Wednesday, May 28, 2014

I’m Looking Through You: A Day in the Life of a Sonographer

By Rick Fromme

Rubber Soul
Rubber Soul (Photo credit: Wikipedia)
As most of you have probably surmised from reading my earlier posts, I’m a Beatles fan. Hence, combining the subtitle of one of the Fab Four’s earlier songs from the album,“Rubber Soul,” along with the series title adapted from “Sgt. Pepper’s Lonely Heart’s Club Band” just made sense, word play-wise.

The Beatles changed our lives in so many ways; they were an unequivocally talented band that also became a social phenomenon. They were responsible for many innovations that we take for granted today, such as the performing in-concert to huge stadium crowds; the concept albums; music videos; starting their own record label; inventing numerous, innovative recording studio techniques and more. 

Arguably, the Beatles changed the world as we know it with sound.  Likewise, Sonography changed the diagnostic medical profession as it uses ultrasound waves to image our internal anatomy and physiological processes in real time.

Skilled Sonographers — also known as Ultrasound Technicians, or Diagnostic Medical Sonographers — have become an invaluable asset to modern health care diagnostics and treatment.  They’re trained to operate specialized equipment, a type of transducer, which  produces a special image to help diagnose patients' ailments inside the human body. The ultrasonic instrument emits high-frequency sound waves, inaudible to humans, to digitally record the echoes as its sound waves bounce back to determine the size, shape, and consistency of soft tissues and organs. These sound waves and their echoes create ultrasonic images, called a sonogram, of our internal bodies. Sonography can now produce 2D, 3D, and even 4D images of our internal organs and life forms that sometimes inhabit some of us, babies that is.

English: 4d ultrasound showing 3 month old fetus
4D Ultrasound showing 3-month-old fetus (Photo credit: Wikipedia)
Sonographers may specialize in OB/GYN, abdominal, neurosonography, breast, vascular, or cardiac sonography. An integral part of the health care team, sonographers work directly with patients, physicians and other medical personnel. While a licensed, skilled sonographer actually images the patient, most of his or her ultrasound readings are interpreted by radiologists, who then contact the ordering physician (i.e., OB/GYN, cardiac or thoracic surgeons) to detail and discuss the results. 

 Job Outlook & Responsibilities

The U.S. Bureau of Labor Statistics (BLS) predicts that job growth in this field will be much faster than the average for all occupations through 2020. Sonography is listed among those occupations expected to grow faster than most others, especially those that require an associate degree.

Of course, one of ultrasound’s most common uses is to provide a “womb with a view” perspective of developing fetuses inside a woman’s uterus. Ultrasound has many uses during pregnancy. Pregnancies can be dated and hence, due dates can be reasonably estimated. It can determine if a mother is carrying multiple fetuses such as twins, triplets, or quadruplets. It can also determine if the pregnancy is ectopic. Sonography can be used as a screening tool to detect possible birth defects, if there are issues with the placenta, if the baby is in a breech position, and more. After several months of pregnancy, ultrasound can tell expecting parents whether to buy blue or pink paint for the nursery. And, just prior to delivery, ultrasound can estimate the baby’s size. 

Ultrasound Machine
Ultrasound Machine (Photo credit: The Facey Family)
Furthermore, in addition to its imaging capabilities, sonography is used for a wide variety of non-invasive applications, some of them potentially life-saving. Sonographers are an integral part of the health care team, as ultrasound helps doctors diagnose a wide variety of conditions affecting certain the organs and soft tissues, including the heart and blood vessels, liver, gallbladder, spleen, pancreas, kidneys, bladder, uterus, ovaries, prostate, testicles, eyes, and thyroid gland. Sonographers help “stage” cancers and can help locate arterial blockages such as through venous Doppler exams. Ultrasound can also guide doctors through precise medical procedures such as needle biopsies, which require the doctor to remove tissue from a very precise area inside the body for testing in a lab. Ultrasound technology can identify the cause of soft tissue injuries, and can sometimes help treat them. There are diagnostic limitations, as the sound waves don’t transmit well through dense bone or the bowel, because it holds gas, and lungs because they hold oxygen.

A typical day includes seeing eight to twelve patients, performing a variety of ultrasound procedures and obtaining acoustic images of organs, including abdominal, gallbladders, aortas, carotid arteries, obstetric imaging, venous Dopplers (of arms and legs) and more. Because ultrasound images are captured in real-time, they can show the structure and movement of the body's internal organs, as well as blood flowing through arteries and veins.

