practice Levels of RPA-RAs (CBRPA)
The Progression of the Advanced Practice Levels of RPA-RAs (CBRPA)
The Progression of the Advanced Practice Levels of RPA-RAs (CBRPA)
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The Progression of the Advanced Practice Levels of RPA-RAs (CBRPA)

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  • 1. 22 P R O F E S S I O N A L L I F E N O V E M B E R 2 0 0 5 The Progression of the Advanced Legend Practice Levels of RPA-RAs (CBRPA) ASRT: American Society of Radiologic Technologists Charles O. Williams, BS, RPA-RA, RT (R) (CV)(CI), RCIS, CPFT, CCT ARRT: American Registry Cardiovascular Lab C-430, Emory University Hospital, Atlanta, Georgia of Radiologic Technologists Bhawna Oberoi, BSRS, RPA-RA, RT(R) (M), Sherman Radiology Associates and ACR: American College of Radiology Consulting and Education, Parker, Texas Radiology RA: Radiologist Assistant James Abraham, RPA, Northwest Imaging, Kalispell Medical Center, Kalispell, Montana RPA: Radiology V. Lanier Hall, RT(R), RPA Student, Department of Radiologic Sciences, Weber State University, Practitioner Assistant Ogden, Utah CBRPA: Certification Board of Radiology Practitioner *With editing assistance from Jarrod Allen Williams, BA, Cruise Program Administrator, Legend of the Seas, Royal Caribbean Assistants Cruise Lines, Miami, Florida.v Why the Need for “Radiology fluoroscopic procedures, radiographic Weber State University Develops continue to reach higher-level clinical Extenders”? anatomy, radiation biology, radiograph- an RPA Program skills and broaden their abilities to par- In 1993, the concept of training radi- ic positioning, radiation safety and other The proposal document was sent in ticipate in more challenging procedures. ologic technologists with five or more disciplines that are the foundation of late 1993 to Dr. Jane Van Valkenburg, The original intent of the RPA pro- years of clinical experience to perform well-educated and well-trained radiogra- former Chairperson of the Department of gram was to train military radiology procedures and make basic interpreta- phers. These advanced radiology-based Radiologic Sciences at WSU. Upon read- specialists who were to be assigned to tions of medical images was proposed by subjects were not and are not part of the ing the proposal, Dr. Robert Walker and military hospitals that lacked radiolo- two U.S. Army radiologists, Colonel didactic and clinical training of NPs and Dr. Van Valkenburg visited the radiolo- gists or to field units that encom- Sankaran S. Babu and Lieutenant PA-CS. Dedicated and motivated radio- gists at Madigan Army Medical Center in passed combat situations. These men Colonel Gregory N. Bender, of the logic technologists, on the other hand, Tacoma, Washington. Five years later in and women would perform the imag- Madigan Army Medical Center in are well trained in these essential areas. 1998, the professors’ concept for what ing procedures at their duty stations, Tacoma, Washington.1 These two inno- Drs. Babu and Bender approached became known as the “Radiology make basic interpretations so injured vators were reacting to the military’s use the Department of Radiologic Sciences Practitioner Assistant (RPA)” program soldiers could be treated emergently, of nurse practitioners (NPs) and Certified at Weber State University (WSU) in became a reality. and then transmit the images by tel- Physician Assistants (PA-Cs) throughout Ogden, Utah, with a proposal to The professors worked as a team eradiology to a base medical facility the clinical healthcare systems within the develop an advanced-level, modified with the physicians, who provided the where a civilian-contracted or mili- U.S. military to help solve the problem of distance-learning program to educate professional assistance and guidance to tary radiologist would complete the physician shortages.2 and clinically train radiologic technol- develop a curriculum similar to the final interpretation.3 Radiology was not included in the ogists as “radiology extenders” in the didactic training for NPs, with clinical Three important matters remained military’s plan, however, because NPs United States Army Medical Corps. training focused on radiographic imag- unresolved before the program could and PA-Cs are traditionally indoctri- The proposal, which was drafted as a ing. This established course of studies is accept students for the first class. One nated in clinical health fields such as hospital-approved research protocol, the same one that the American Registry dealt with the lack of a certification cardiology, cardiovascular surgery, was written by Laurence Briggs of Radiologic Technologists (ARRT) examination, another was the title for emergency medicine, family medicine, RT(R).3 The plan focused on training refers to as the “nationally recognized the soon-to-be highly advanced-trained internal medicine, obstetrics-gynecolo- experienced civilian and military radi- curriculum,” such as the one purported- radiology specialists, and the final mat- gy, orthopedics, and so forth.2 This ologic technologists as “Radiology ly developed by the American Society of ter involved financial support for the group of advanced practice allied Physician Assistants” in a pilot pro- Radiologic Technologists (ASRT) in the military students who would become health professionals are neither didac- gram in collaboration with WSU in current ARRT Annual Report to distance-learning students located tically nor sufficiently clinically trained Ogden. 