History and Professional Development
Diagnostic Medical Sonography



History of Development


Military Background

Titanic Disaster
impetus for development of underwater detection system
Sonar
developed during WWI - refined during WWII

Principles of Sonar

Pulse-Echo principle:
Range equation:
Relationship to Radar:


Through - transmission Era (1935-1952)

Dussik
Firestone
Guttner (published 1952)


Soft - Tissue Era (1949-1956)

John Julian Wild / John Mitchell Reid (Univ. Minnesota)
Douglass Howry / Joseph Holmes (Univ. Colorado)
William J. Fry (Univ. of Illinois)
George D. Ludwig / F.W. Struthers (MIT Acoustics Lab)


European Era (1951-1963)

Echocardiography
Echoencephalography (Neurosonography)
Obstetrics/Gynecology
Ophthalmological
Breast
Abdominal Ultrasound


Bistable Era 1963-1974

Move from research tool to clinical use in the USA
Age of the zealots
Radiologists established careers on ultrasound
Cardiologists
Physicists and Engineers


Grey Scale, Articulated Arm Era (1974 - 1980)

Ultrasound Boom Period
Reimbursement Available
Resolution improved
Specialty Boards began to test on ultrasound



Realtime Era (1978 - present)

Move into clinics and private offices
Decentralization of ultrasound services an ongoing trend
Issues of quality and personnel shortages
Widespread acceptance and demand by the public
Increased utilization by diverse medical specialties



Pulsed Doppler (1980 - present)

Developed in Seattle, Wash., USA in late 60's
Donald Baker - one of engineers who developed doppler
Widespread use of doppler occurred in late 70's
Color Flow utilized (1984 - present)



Technological Advances

1963 first commercial contact scanner - Picker
1966 first commercial real-time - Siemans
1967 analog scan converters added
1968 phased array real-time equipment
1969 pulsed doppler
1971 grey scale
1984 color flow doppler
1975 Ultrasound Holography (first 3D machines)
1990's


Professional Development



AIUM American Institute of Ultrasound in Medicine

developed in the early 1950's (first meeting 1952)
primarily physical therapists for many years


ASUTS/ American Society of Ultrasound Technical Specialists/
SDMS Society of Diagnostic Medical Sonographers (http://www.sdms.org)

Founded in 1969 by Joan Baker and L.E. Schnitzer
Joan Baker first president
Name changed to Society of Diagnostic Medical Sonographers after registry adopted ARDMS in 1974


ARDMS American Registry of Diagnostic Medical Sonographers (http://www.ardms.org)

Founded in 1974 by SDMS
Separate from SDMS
Joan Baker first chairman


JRC-DMS Joint Review Committee for Education in Diagnostic Medical Sonography

Sonography recognized as a separate profession by AMA in 1974
Negotiations for standards began in 1974, adopted in 1979
First programs accredited in 1981
7 sponsoring organizations
3 learning concentrations: general, cardiac, vascular
Vascular was added with new essentials in 1997

Program Statistics 1996 2001
Accredited Programs 77 85
Baccalaureate* 8 11
Associate 30 38
Certificate 56 36
General 62 83
Cardiac 15 24
Vascular 0 7
* 3 baccalaureate programs (including OU) offer general and vascular learning concentrations (SUNY, GWU)
1 baccalaureate program offers all three learning concentrations
7 baccalaureate programs offer general learning concentration only

JRC-CVT Joint Review Committee for Education in Cardiovascular Technology

Recognized as a separate profession in 1981
Invasive CVT, Non-invasive CVT, Vascular Technology
Standards adopted in 1985
12 sponsoring organizations
Began accrediting programs in 1986


Current Issues in the Field

Shortage of Sonographers
Minimum Standards for Sonographers

Ultrasound Practitioner
Advanced Practice Sonography
Competency Examinations for Physicians
Emergency Room, Family Practice Physician Usage
Programs in Vascular Technology
Laboratory Accreditation (ACR, AIUM, ICAVL, ICAEL) standards
Reimbursement and Bundling

Musculoskeletal Injury