Doppler echocardiography
Doppler echocardiography (Photo credit: Wikipedia)
Many sonographers will first take a “bare belly” reading of the patient. Using the digital equipment and specially created acoustic gel, the sonographer will image the abdominal cavity to determine if there is any pathology, cysts, tumors, masses, or anything else that may be out of the ordinary.

Sonographers’ hours vary depending upon if they’re working in an office or hospital setting. Some, particularly if working at a hospital, may have weekend and night shift work. Or, if on call, may get called during any time in the middle of the night… and then may have to work their normal shift. Those working in private imaging clinics — usually alongside other imaging technology such as X-rays, MRI, CAT scan — enjoy more regular hours.

Most sonographers find the career rewarding as they’re helping patients in numerous ways and also utilizing their specialized skill sets within a skilled health care team.


Most employers, especially hospitals and medical centers, prefer to hire job candidates who have received training from accredited programs. Visit the Commission on Accreditation of Allied Health Education Programs site to learn more and see which programs are accredited.  

Furthermore, while Sonography/Ultrasound Technician isn't currently a licensed occupation, most employers prefer to hire candidates who’ve been certified by a credential-granting organization such as The American Registry for Diagnostic Medical Sonography (ARDMS). To earn this credential, one must take an exam and meet prerequisites that include a combination of education and work experience.

In this article, I discussed the in-demand field of Sonography, also known as Ultrasound Technology. I briefly touched upon how the technology works, the areas in medicine where Sonography is most effective, where sonographers work, future job outlook, and its educational requirements. If you liked this article, please comment and share it.

Rick Fromme combines entrepreneurial enthusiasm with an insider's knowledge of the medical industry to co-found Both his drive and perspective helps provide health care professionals with a superior mechanism with which to communicate, network and market their strengths. Prior to founding, Rick operated a highly successful medical device distributorship. Other milestones in his 12-year career in the medical industry include a key position at a medical device start-up company that was later sold to the Ethicon Endo division of Johnson & Johnson. You may also reach Rick by connecting with him on FacebookTwitterGoogle+LinkedIn and YouTube. 

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Friday, May 23, 2014

A Site for Your Eyes

Computer Setup April 2010
Computer Setup (Photo credit: Paul Mayne)
As many of you know who’ve been reading my blogs (and my bio at the end of them) I’ve had a successful career in the medical industry for over a decade, mostly dealing with medical device sales.

Like many in the health care profession,  I had joined, and still belong to, several social media and professional networking sites. I would also periodically visit several job board sites, some of them generic, others slanted towards the health care profession. While I felt some of them were fairly well conceived and designed, I still thought that none of them were optimized for today’s busy health care professional. Especially in this era of Web 2.0, where the emphasis is on participation, sharing, collaboration, and recommendation; as well as blogging, audio/video, being user-centric and easy to use.

So I started thinking: "If I were to build my own site geared for health care professionals, one that combined the best features of an industry specific job board and social media website, what are the key elements and components I’d like it to have?" 
  • First, I thought the site should provide a robust social network for the medical community. One that would also act as a directory for users to find and connect with each other based on their specialty within the health care industry.

  • The site would also facilitate members’ ability to collaborate with each other, share ideas, and join networking groups pertinent to their interests and work specialties.
  • It would be a dynamic, interactive online portal where members could join networking groups specific and exclusive to their interests, acumen, and area(s) of expertise. For example, recruiter-only groups, doctor-only groups, medical sales-only groups, etc.
  • As far as job board functionality, individual members could also find career opportunities, get leads, and locate people and products. It would also allow companies and recruiters to source active and passive members looking for jobs specific to the medical and health care industries.

  • The site would allow health care and medical community job seekers to join a networking community that was outside the labeling of traditional job boards.  Since social networks are more popular these days, they could post their profile, specialties and résumé (printed and video) — without worrying about a manager wondering if they’re really looking for other jobs. 

  • A key feature I wasn’t seeing on other sites were opportunities for professional development and career advancement. I envisioned this new site would provide an area to learn new skills, evaluate one’s current skills and provide users with supporting material to help with their career advancement.

    Network (Photo credit: michael.heiss)
  • It would also offer employers and recruiters the ability to objectively evaluate candidates based upon measurable benchmark assessments, not just relying on someone’s résumé, or how well he or she interviewed, etc.

  • The site would allow providers to find products (we haven’t implemented this yet) they’re seeking and also locate associated vendor providers and product distibutors.

