The Sonography Profession

The Sonography Profession

Diane M. Kawamura

This chapter introduces the sonography profession, which includes sonographers and sonologists. Sonographers are health care professionals who are educated to use imaging equipment, sound waves, and echoes to acquire and to evaluate sonograms in order to determine when sufficient imaging data have been recorded. Sonologists are physicians who interpret sonograms. Sonograms are the recorded images of a sonography examination.



A profession can be described as a group of disciplined individuals who adhere to ethical standards.1,2 When sonography is defined as an occupation, its definition is limited and refers only to the activity the sonographer renders for
the salary the sonographer receives.2 Although members of any profession can be linked to monetary compensation, the definition for an occupation and the definition for a profession are not synonymous. The sonography profession is made up of those individuals who have completed specialized academic courses and acquired clinical scanning competencies in an educational, a clinical, and/or a research environment. To ensure uniformity of each individual in the profession, a graduate sonographer must be competent to meet the profession’s criteria.1, 2 and 3


A professional is a member of a profession and adheres to the required codes of conduct, ethics, standards, and guidelines and is accountable to those they serve and to society.1,2 Normally, professionals are perceived as competent, are known and respected for their specialized knowledge, and for keeping this knowledge current.4 A sonographer should understand that professional behavior is determined from one’s aptitudes, attributes, and attitudes.5 Table 1-1 presents a summary of definitions and a positive example of professional aptitudes, attributes, attitude, and behavior.5, 6, 7, 8 and 9 Sonographers can determine if their professional standards need to be enhanced by routine and thorough evaluation of how their aptitude, attributes, and attitude affect their professional behavior and their professional competency. Figure 1-1 illustrates the relationship of aptitude, attributes, and attitude to behavior.10 One can judge someone’s behavior but not their aptitude, attributes, and attitude.


The roof of professionalism is the profession. The profession is where disciplined individuals adhere to professional standards.8 The word professionalism is based on the word professional, which describes a member of a profession. Professionalism does not refer to the task of completing a sonography examination but to how the sonographer completed the sonography examination. As illustrated in Table 1-1, promoting professionalism includes aligning one’s aptitudes, attributes, and attitudes to enhance professional behavior.5, 6 and 7 When viewed as a competency or proficiency, professionalism uses practice methods recognized as being professional. These practice methods include upholding the profession’s principles and standards.1,2,4,5,8,11


Many historians believe that to know where we are going, we need to know where we have been. This belief provides the rationale to review a brief history to appreciate the sonography profession and its leadership.

Evolution of a Professional

In 1969, Joan Baker, Marilyn Ball, Margaret Byme, James Dennon, Raylene Husak, and L. E. Schnitzer gathered and initiated a proposal to create the American Society of Ultrasound Technical Specialists (ASUTS).12 Baker and Schnitzer presented the proposal to the American Institute of Ultrasound in Medicine (AIUM) board of directors (BODs) explaining that the goal was to reach out to those individuals performing ultrasound procedures.12,13 The AIUM board members did not oppose the request to establish a technical society, but many expressed a belief it would be a waste of time. ASUTS made its debut in 1970, at the AIUM’s annual conference in Cleveland, Ohio. The conference had 187 registrants, which included 12 exhibitors and 13 technical specialists. Following the constitution and bylaws, the members proceeded to electing an ASUTS (BOD) comprised of 11 members to serve two-year terms and meeting the criteria of being an active member in the society and employed in sonographic technology.12 Joan Baker became the first ASUTS president along with the remaining officers and six regional directors, each representing one of the six geographical regions in the North American continent.13 In a short time period between 1969 and 1974, members of this group used their time, energy, and talent to create the goals and pathways of collaborating with other organizations. The ASUTS leadership identified the need to establish professional standards and was aware that the term “technical specialist” was not well received in the medical community.12,13 Coming from Great Britain where radiography was used to describe x-ray technicians, Baker suggested the term “sonography” as a logical choice to incorporate sonar for those making an image with sound. History documents that the formation of ASUTS was initiated in 1969 and that it was created in 1970 and incorporated in 1972. The organization’s name was officially changed to the Society of Diagnostic Medical Sonographers (SDMS) on September 16, 1980. With the advancements in equipment, diagnostic imaging, and membership, the name was again changed in 2016 to the Society of Diagnostic Medical Sonography. Changing “sonographers” to “sonography” made the name more inclusive to better represent the changes in the profession between 1980 and 2016 while maintaining the same acronym.