3 The Radiology Physician Radiologic Technologists.4 The clinical around the world. Another important in medical imaging, which includes Assistant would have been deployed training also focuses on radiology-based stepping-stone involved financial sup- invasive and interventional imaging to a remote military teleradiology site procedures that many experienced radi- port approval from the Department of procedures. Nevertheless, due to radi- that had no military- or a civilian- ologic technologists have been quietly the Army and the Department of ology practitioner manpower short- contracted radiologist.3 performing for years. Defense (DOD), with an anticipated ages in both civilian and military imag- WSU, a top-rated state university, Two major requirements of the RPA start date of October 22, 1993.5 After ing departments, radiology depart- was selected because the two radiolo- program were that student applicants waiting two more years, the DOD nixed ments are hiring NPs and PA-Cs to: gists had researched the quality of the possess at least five years of clinical expe- the budget. Nonetheless, the curriculum 1. Assess patients; advanced radiologic science educational rience in radiologic technology, and pro- and study modules for the “radiology 2. Perform procedures similar to the programs at several universities in the vide a minimum of three strong recom- extenders” program had already been American College of Radiology United States and determined that WSU mendations from radiologists who know completed through the efforts of the mil- (ACR) guidelines for a Radiologist had well-recognized advanced imaging them and their competency level. While itary radiologists and the instructional Assistant (RA); programs and had already implemented they hammered out the curriculum, these staff at WSU. With the military dream 3. Write pre-procedure, post-procedure, outstanding online degree learning pro- men also wrote the first job description shattered, the university decided to open and post-care orders. grams. It was assumed that to attract for RPAs, which is available on the program to the civilian sectors. The Unfortunately, this same group lacks seasoned radiographers who possessed www.cbrpa.org. The job description has first class of ten students commenced the education in computed imaging, the knowledge, experience and desire to undergone changes at the hands of sever- their formal education in August 1996.6 knowledge of invasive and interven- become “radiologist extenders”, a dis- al radiologists who have observed how The class of 1999 began their courses tional procedures, and knowledge of tance-learning model wold be necessary. these advanced-trained technologists one year later, in 1997.6
  • 2. 24 P R O F E S S I O N A L L I F E N O V E M B E R 2 0 0 5 The RPA Credential Title was a necessary process so that RPAs didactic competency mentions that the and interested radiographers remain Since the nationally accredited could be recognized as certified allied topics for professional education skittish and are evaluating other options. Physician Assistant programs do not offer health professionals with hospital cre- requirements “...should be covered as The ACR established guidelines for extensive clinical training in imaging pro- dentialing committees, similar to NPs part of a nationally recognized curricu- the RA programs without consideration cedures and invasive imaging studies, the and PA-Cs.6 On March 11, 1998, the lum such as the one developed by the of the role being filled by certified RPAs. title “Radiology Physician Assistant,” CBRPA was incorporated in the State of ASRT”.4 In addition, the certification In April 2002, (article author) Charles mentioned in the two U.S. Army physi- Utah. The office is located at 1074 East process for this modified RA program Williams addressed each of the sections cians’ proposal, would be inappropriate. 