Hence, the birth and ongoing development of, which has become the nation’s premier niche job board and social media site designed by and exclusively for health care professionals. Again, since we operate in the world of Web 2.0, there are currently a dozen or so videos we’ve created to answer specific questions for potential members, individual members, and recruiter members, and new employer members. As with our dedicated blog site, Medical Social Network News, we’re always adding new content to our video library as well. 

Here are some key questions and issues some of current our videos address:

What are the Principal Elements of an Effective Niche Job Board & Social Media Site?

A truly functional niche job board and social media site should enhance your ability to reach out to and connect with medical professionals, as well as allow you to locate and take advantage of industry specific services.  For job seekers, it should also facilitate — from a variety of approaches and services — your ability to research and apply for new career opportunities. For recruiters, it should provide a comprehensive database from which to research, evaluate and even assess a wealth of qualified candidates. In short, it should function as the most comprehensive networking and career management site in the health care community today.

The site should further your ability to reach your professional aspirations as well as expand your network of fellow health care and medical professionals.  

Especially for the current job candidate, the site should allow medical professionals to connect with and keep their name and qualifications in front of business associates, medical recruiters, employers, distributors and decision makers.

MedMasters: Real-time Opportunities, Real-time Results

How to Build Your Network Online?

Ever since humans engaged in commercial enterprises, creating a professional network has been essential to anyone in nearly any profession. That’s why there used to be guilds, even pubs and taverns specifically associated with a particular profession; because they facilitated and encouraged networking … tankerd in hand or not. Today, it’s particularly important for health care professionals to have an online “organic” network that works for them around the clock. A good niche job board/social media site should help you to expand your network in a variety of ways.  

First, you should be able to invite any professional medical contact you know to join the site to become part of your own network.  That way, you grow your own network while concurrently helping them to expand their network on the site. Remember, “givers gain.”

Secondly, you should be able to search a site’s member database by name or category (i.e., nurse practitioner, pharmaceutical sales representative, internist, etc.) Once you’ve identified that person, it should be easy to reach out and contact them.

Thirdly, when another member reaches out to you, it should be easy to see who they are, what their specialty is, and can easily accept their invitation to connect with them.

Building Your Network on MedMasters

How Can Recruiters Search for Applicants and Post Job-Specific Openings?

Professionals across a broad range of specialties such as a medical sales representative, allied health professional, doctor, or health care IT, etc., should be accessible by medical industry job recruiters. Likewise, job applicants should have the ability to network with recruiters that focus on their specialty or area of practice.  

The savvier job seeker can utilize a well-designed niche job board to expand their professional networking opportunities, have access to industry specific recruiter networks, and can post or look for job openings posted on the site. This enables them to promote themselves and their qualifications to hundreds of recruiters and thousands of other health care professionals.

Health Care Recruiters Can Post and Find Applicants on MedMasters

In this article, I shared with you my ideas on what would make an ideal niche job board and social network site geared specifically for the health care community.  I also shared with you several of the videos we created specifically for potential members, individual members and recruiter . If you found the content and videos helpful, please leave a comment below. FYI: If you’d like to check out MedMasters’ other videos, visit my YouTube Channel.

Rick Fromme combines entrepreneurial enthusiasm with an insider's knowledge of the medical industry to co-found Both his drive and perspective helps provide health care professionals with a superior mechanism with which to communicate, network and market their strengths. Prior to founding, Rick operated a highly successful medical device distributorship. Other milestones in his 12-year career in the medical industry include a key position at a medical device start-up company that was later sold to the Ethicon Endo division of Johnson & Johnson. You may also reach Rick by connecting with him on FacebookTwitterGoogle+LinkedIn and YouTube. 

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Thursday, May 15, 2014

Humerus Я Us Part 2

By Rick Fromme

"I'm a doctor, not a psychiatrist!" (Photo credit: JD Hancock)
A new father calls his pediatrician’s office and is very concerned. “I need to speak with the doctor; this may be an emergency. Our baby has a temperature of 102.”
The doctor, upon being informed of the situation, instructs his new receptionist, “Find out how he’s taking the baby's temperature.”
So the receptionist asks the young dad, “How are you taking it?”
To which the father replies, “Oh, I’m holding up ok.” 

<Sound of heartbeat: “Flub dub bum!” Followed by cymbal crash.>
Those of you who read my first installment of this series will recall there’s plenty of research and evidence pointing to laughter’s  positive effects on our immune system and other biological systems; not to mention it just feels good psychological to laugh. Humor’s positive effects stimulate several different physiological processes nearly instantaneously. The field of gelotology has repeatedly shown that humor is a “better” pill we should swallow on a daily basis.  
Laughing matters. So let’s have at it.  

