Forexample, apatientshortofbreathcan
seefluidon the lungsandbetterunder-
standwhy itneeds tobedrained,hesays.
Doctorsneed to learn tocorrectly
decipherwhat they’re lookingat, saysDr.
LouiseDavies, ahead-and-necksurgeon
with theVeteransAffairsMedicalCenter
inVermontandaresearcheron the
thyroid-cancerstudy. “Peopleseesmall
variationsandsay, ‘That’sabnormal.’”
What ifaverysmallareaoffluid isflagged
near the lungs?Should thatbedrained?
“Youcan imagine that it’sdefinitely
going to lead toa lotofadditional testing,
at least initially,”Daviessays. “Will itbe10
years fromnow?Idon’tknow.Certainly
there’sa learningcurvewith the introduc-
tionofanynew technology.”
stethoscopeof the21stcentury.Thebottle-
neckrightnow isadequate training.”
Inrecentyears, though,otherschools
havebegun to incorporatesuch training,
someonapilotbasis, includingHarvard
MedicalSchool,NewYorkCity’sIcahn
SchoolofMedicineand theUniversityof
California, Irvine.Once thatnextwaveof
physicians launches theirpractices, they
canuse thedevices—somehand-heldand
othersmore thesizeofa laptop— tocheck
forpotentialmedical issuesranging from
heart failure tofluidon the lungs toablood
clot in the legswithoutvacillatingabout
whether torefer thepatientelsewhere for
testing, saysDr.NilamSoniat theUniver-
sityofTexasHealthScienceCenteratSan
Antonio,whichbegan to trainall incoming
students thisyear.
“Noneofuswant tobewrong,”says
Soni,whoco-directshisschool’snew
ultrasoundcurriculum. “Itgivesusa level
ofconfidence in thedecision-making that
wedidn’teverhavebefore.”
Whowouldn’twant tobeFreeman’s
patient, avoidingapotentially life-
threateningruptureof theaorta?
Someresearch,however,providesa
cautionarynote, indicating thatmore
imagingmightnotonly triggermorecostly
andanxiety-provoking testsbutalsomight
“catch”amedical issue thatmightnothave
caused long-termproblemsanyway.One
2014study found thatdiagnoses for thy-
roidcancers—someofwhichcanbequite
slowgrowing—havenearly tripledsince
themid-1970s.Yet thedeathratehasn’t
changed, suggesting that theproblem
mightbean“epidemicofdiagnosis”via
imaging testsrather thanan“epidemicof
disease,” theresearcherswrote.
Butportableultrasonographycan
streamlinediagnoses insomecircum-
stances, saysDr.DanSepdham, associate
professorof familyandcommunitymedi-
cineatUniversityofTexasSouthwestern
MedicalCenter inDallas.Sepdham,who
startedusinga laptop-sizedevice last
fallwhile trainingphysicianresidents,
describesonewomanhe treatedrecently
inanoutpatientclinicatnearbyParkland
Hospital.Thewomanhadpreviouslybeen
prescribedantibiotics forasore throatbut
hadreturnedstill insignificantpain.Apor-
tableultrasoundscan foundafluid-filled
areanototherwisevisible—apocketof in-
fection thatcouldhavespread toherairway
—andsenther to theemergencyroom.
The imageon theultrasoundscreencan
alsohelpdoctorseducate theirpatients
aboutvague-soundingmedical terms like
heart failure
,Soni says. “There is thesaying
thatapicture iswortha thousandwords.”
CHARLOTTEHUFF
, awriter inFortWorth, Texas,
reportsonall aspectsofmoneyandmedicine.
88
OCTOBER2015
AMERICANWAY
TECHNOLOGY
THEULTRASOUNDDEVICESARE
CATCHINGTHEATTENTIONOF
DOCTORSINPRIVATEPRACTICE
ASTHEYBECOMEMORE
PORTABLEANDAFFORDABLE.
TOOLOFTHETRADE
:
Theportable
ultrasoundcould
revolutionizemedicine.
u