2750 North, Ogden, Utah, 84418-2741.6 was not developed. The only informa- developed by the ACR and ASRT on The American Academy of Physicians tion that the ASRT staff was able to how an RA would function under the Assistants (AAPA) does not have a certifi- The ASRT Develops the Radiologist obtain readily came from WSU and the supervision of radiologists and/or other cation process for men and women Assistant (RA) Credential CBRPA website. The copyrighted course physicians. The nineteen-page document specifically trained in the subspecialty of In 2001, the ASRT drafted the con- materials, which the students were was sent to an ACR representative, two radiology. To differentiate from the origi- cept of a “new” career field called the required to use, were not released to the ASRT representatives, and a representa- nally suggested title of “Radiology “Radiologist Assistant (RA)”. This idea, ASRT or any of the first four university- tive from the CBRPA, before an adjunc- Physician Assistant”, the thought was to along with the addition of the curricu- based RA programs. tive meeting held at the ASRT offices in name the advanced-trained technologists lum and clinical requirements, was May 2002.9 Another meeting was later “Radiology Practitioners”. The civilian based on the original concept, proposal Development of RA Programs; RPAs held with representatives of the ACR, WSU classes of 1998 and 1999 had also and developments that Drs. Babu and Present Concerns ARRT and ASRT, along with two considered the term “Radiology Bender and WSU educators created for To promote and establish the first CBRPA-certified RPA representatives.10 Physician Assistant”, but the student bod- the RPA program at WSU. The excep- four RA programs, the ASRT approved The letter focused on many concerns ies chose “Radiology Practitioner tion was that the ASRT lobbied the ACR four $25,000 grants to seed four univer- related to the RAs and the recommenda- Assistant (RPA)” instead.6 and ARRT between 2001 and 2003 to sities. The selected facilities were Loma tions for RA programs that did not yet The primary reason for changing the garner their support for the “new RA”. Linda University in Loma Linda, exist. The focus of the meeting centered credential term to “Practitioner” was to The “new RA” concept was accepted by California; University of North Carolina on misinformation about “image inter- maintain parallels with the outcomes of the ACR and ASRT in Spring 2003. at Chapel Hill in Chapel Hill, North pretation” done by advanced-practice the ASRT Educational Conference, Carolina; Midwestern State University RPAs. This factor was not the intention where the model for the profession was RPA Program is Undermined, but in Wichita Falls, Texas; and the of Drs. Babu and Bender, whose original developed.6 In the ASRT documents, the Curriculum is Utilized University of Medicine and Dentistry of concerns were the shortage of radiolo- label “Radiology Practitioner” was used The American College of Radiology New Jersey in Newark, New Jersey. The gists, the reality of training technologists for the advanced-practice level.6 Further (ACR) disputed the RPA Program at purpose of the grants was to quickly to perform procedures, providing basic research and input revealed that the WSU on the premise that advanced- implement the four RA programs in the image review in hospitals or in remote nomenclature “Radiology Practitioner” practice level technologists should not be schools’ radiologic science departments. areas to enhance patient care standards actually meant “Radiologist”.6 The two interpreting images. However, this was In January 2002, Mr. Lynn May, where radiologists were not available, class bodies decided to attach the word and to transmit the images electronically “Assistant” to the ASRT label. Hence, from remote sites to radiologists in hos- the new, highly advanced-trained radio- pital departments, imaging centers and logic technologists would become assis- To promote and establish the first four offices for formal interpretation. It seems tants to the radiologist, who was also RA programs, the ASRT approved four that misinformation will play a major known as a “Radiology Practitioner”.6 role in determining the fate of the RPA $25,000 grants to seed four universities. and RA professions in the years to come. Creating the Certification Board of Radiology Practitioner Assistants The selected facilities were Loma Linda RA Certification Exam: RPAs (CBRPA) University in Loma Linda, California; Solicited for RA Advisory Committee Now that the name was decided upon, In mid-2002, the ACR, in conjunction the next step was to determine how to cer- University of North Carolina at Chapel with the ASRT, asked the ARRT through tify these professionals and how to estab- their Board of Trustees to begin develop- lish recognition of them in the advanced- Hill in Chapel Hill, North Carolina; ment of a formal certification exam for level allied health community. Dr. Jane Midwestern State University in Wichita RAs. To accomplish this task, the ARRT Van Valkenburg presented the concept to had to complete a survey analysis, which the officials at the ARRT and the ASRT Falls, Texas; and the University of was sent to 1,000 radiologists and all cer- House of Delegates, where some resolu- tified RPAs.11,12 The board cordially tions were passed, but no definitive action Medicine and Dentistry of New Jersey in asked two CBRPA-certified RPAs to sit was taken on the resolutions.6 Neither of Newark, New Jersey. on the RA Advisory Committee. Why? the organizations showed interest in the Because there were no certified RAs in RPA program and/or had a clear interest the United States. This committee has in establishing a certification program for developed