Not So Chart Smart

“The patient has been depressed since she began seeing me in 1993.”
 “She stated that she had been constipated for most of her life, until she got separated."
“Patient has two teenage children, but no other abnormalities.”
 “The patient was to have a bowel resection. However, he took a job as a stockbroker instead.”
“On the second day, the knee was better, and on the third day it disappeared!”
“Patient has chest pain if she lies on her left side for over a year.”
 “Rectal examination revealed a normal sized thyroid.”

“Occasional, constant, infrequent headaches.”

“Patient was alert and unresponsive.”

“Patient complained of having ‘harbor tunnel syndrome.’”
 “The patient refused autopsy.”

 “Patient complained of having anxiety related to hospital bills.”

“She has no rigors or shaking chills, but her husband states she was very hot in bed last night.”

 A Five-Year-Old’s 911 Call Turns Funny


A Joke a Day Keeps the Collywobbles at Bay

I was caring for a woman and asked, “So how’s your breakfast this morning?”
“It’s very good, except for the Kentucky Jelly. I can’t seem to get used to the taste,” the patient replied.
I then asked to see the jelly and the woman produced a foil packet labeled “KY Jelly.”
— Dr. Leonard Kransdorf  

A woman in Arkansas brought her baby in to see the doctor, and he determined right away the baby had an earache. He wrote a prescription for eardrops. In the directions he wrote, “Put two drops in right ear every four hours,” and abbreviated “right” as an R with a circle around it ®. Several days passed, and the woman returned with her baby, complaining that the baby still had an earache, but that his little behind was getting really greasy with all those drops of oil. The doctor looked at the bottle of eardrops and sure enough, the pharmacist had typed the following instructions on the label: “Put two drops in R ear every four hours.”       From Café Mom

Sally walked in to the dentist’s office to schedule an appointment. “How much do you charge to pull out a tooth?” she asked.
“It’s $130,” the dentist replied.
“$130!” gasped Sally, “that’s ridiculous! There must be a way for you to do it cheaper.” 
“Well,” said the dentist thoughtfully, “I suppose if we don’t numb it first, we could knock off $30.”
“Only $30?” countered Sally, “that’s still $100 out of pocket. Can you do it any cheaper?”
The dentist thought a moment. “I suppose if we simply yanked it out with a wrench we could knock it down to $50.”
“Perfect,” smiled Sally. “I’d like to make an appointment for next Tuesday. It’s for my husband.”

A pediatric nurse often has the painful job of giving shots to the children. One day upon entering the examining room to give a shot, a little girl starting screaming “NO! NO! NO!”
“Meagan” her mother scolded, “that’s not polite behavior!”
At that the girl continued to scream, “NO THANK YOU! NO THANK YOU! NO THANK YOU!”

A man comes into the ER and yells, “My wife’s going to have her baby in the cab!” I grabbed my stuff, rushed out to the cab, lifted the lady’s dress, and began to take off her underwear. Suddenly I noticed that there were several cabs … and I was in the wrong one. — Dr. Mark MacDonald

Before going in for surgery, a patient thought it’d be funny if he posted a note on himself telling the surgeon to be careful. After the surgery he found another note next to the incision. “Anyone know where my cell phone is?!”

Knock. Knock.
“Who’s there?”
“HIPAA who?”
“Sorry, I can’t tell you that.”

What Does the Spleen Do? A Harvard Medical School Production

It’s All in the Name

Dr. John Looney (Psychiatrist) 
Dr. D. Cure (Internal Medicine)
Dr. Alden Cockburn (Urologist) 
Dr. John Heine (Proctologist) 
Dr. Gary Ricketts (Dietician)
Dr. John Spine (Orthopedist)
Dr. Cynthia Rasch (Dermatologist)
Dr. Bonnie Beaver (Gynecologist) 
Dr. Lana Cain (Pain Specialist)
Dr. David Dickoff (Urologist)

Dr. Edmond Lipp (Dentist)
Dr. Wan Pinn (Acupuncturist)
Dr. Rebecca Pishkoff (Nephrologist)

Dr. Phillip Hipps (Orthopedist)
Dr. Charles Payne (Pain Specialist)
Dr. Long Vu (Opthamologist)

Dr. Maroon Dick (Urologist)
Dr. Michael Achey (Primary Care)
Dr. H'doubler Peter (Urologist)
Dr. Dan Medic (Emergency Room)

If Women's Medication Ads Gained Self-Awareness


A patient who kept getting worse,
cried out, "I must go home now, nurse!
You've done all your best,
and performed every test;
but I've come to the end of my purse!"

