Thanks Frank, I had not realized that "Vascular Technologist" had
emerged on its own. Last time I browsed around the gov't website we
were still under CV Technician & Technologist. I'm glad that has
changed.
Nancy

-----Original Message-----
From: f_west [mailto:[log in to unmask]]
Sent: Monday, March 22, 2004 2:48 PM
To: [log in to unmask]
Subject: Re: RVT Name Change by the ARDMS


Nancy,

With apologies for the following stream of consciousness ...

Against my better judgment and at the danger of offending many, I will
attempt to keep this semi-brief ... also, with apologies if my comments
raise anyone's blood pressure ...

First, I have no great desire to be called a technologist, technician,
sonographer, stenographer, etc., simply because I do not believe these
terms remotely describe 'our' role. That is, IMHO, our role is to
provide patient care, and these terms, at least to me, suggest that our
fundamental role is to work with technology, this inferring that the
patients are incidental. The expertise/technologies we employ, whether
they be in performing patient histories, physical examinations, using
stethoscopes, any of the various forms of plethysmography, various forms
ultrasound can take, etc. are all simple tools that can be utilized to
provide patient care. At the end of the day, it is not the technology
that is of significance, but the human impact of our actions, without
which the technologies are meaningless. Thus, at the risk of being
viewed as a radical revolutionary, my suggestion is that we discard all
the current suggestions and begin a search for terminology that actually
describes our fundamental focus. On the other hand, if our job is
simply to 'do studies' we can adopt whatever terminology best describes
those studies (I have read a definition of 'sonographer' that read
'ultrasound technician', both of which I found offensive). But I will
leave that to others ...

With re to reimbursement: this is a complex issue, all the impacts of
which (and history) I will not attempt to completely discuss here. I
invite any interested in a primer to read the 11/1/2001 Federal Register
(Physician Fee Schedule; Final Rule for 2002 - pages 55246 through 55503
inclusive). This contains (on page 55261) a table of the 'revised' wage
rates for CPEP staff types. For any that are confused after reading
this FR, I recommend review of each years FR starting with 10/31/97 (at
least) to current - and for any obsessive/compulsive enough to do this,
I recommend talking with your psychiatrist regarding a medication change
- it's obviously not working (;-)).

'Short' version: for "Vascular Technologist," the wage rate of
$0.35/min was changed to $0.54/min based on the nVision Survey that was
done (funded by SVT is memory serves). In comparison, for categories of
"Diagnostic Medical Sonographer" and "Cardiac Sonographer," the wage
rate of $0.39/min was changed to $0.50/min based on BLS data.
Consequently, assuming that CMS has or ever gets the formula
straightened out (debatable), the non-physician clinical staff time
(probably the single most significant) inputs will result in vascular
procedures having inputs that are 8% higher than echocardiography and
diagnostic ultrasound procedure codes (this I do not worry about).
While CMS has noted that the "cardiac sonographer" inputs were simply
crosswalked from "sonographer," CMS did note that they would be willing
to reconsider pricing given valid salary data was submitted (here lies
an example of the lumping that can occur simply on the basis of a name).
Given the cardiac sonographers and cardiology associations have not
addressed this issue in the interim, it is my assumption that the input
is viewed as adequate. However, in the case of deletion of "Vascular
Technologist" as a category, a very real danger exists that the
sonographer rate could be applied, this representing an 8% decrease
(this I would worry about). While this probably could be avoided, it
would require a coordinated effort (SVU Govt. Relations, attorneys,
etc., & money). Also, given removal of the vascular codes from the ZWP,
and the rather ill-logical current determination of the -TC based on the
simple difference of the global minus the -26, I doubt that any of this
has any applicability in the current calculation (it is interesting the
true PE seems to have been lost somewhere along the way - plus 10 points
for pragmatism, minus 100 for failing to follow anything that can be
defended as remotely rational - may bite us big time in the long run).

I also fear that from a CMS viewpoint, we may well not be viewed kindly.
That is, in 2001, after roughly a decade of regular visits to HCFA/CMS,
CMS altered our recognized descriptions based on input from a
"Coalition" including AAVS, ASN, SDMS, SVS & SVT - from 'cardiovascular
technologists & technicians' to "Vascular Technologist," - they also
maintained 'cardiac sonographer' (eliminating the description
'ultrasound technician') and changing 'sonographer' to "Diagnostic
Medical Sonographer". Now here we are a couple of years later
suggesting that "Vascular Technologist" does not in fact describe the
clinical staff type? It would be all to easy to conclude that we do not
know who or what we are ... but then, that might be accurate.

Personally, having shed enough blood on this field of battle, I'll be
happy to sit and observe from the sidelines, and am erecting a "Somebody
Else's Problem Field" around this issue (10 points to anyone that can
provide a description of, and cite for, this very useful piece of
technology) ...

Franklin W. West
425.398.7774 (voice)


-----Original Message-----
From: [log in to unmask]
[mailto:[log in to unmask]]
On Behalf Of Nancy Hohn
Sent: Monday, March 22, 2004 7:43 AM
To: [log in to unmask]
Subject: Re: RVT Name Change by the ARDMS


I agree with the RDVS for consistency among sonography professions. How
about echo/vasc cross trained? Can we be RDCVS? This would shorten the
alphabet soup chain a bit. I also thought as far as government
categorizing we wanted to get vascular technology moved from CV Tech
category to the diagnostic sonography category. This would group our
pay ranges with other sonographers instead of ekg/TM techs. Then when
medicare was looking at the cost of vascular exams the "average" salary
would be more accurate than it is now, thus increasing reinbursement
(someday) for vascular exams. Is this correct Frank?

Nancy

<SNIP>

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