the mechanism for incorporat- the small group of advanced-practice level never the intention of the program. CEO of the ASRT, spoke by invitation at ing didactic and clinical competency student technologists. During the ASRT planning stages, focus- the Third Annual Conference of the requirements into a comprehensive col- Knowing that this group of students ing on getting the idea for the RA pro- NSRPA about his proposed RA pro- lection of documents that meet the needed formal certification to be recog- gram accepted by the ACR and ARRT, gram. The RPAs in attendance devel- Continuing Education Requirements, nized by hospital credentialing commit- the ACR and ASRT used the curriculum oped mixed views and waited for what Rules and Regulations, Standards of tees, Dr. Van Valkenburg helped organ- and clinical evaluation system developed would ensue in the years ahead. Ethics, and Standards of Practice estab- ize and establish the Certification Board and copyrighted by the WSU program to Although willing RPAs helped, the first lished by the ARRT, with ACR and of Radiology Practitioner Assistants draft their (ACR/ASRT) model. In the RA program, which was launched at ASRT input for exam eligibility.4,13–15 (CBRPA).6 The concept for certification current ARRT Annual Report to Loma Linda University, did not accept The RPAs helped to bring this about to was based on guidelines for NPs. This Registered Technologists, the required students until Fall 2003. Many RPAs better the profession for all technologists
  • 3. 26 P R O F E S S I O N A L L I F E N O V E M B E R 2 0 0 5 Directors would discuss a merger with hospital credentialing guidelines; through the efforts of the RPAs, the Legend the ARRT.6 The National Society of the 3. The levels of supervision for each CBRPA and the WSU program, since RPA (NSRPA) Board of Directors appre- procedure required for RAs to there are no ARRT-certified RAs in the ciatively declined. The reason focused on function under radiologists, which workforce who are actively participat- ASRT: American Society of the narrowed scope of practice estab- constrict RAs; ing in the development. We are hoping Radiologic Technologists lished for RAs. The fact that the CBRPA 4. The requirement of a bachelor’s this, too, is due to misinformation and ARRT: American Registry continues to work with the ARRT offers degree; misperception issues. of Radiologic some hope of resolution of the confusing 5. The applicant requirements for Technologists RPA/RA issue. the RA programs which differ in Concerns for RAs and Why RPAs ACR: American College of The decision to decline this charitable terms of required levels of experi- Offer More Radiology offer was based on the recognition of the ence — ranging from accepting The first RAs graduated in mid-May RA: Radiologist Assistant currently CBRPA-certified RPAs. These newly certified general radiogra- 2005, yet these students face two signif- RPA: Radiology RPAs function under a broader scope of phers to those with one year of icant certification issues: Practitioner Assistant practice that allows them to work in experience.19 1. They do not meet the rigid require- CBRPA: Certification Board interventional radiology, whereas RAs The CBRPA requires each exam ments for the CBRPA certification of Radiology Practitioner are limited in the types of procedures applicant to possess a minimum of five examination; Assistants they can perform. Also, there are several years of postgraduate experience.19 2. A certification exam was not avail- RPAs employed in invasive and interven- None of the RA programs had any able until October 2005 for these tional cardiology settings. CBRPA-certi- educational standards to guide the graduates.16,17 in radiology as well as to give much- fied RPAs are being offered jobs as direc- programs during the development of Again, will the RA movement needed relief to the many overworked tors and instructors for the starting RA the curriculum.19 Another point improve radiology as lobbied by the radiologists in this country. RPAs and programs. The contribution of RPAs to brought up by the CBRPA representa- ASRT and marketed by Dr. Sal Martino the RAs appear to be on the same page, the establishment of the advanced prac- tives involved hospital credentialing in Song’s article: “We believe the RA is but it seems that misinformation con- tice level for technologists — education- committees’ requirement of documen- the solution...” and “...As radiology tinues to get in the way of how things ally, legislatively and professionally — tation of clinical competency records.19 departments struggle to meet patient are being perceived. It is the RPA’s goal should be recognized by all entities. Other subjects discussed were: needs, …people are talking about using to legitimize the practice of the “radiol- How can one refuse to recognize the 1. Why the ARRT was asking ques- advanced level technologists as a way ogist extender,” not become rogue mid- RPAs who are educating the RAs, but tions on disease processes, but not to make the radiology