Abstract
Medical practitioners have a duty to maintain a certain standard of care in providing their services. With critical care ultrasound gaining popularity in the ICU, it is envisaged that more intensivists will use the tool in managing their patients. Ultrasound, especially echocardiography, can be an 'easy to learn, difficult to manage' skill, and the competency in performing the procedure varies greatly. In view of this, several recommendations for competency statements have been published in recent years to advocate the need for a unified approach to training and certification. In this paper, we take a slightly different perspective, from an Australian medical-legal viewpoint, to argue for the need to implement a critical care ultrasound certification program. We examine various issues that can potentially lead to a breach of the standard of care, hence exposing the practitioners and/or the healthcare institutions to lawsuits in professional negligence or breach of contract. These issues, among others, include the failure to use ultrasound in appropriate situations, the failure of hospitals to ensure practitioners are properly trained in the skills, the failure of practitioners to perform an ultrasound study that is of a reasonable standard, and the failure of practitioners to keep themselves abreast of the latest developments in treatment and management. The implications of these issues and the importance of having a certification process are discussed.
Highlights
Ultrasound has been used in various settings for decades, it is only in the past 10 to 15 years that critical care physicians have increasingly become aware of its usefulness
While critical care ultrasound is seen as an indispensable tool in the ICU nowadays, proper training and assessment modules are still lacking in many countries
This article examines the need for establishing a proper training and assessment program but from a medicallegal perspective
Summary
Ultrasound has been used in various settings for decades, it is only in the past 10 to 15 years that critical care physicians have increasingly become aware of its usefulness. While critical care ultrasound is seen as an indispensable tool in the ICU nowadays, proper training and assessment modules are still lacking in many countries. International statements (guidelines) specifying the requirements for different levels of competency and the scope of knowledge have been published [3,4]. These statements acknowledge the need for establishing a unified training pathway, the rationale of which mostly rests on improving the clinical skills of the physicians, the management and care of patients. This article examines the need for establishing a proper training and assessment program but from a medicallegal perspective. While this article is written from an Australian legal perspective, similar principles can be found in many other jurisdictions
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