Creating the Occupation12, 13 and 14

The ASUTS leaders determined that if the society was going to be successful, it was essential to create a new and separate occupation. The rationale for creating an occupation was to avoid the loss of diagnostic ultrasound to any other occupation that would require students to complete academic and clinical prerequisite education in a different field before gaining access to ultrasound education.

Establishing the new occupation had many challenges. The American Medical Association’s (AMA’s) Manpower Division was preparing to disband, which would create an unknown or a delayed procedure for creating a new occupation. The Manpower Division did not want to be involved with a new occupation. The United States Office of Education (USOE) released a statement discouraging the proliferation of allied health occupations and promoted new occupations such as ultrasound to be incorporated under the existing occupations. Joan Baker sought the assistance of Dr. Gil Baum, the current AIUM president. Dr. Baum successfully convinced the Manpower Division to respond to ASUTS’ request. In 1973, the occupation of Diagnostic Medical Sonography (DMS) was created.14 The ASUTS was very appreciative of Dr. Baum for his timely influence.13,14

The next challenge in the process was to work with the AMA’s Department of Allied Health to compose a Document of Essentials that would have to be approved by all the collaborating organizations. Joan Baker, Jackie Ellis, and Betty Phillips met with the director of Allied Medical Professions and Services and two representative members with the Allied Medical Emerging Health Power of the AMA. Baker, Ellis, and Phillips presented the intentions of ASUTS. The outcome of the meeting required the ASUTS leadership team to develop and complete specific tasks. The outcome was the development of nine tasks, which included the foundation to develop the essentials for programmatic accreditation and the foundation to develop written and practice examinations to earn credentials.


A professional organization can also be referred to as a professional association. The word association can be ambiguous and can refer to different types of organizations.15 One must review the infrastructure of an association to determine if it is synonymous with an organization.

When used as a verb, an association is a type of organization for individuals who share common interests and focus attention on promoting an area of interest such as art, history, science, alumni, etc. When used as a noun, the term association has a very broad meaning, one that can include different types of alliances, leagues, cooperatives, conventions, clubs, fellowships, unions, etc. An association can also be a collection of people forming an alliance to provide a particular service for a particular occupation or profession such as lawyers, accountants, or engineers. There may be an association of health care professionals having members of a specific imaging profession such as sonologists and sonographers.

The primary rationale why professional organizations were created was to provide continuing education (CE), to support the advancement of the specific profession, to support the interests of members employed in that profession, and to serve the public good.15, 16 and 17 Professional organizations can be at the state, regional, national, and/or international level.18 In most cases, the members and the environment oversee the legitimate practice of any professional organization.17 Different types of professional organizations can dramatically influence the required student education, student clinical experience, credential or certification, program accreditation, scope of practice, and requirements and evidence for completing continuing medical education (CME).

The main purpose of a member benefit organization is to create value for its membership.15 Reflecting on history, a group of six sonographers saw a need to form an organization with the goal to reach out to those individuals performing sonography examinations.12,13 The historical member benefits’ value was the creation of a professional organization for sonographers performing examinations in all the specialty areas of sonography. This led to the formation of several sonography organizations composed of students, sonographers, physicians, researchers, and other sonography-associated practitioners.16 The benefits provided for individual members include numerous resources such as a professional journal, educational conferences, virtual seminars or webinars, practice parameters, research grants, and codes of ethics.18, 19 and 20 Several organizations provide both CME credits and a CME tracking system.

In addition to providing current educational resources, numerous professional organizations provide members with opportunities to author, edit, and present current educational information. Student members often have discounted membership fees, education scholarships, and research grants.18

Professional member benefit organizations frequently recognize individual members who have shown outstanding achievements, such as outstanding educators, outstanding sonographers, memorial lecturers, fellow members, life members, and pioneer members. Sonography students may also be recognized for posters, essays, research, etc. Table 1-2 lists several member benefit sonography organizations and the acronyms for those primarily located in the United States.18,21 The organizations’ members may include students, sonographers, practitioners, physicians/sonologists, researchers, educators, etc.18 These professions usually provide its members with current information, employment opportunities, published professional journals, opportunities to submit peer-reviewed manuscripts, national annual conference, scholarships, professional liability insurance, personal medical insurance, virtual webinar courses, and CME.19,20

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Dec 10, 2022 | Posted by in ULTRASONOGRAPHY | Comments Off on The Sonography Profession

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