department level providers. then go on to only recognize the students on the image appearance of the dis- more productive and to enhance overall (RAs) who learned from them? ease process. The explanation pro- quality in patient care”?7 What about RPAs Undermined in State Licensure vided was that the organization the recent RA graduates from Loma Bills for Both RAs and RPAs A Meeting to Discuss the RA hoped to extend into those areas, Linda University, most of whom have While these somewhat political issues Highlights Credential’s Challenges thus they made the content specifica- been unable to find employment? are being resolved, several RPAs have By invitation of Mr. Jerry Reid, tions for pathophysiology very We feel that the RPA-RA (CBRPA) been working with their state house Executive Director of the ARRT, Dr. Van extensive.19 A copy of the most has more to offer radiologists, hospitals members and state senators to draft bills Valkenburg attended a meeting at the recent CBRPA content specifications and imaging centers because: to license RPAs and RAs alike. The cur- ARRT offices on April 22–23, 2005, were surrendered to the ARRT.19 1. These professionals were accepted rent RPAs are trying to open doors for along with educators from several pro- 2. The CBRPA did mention that into their program with at least five whoever follows them, whether they are posed RA programs.6 The meeting was many RPAs would not take the years of experience; RPAs or RAs. Thus far, however, each held to discuss clinical competency ARRT’s RA examination because 2. They have undergone excellent time a state begins to work on a licen- requirements and other issues that the the scope of practice was too nar- training as “radiology interns” by sure bill, an ASRT official contacts the ARRT developed for the RA certifica- row.19 Also, Mr. Reid mentioned their preceptors;23 state legislators, requests that they elimi- tion requirements. Dr. Van Valkenburg that constraints of the National 3. Their clinical training in patient nate the term “RPA” from the proposed was invited because no certified RA Organization for Competency assessment and management coin- legislation, and encourages the state offi- instructors with extensive experience are Assurance (NOCA), the accredit- cides with the training for other cials to only include “RAs”.6 Montana, currently available. (This fact was well- ing agency, would not permit the mid-level providers; Tennessee, Kentucky, California, covered in Jenny Song’s article, The current CBRPA-certified RPA-RAs 4. Their sponsoring radiologists see a Mississippi and Washington have had Lessons of Loma Linda: Expect to be grandfathered in as ARRT- need for technologists who have been such interferences. In two situations, the Challenges, that was also published in certified RAs.19 trained to perform procedures and ASRT pleaded with the states of the Advance for Imaging and Radiation are knowledgeable about pathologi- Montana and Kentucky to hold off pre- Therapy Individuals on January 24, RPA Progress Remains cal processes as observed in general senting their state licensure bills to the 2005.18) On September 15, 2005, Dr. Unacknowledged radiography, computed and magnetic assembly floors until the RA criteria Van Valkenburg, CBRPA Executive The ASRT and ACR continue to resonance imaging, invasive, inter- were established and approved for the Director, Roland Clements, CBRPA scrutinize and discredit the WSU pro- ventional and ultrasound studies. certification process by the ARRT.6 President, and Terry Liccardi, CBRPA gram, the CBRPA and its well-trained Some RAs will no doubt receive sim- board member, attended the joint meet- and recognized RPAs — all of whom ilar training and education, but there is CBRPA Continues to Work for ing of the CBRPA and ARRT. The they have refused to acknowledge. In presently no consistency in these pro- Appropriate RPA Recognition ARRT was represented by Jerry Reid, the current Annual Report to grams. The ARRT, in the hopes of stan- The ARRT was given an opportunity ARRT Executive Director, and Ann Registered Technologists, the ARRT dardizing, has developed requirements to develop the certification examination Chapman, ARRT board member.19 acknowledges several medical imaging that will apply to all RAs entering pro- for RPAs, and the request for interest This group of professionals discussed: societies, with the exception of the grams. One requirement is to possess continued through early 1998. The 1. The differences between the two NSRPA (National Society of Radiology one year of RT experience before attend- opportunity was repeatedly declined by scopes of practices; Practitioner Assistants).4,20–22 ing what is considered a very tough RA the ARRT. However, Jerry Reid, 2. How the RA role delineation, as Ignored is the fact that any progress program.17 Some students are very bright Executive Director of the ARRT, recent- established by the ARRT, has made in the establishment of the and can manage with this level of expe- ly contacted Dr. Van Valkenburg and inhibited the use of RAs in the advanced-practice level for technolo- rience, but most veterans of radiology asked her if the CBRPA Board of practical work force because of gists has been accomplished solely know that several years of experience
