What is a Radiologic Technologist? | 4 Common Misconceptions

4 Common Misconceptions About Radiologic Technologists.

  1. No, we can’t tell you what we see in your x-ray. That’s called interpreting images and out of our scope of practice. We could lose our license for doing that. Plus, if we did….what’s left for the Radiologist?
  2. We are not Technicians. Technicians fix the equipment. We are trained for two years on how to acquire diagnostic images through the skilled use of the equipment. 
  3. We aren’t “just button pushers.” That’s like saying pilots just “stare out the front window of the plane.”
  4. I’m not a Doctor or Nurse. Just because I wear scrubs in a hospital doesn’t make me one. Feel free to READ MY BADGE.

We Image Gently, We Don’t Interpret

There are approximately 337,077 registered radiologic technologists in the United States as of 2018, according to the American Society of Radiologic Technologists. I have been one of them since 2005. Rad Techs are formally educated in anatomy, proper patient positioning, precise examination techniques, standard equipment protocols, radiation safety and protection, and proper patient care. These are all encompassed in a two-year program that technologists must complete before sitting for a national board exam. The exam must be successfully passed to earn the title Radiologic Technologist.

A part of our profession is abiding by a Code of Ethics. Among these ethics, is a clear understanding of our role in providing healthcare. We capture diagnostic images that a radiologist will use to interpret and diagnose a condition. This interpretation is one of the pieces of the medical puzzle that a patient’s attending physician will use in an attempt to solve a problem. Rad Techs obtain the image, radiologists interpret the image and attending physicians gather all the information they can to solve the riddle. None of us are trained nor qualified to do the job of the other members on this triad.

That is why we absolutely cannot tell a patient what we think we might see on an x-ray image. First, it is out of our scope of practice to interpret images. We didn’t learn how to do that in school and have no business attempting it. Second, if we attempted to interpret and failed to identify a pathology properly there could be dire consequences up to and including death. Or even worse… a lawsuit (I’m kidding…sort of.) So we are doing you no favors by attempting to read the image upon your request.

Technologists see pneumonia on chest x-rays every day. We see them enough that most of us know what it looks like on the x-ray image. But we couldn’t tell you what caused it, physiologically. And if we could, we didn’t get any pharmacology classes in x-ray school. So we can’t tell you how to treat pneumonia with antibiotics, steroids, expectorants or whatever else a physician may prescribe to you as a means of treatment. The best practice for good quality patient care is to let each member of the healthcare team do the job they were trained to provide.

This is why we politely decline to “just tell me what you see.”

Technicians vs Technologists

This is an age-old rub and I couldn’t even tell you where it started. I don’t know of many other professions where people get called the wrong names. We don’t call our auto mechanics “auto musicians.” I understand that technician and technologist sound similar but they mean completely different things. The common understanding through the lens of healthcare is that technicians work on equipment. They are the medical mechanics who fix our portable x-ray machines and ultrasound machines when they break down. They don’t know anything about using the equipment to capture diagnostic images. On the contrary, technologists couldn’t tell you the first thing about how to fix any of this stuff. Our plan of attack – turn it off and back on. That’s the best we can do when our equipment fails. Then we call the technicians.

The funny thing isn’t that we, as technologists, get called technicians all the time….cause we do.  The funny thing is that even the “technicians” don’t get called technicians. They are called “biomedical engineers” or “clinical engineers.” Some are called “field service engineers…but none are called technicians. At this point, we just need to let it go. When I’m called a technician, I revert back to the old phrase…” just don’t call me late for dinner.” It’s not that big of a deal anymore. But it does make for a good chuckle at annual conferences when keynote speakers bring it up. (a nod to AHRA 2017 annual keynote.)

This Really Pushes Our Buttons

Interestingly enough, the engineers who have designed the operator console for CT scanners thought they were being helpful. I noticed early on in my cross-training that when performing a CT scan, in several instances the button that the technologist needs to push next automatically lights up when the machines are ready. I naively joked to my trainer that all I had to do was push the blinking button to perform a CT scan. That’s the first time I was lectured about being a button pusher.

This section of this article was targeted at other healthcare workers or patients who may quip that all technologists do is push buttons. Like we’re haphazardly just poking buttons on a console and miraculously an image pops out the other side. But I have to admit, there are some technologists who could be literally considered button pushers. Technology has come so far now that we no longer have to select certain manual parameters like we used to do. For example, we used to adjust the strength of the x-ray beam depending on how much our patient weighed. A heavier patient would require more energy to penetrate the body than a skinny counterpart. Our schooling taught us how to calculate those variables to maximize our ability to capture a diagnostic image regardless of weight, handicap, altered mental status (patient, not ours) and other limiting factors.

But just like the buttons on today’s fast food restaurant registers, the buttons with words have been replaced with buttons that have images. The fast-food worker no longer has to look for the word “large fries” on the register. They just look for the picture of a large box of fries and push it. Technological advancement meets the dumbing down of America. Imaging technology has done the same thing. instead of knowing the techniques required to image the ankle of an obese patient, the technologist can now push an image of an ankle and select a button showing an image of a large patient. All of the radiographic techniques are then automatically selected. That’s where the character is determined as a technologist. Are you a technologist or a button pusher?

My clinical instructor (a nod to the infamous Capt. James R. Sheppard) explained it to me that day, after mistakenly joking that we were button pushers. He said, “Technologists who don’t care about the outcome of the image and just push buttons to collect any image…are just button pushers.”  He continued on, “You want to be a professional who monitors quality and adjusts the buttons as needed. Machines are not always going to be accurate. It is the skilled technologist who has the eye to know the difference.” And with that lecture, he taught me not to be a button pusher and to take pride enough in my profession to care about quality.

So if we jeer at you when you refer to us as button pushers, just know that it is pride that keeps us from chuckling along with you. We worked hard to be licensed radiographers and we know what we are doing. Now, if you’ll excuse me, there’s a button blinking on my console.

Badges Speak Louder Than Scrubs

On any given day during the week, there are hundreds of healthcare workers walking around inside a hospital. Many, not all, but many are wearing what we know as typical hospital scrubs. Somehow the stigma has taken a firm hold in the human mind that any male wearing scrubs must be a doctor and any female wearing scrubs must be a nurse. I’m just not sure how something so diverse can be simplified to such a foregone conclusion?

As a technologist, I frequently walked to the emergency department to get my patients. I would bring them back to my x-ray room for an examination. More times than I can remember, I would pull an ER curtain back to greet my patient and be greeted with “Are you the doctor?”  A few times I was tempted to say “Yep, but today I’m only taking x-rays. You’ll have to be treated by Tommy from Environmental Services. He’s the doctor today.” I mean, when someone knocks on the front door at your house… do you open it and say “Are you the postman?”

Then there’s the whole badge thing. You know, the big, floppy piece of identification that is hanging right on my chest. It clearly says my name and department “Ron – Imaging”. Nevermind the big, noisy portable x-ray machine I just pushed right up next to your gurney. But it’s okay. I explain who I am anyway as part of my patient care protocol. “My name is Ron, I’m here to take your x-ray. We’ll be looking at your lungs and it should only take about five minutes. Can I see your patient armband please?” And off I go, saving the world one x-ray at a time.

If you see a common misconception in the field where you work, consider commenting below and sharing it with us.

Additional Information:

If you are curious about the career of radiography, I have written some articles on various topics:

I hope you find this helpful. You are welcome to email me with any questions. Thanks for stopping by TheRadiologicTechnologist.com.

Ron – [email protected]


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