Reviewing the charts is a pain,
Poor handwriting gives me eyestrain.
By the end of the shift,
What I need is a lift.
Not further assault on my brain.
 Betty Ann Cassano, RN

Treatment of atrial fibrillation,
With radiofrequency ablation
Can perf your esophagus,
Cause problems infectious,
And send air through the circulation.
 By William J. Stone, MD

An anesthesiologist named Fred,
had a fetish about loving the dead;
He’d bring home a date,
When the evening was late
And put her to sleep before bed!

A young female nurse named Cecilia,
Would work overtime just to heal ya’.
Except she would not
Touch a needle or shot
because she suffered from hemophilia.

Cats Acting Strangely After a Veterinary Surgery

Emergency Medicine Haikus  (The haiku is an ancient form of Japanese poetry where the first stanza has five syllables, the second has seven, and the third has five.)

You are here again.
There is nothing wrong with you.
You are here again.

Normal X-ray film. 
But cannot rule out disease. 
Suggest CAT scan now.

Four a.m. pages.
“Doc, this patient seems depressed.”
Clown to bedside STAT!

Night ambulance call.
The itchy rash not so bad.
Why call me at two?

Cool procedure, but
Biohazard on my shoes.
Please, clean up your trays.

Ice outside all week.
Lots of fall down and go boom
Ortho here they come!
  By “Seaglass”

The Gram Positive Bacteria Song

Fractured Medical Terminology

Adenoma: What you say to your mother when you don’t have an answer
Alimentary: What Sherlock Holmes said to Dr. Watson
Antepartum: When your mother or father’s sister goes home
Artery: The study of paintings
Bacteria: Back door to a cafeteria
Bandages: The Rolling Stones
Barium: What doctors do with dead patients
Cesarean Section: A neighborhood in ancient Rome
CAT Scan: Searching for a cat
Colic: A breed of sheep dog
Coma: A punctuation mark
D&C: Where our nation’s capitol is
Dilate: To live long
Enema: Opposite of a friend
Fester: Quicker than someone else
Ganglia: A very tall, thin person
Genital: Not Jewish
GI Series: World series of military baseball
Hangnail: Used to hang a coat upon
Herpes: What women do in the bathroom
Hippocampus: A medical school for hippopotami
Labor Pain: Injuring yourself at work
Medical Staff: A doctor’s walking cane
Morbid: Continuing financial bartering
Nitrates: Cheaper than day rates
Node: Past tense of knew
Outpatient: A patient who fainted
Pelvis: 1st cousin to Elvis (who taught him to dance)
Protein: In favor of young adults
Recovery Room: Place to do upholstery
Seizure: Roman emperor
Tablet: Small table
Terminal Illness: Getting sick at the airport
Tumor: More than one
Varicose: Nearby
Vas Deferens: A big dissimilarity

ERronneous Situations

EMTs received a frantic call from a woman who claimed she’d overdosed and needed help immediately. They arrived on scene and she handed them an empty mint container, saying she took them all. That night she learned that you cannot overdose on mints.

EMTs were transporting a code through downtown at 5 p.m. on a Friday. Traffic is terrible, and their lights and siren were of little help. The passenger gets on the external PA and starts talking to the drivers of the surrounding cars. He’s yelling, “Move to your right! (pause) Move to your right!” Apparently one driver became confused because the EMT exclaimed, “No! Your other right, you idiot!”

An ER nurse was reviewing an elderly female patient’s surgical history and asked if she’d been bedridden after her hip fracture. She replied, “Not since my husband was alive.”

EMS was called to a crash where driver had lost control of vehicle and crashed into cellular phone store. Ironically, the driver had been on talking on his cell phone when he careened into the store front. 

In this article, I briefly reviewed the health benefits scientific research has discovered about the positive effects of laughter humor and laughter, scientifically known as the study of gelotology. I also shared jokes, quotes, limericks, haikus, videos, cartoons and other medically related humor.  If you found it useful or amusing, please click Like and Share. Also, please leave a comment (or even a joke or two) below. Laughter’s infectious; spread it around.  

Rick Fromme combines entrepreneurial enthusiasm with an insider's knowledge of the medical industry to co-found Both his drive and perspective helps provide health care professionals with a superior mechanism with which to communicate, network and market their strengths. Prior to founding, Rick operated a highly successful medical device distributorship. Other milestones in his 12-year career in the medical industry include a key position at a medical device start-up company that was later sold to the Ethicon Endo division of Johnson & Johnson. You may also reach Rick by connecting with him on FacebookTwitterGoogle+LinkedIn and YouTube. 

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