  • 4. 28 P R O F E S S I O N A L L I F E N O V E M B E R 2 0 0 5 are needed to become sufficiently famil- A Final Note: Future Plans for RPAs similar to fellowships completed by August 23, 1993. 6. Van Valkenburg J. Personal communication, iar with the profession. Once a technol- The controversies and misunder- physicians. Efforts are being made to April 1, 2005. ogists can do everything in radiology standings should be addressed by the initiate recognition of RPA-RAs 7. Song J. The radiologist assistant, new times demand a new profession, high hopes in the with their eyes closed, only then can they appropriate higher officers within the (CBRPA) by the American College of air as the first class of RAs prepares to enter take on more challenging tasks and inte- ACR and the ASRT. If this is not done, Cardiology and by Cardiovascular the field of medical imaging. Advance for grate clinical pathways, etc. both RPA-RAs (CBRPA) and RAs Credentialing Incorporated (CCI). Imaging and Radiation Therapy Professionals 2005;15:31. There remains one major issue that (ARRT) risk becoming extinct, just as The main reason for these efforts is so 8. Van Valkenburg J. Personal communication, current CBRPA-certified persons should “Radiology Physician Assistant” that RPAs can be hired by cardiology February 4, 2003. 9. Van Valkenburg J. Personal communication, consider. Since the ARRT cannot grand- programs at Duke University and groups to assist them with invasive March 15, 2002. father in the RPAs as RAs, and we pass the University of Kentucky did in and interventional cardiac proce- 10. Larsen J. Personal communication at the Fourth Annual NSRPA Conference, February the ARRT RA exam, we will be forced the early 1970s. This means that dures, echocardiograms and other 4, 2003. to work under a very narrow scope of both credentialed professionals related invasive cardiac studies. 11. American Registry of Radiologic practice.13–15 This means that the men could return to their original envi- In February 2005, the CBRPA grand- Technologists (January 2004). RA Job analy- sis survey – suitable for printing. In: ARRT and women who participate in interven- ronments as “super techs”, without fathered in all certified RPAs with an Develops Radiologist Assistant Certification tional procedures in Massachusetts, the ability to use what they have additional credential, “Radiologist Program. Retrieved May 7, 2005, from http://www.arrt. org/web/rasurvey.pdf. Montana, Georgia, Florida, Colorado been trained to do as proposed by Assistant (RA)”, in keeping with the 12. American Registry of Radiologic and other states, will become very limit- Mr. Briggs and Drs. Babu and political shift that was taking place. Technologists (December 19, 2003). Sample ed in their abilities to improve depart- Bender in 1993. WSU is in the process of modifying the of ACR members to be surveyed by mail: RPAs asked as well. In: ARRT Develops mental productivity and enhance the Although the Department of Defense RPA program so that a RA program will Radiologist Assistant Certification Program. quality of direct patient care. denied financial support for the military be offered. The differentiating factors Retrieved May 7, 2005, from http://www.arrt.org/web/content.jsp? The other point to ponder is that facilities in 1995, the concept opened between the RPA and RA are: include=/radasst/rasurvey.htm. many of us have had the experience of doors for slow-accepting civilian and 1. The RA curriculum will be at a 13. American Registry of Radiologic working with radiology assistants military radiologists who continue to bachelor of science degree level; Technologists (February 22, 2005). RA exam content specs, competence, requirements build throughout our careers. When technol- judge RPA-RAs (CBRPA) as a result of 2. The RPA will be at a master of sci- on role delineation. In: ARRT Radiologist ogist shortages increased over the past numerous misunderstandings. The his- ence degree level. Assistant Certification Program. Retrieved May 7, 2005, from two decades, facilities created positions tory of the original course of action was We are in for an evolutionary change, http://www.arrt.org/web/content.jsp? for darkroom technicians and technol- never taken into full consideration by which is certainly not going to be easy. include=/radasst/raexamcontent.htm. ogist assistants who prepared the bari- the ASRT, ACR and ARRT. From our experience, once this evolution 14. American Registry of Radiologic Technologists (February 22, 2005). ARRT um mixtures for UGI patients and bar- adopts role delineation for radiology assis- ium enema patients, stocked procedure tants. In: ARRT Develops Radiologist Assistant Certification Program. Retrieved rooms, and so forth. Why? Because the technologist needed more time to care When technologist shortages May 7, 2005, from http://www.arrt.org/ web/content.jsp?include=/radasst/raarrta- for the patients. These ancillary per- increased over the past two decades, dopts.htm 15. American Registry of Radiologic sonnel were titled “Radiology Technologists (April 12, 2005). ARRT moves Assistants” in many hospital radiology facilities created positions for dark- toward finalization of radiologist assistant eli- gibility requirements, administrative timing. departments. Will a “Radiologist room technicians and technologist In: Educational, Ethics, and Exam require- Assistant” be misconstrued as a ments. 1–2. Retrieved July 24, 2005, from “Radiology Assistant” among our fel- assistants who prepared the barium http://www.arrt.org/web/content.jsp?include=/ new/wn_ra_elig_req_05-04-12.html. low allied health peers? There are now more than 300 well- mixtures for UGI patients and barium 16. American Registry of Radiology Technologists: Broader choices: Supporting categories expand for post-primary certifica- trained men and women who are enema patients, stocked procedure tion. In: Annual Report to Registered known as “RPA-RAs (CBRPA)”, and Technologists. St. Paul, Minnesota: ARRT, there are 165 students in the current rooms, and so forth. Why? Because 2005,p. 27. 17. American Registry of Radiologic upper and lower level classes. All of them have been stringently selected the technologist needed more time to Technologists (July 5, 2005). ARRT Radiologist Assistant … ARRT finalizes RA certification eligibility requirements. and will be trained to do what radiolo- care for the patients. Announces exam format and administrative gists have less time to accomplish, as procedures. 1–2. Retrieved July 24,2005 from http://www.arrt.org/web/content.jsp?include=/ the number of radiologists is dwindling new/rajuly05update.htm. in medical facilities where many new The attending radiologists at one is complete, the medical field will not be 18. Song J. The lessons of Loma Linda: Expect radiologists have no desire to practice, author’s place of employment have able to live without radiologist exten- challenges. Advance for Imaging and Radiation Therapy Professionals 2005;15:33. particularly in small rural hospitals turned a deaf ear to RPA-RAs because ders, just as today it cannot do without 19. Certification Board of Radiologist Practitioner and military facilities. they have serious misunderstandings PAs and NPs. n Assistants. Report to the CBRPA Board on the CBRPA and ARRT representatives meet- As the use of Picture Archiving and about how to incorporate them. The ing. In: Report to CBRPA Board. Ogden, Communication Systems (PACS) radiologists lack interest in hiring RPA- References Utah: CBRPA, 2005. 1. Babu SS, Bender GN. Radiology Physician 20. American Registry of Radiology becomes a reality for an increasing RAs because they have heard so much Assistants (RPAs) — A Proposal. Tacoma, Technologists: CE consensus conference par- number of facilities, why can’t the RPA negativity about the advanced-level Washington: Madigan Army Medical Center, ticipating organizations. In: Annual Report to function in the capacity that was origi- trained technologists. They fear the loss 1993, pp. 1–6. Registered Technologists. St. Paul, Minnesota: 2. Babu SS, Bender GN. Radiology Physician ARRT, 2005, p. 11. nally conceived by Drs. Babu and of reimbursements and choose instead to Assistants (RPAs) — A Proposal. Tacoma, 21. American Registry of Radiology Bender? Do we wait until the NPs and hire NPs and PAs who are approved by Washington: Madigan Army Medical Center, Technologists: Continuing education require- 1993, p. 1. ments for renewal registration: Section 19. PA-Cs saturate our imaging depart- Medicare for reimbursements. However, 3. Babu SS, Bender GN. Radiology Physician Definition of terms. In: Annual Report to ments, fumble through procedures, most of these allied health professionals Assistants (RPAs) — A Proposal. Tacoma, Registered Technologists. St. Paul, Minnesota: and get reimbursement for their work, have never been formally educated or Washington: Madigan Army Medical Center, ARRT, 2005, p. 45 1993, p. 4. 22. American Registry of Radiology while the RPAs, who possess excellent clinically trained to perform image- 4. American Registry of Radiology Technologists: Continuing education require- principles and extensive clinical experi- based procedures. Technologists: RA content specs, competence ments for renewal registration. In: Annual requirements build on role delineation. In: Report to Registered Technologists. St. Paul, ence in imaging operations, are left Several radiologists who employ RPAs Annual Report to Registered Technologists. Minnesota: ARRT, 2005, p. 47. hanging on a limb without any recog- in their groups have canvassed WSU to St. Paul, Minnesota: ARRT, 2005, p. 7. 23. Tigges S. Personal communication, November nition for their skills? begin training RPAs in the subspecialties 5. Briggs LM. Letter to Dr. Jane Van Valkenburg, 12, 2001.

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