By Dr. David Flick

A patient enters your office with a lingering pain in their abdomen. It’s a nagging pain, but not life-threatening, so they came to their primary care doctor for help. What seems like a simple task becomes a convoluted and financially burdensome mess, and you eventually must direct them elsewhere. But what if you had the tools to help them right there in your office? Enter handheld ultrasound.

Finding handheld ultrasound devices in a primary care doctor’s office is uncommon, but with recent educational and technological advancements in the space, this should start to change.

In my personal experience from integrating the tool into my practice, I’ve found seemingly endless benefits from adopting handheld ultrasound. The tool saves time for diagnosis and significantly reduces costs when used bedside (rather than referring patients to a specialist). Most importantly, I have found that integrating the handheld ultrasound into my practice has strengthened my relationship with my patients. It both increases the amount of face time individuals have with us and expands the type of care we are able to provide – from scanning the abdomen to performing a quick check-up on a pregnant mother and her baby.

Here are some of the recent advancements in ultrasound technology, and the benefits we, as healthcare providers, can reap upon adoption.

Starting early in medical school
I have been fascinated by ultrasound since my early days in medical school and am convinced that it may become as beneficial as the stethoscope in primary care.

For years, traditional medical school curricula have not included bedside ultrasound, which has led to the three main barriers to handheld ultrasound adoption — a lack of trained faculty, limited access to (and experience with) the equipment, and a lack of comfort interpreting the images without a specialist present. I was fortunate enough to be part of a pilot program during medical school that incorporated ultrasound into all four years, bringing my education to residents, and colleagues in my own practice.

Today, there is an increased focus on point-of-care ultrasound (POCUS) devices in residency programs, and curricula need to adapt to keep up with this demand. In a recent study that surveyed internal medicine residents, 90 percent reported being interested in POCUS, and 83 percent felt the tool would be extremely useful in the inpatient setting. Not only does learning how to properly use handheld ultrasound benefit students’ expertise long term, but the ability to use tools that can help deepen their understanding of the anatomy, medicine and healthcare as a whole increases their motivation to learn. Giving medical personnel this experience from the start of their education will only benefit their professional careers in the long run.

Technology advancements
POCUS devices have evolved since they were first introduced almost a decade ago, and these advancements in technology have greatly increased their ease of use. Gone are the cords connecting the tool to additional machinery; modern devices are more akin to a smart phone, and with the touch of a button, we can transfer and securely share images. I often see 20 patients a day and can’t afford to lug a large ultrasound system into the room, plug it in, and scan. Instead, I have the Vscan in my pocket; it’s as accessible as the stethoscope around my neck.

Some devices are starting to leverage advanced technologies like artificial intelligence (AI) to quickly interpret images and overall speed up workflows. Technology is making handheld ultrasound easier, faster and more intuitive than ever, effectively knocking down many of the barriers to implementation.


Immediate answers
One afternoon, during my emergency room rotation, a mother rushed her child in with severe abdominal pain. Equipped with my handheld ultrasound device, I diagnosed the patient with a ruptured appendix, which required immediate surgical attention. Typically, an order would have needed to be placed for a computed tomography (CT) scan or an ultrasound examination performed by a sonographer elsewhere in the hospital. This takes extra time, and is anxiety provoking for the patient and the family. Having this technology at my fingertips, I was able to quickly call the surgeon with an immediate diagnosis and use the rest of the time to keep the mother and child calm before the procedure and send them directly into surgery.

Time is of the essence in a case like this and adding an additional cost for a comprehensive ultrasound exam or CT scan only increases stress to an already complex emergency. United States healthcare expenses are projected to increase by 2.7 percent per year — reaching a landmark $6 trillion by 2027; we have a unique opportunity to evaluate every opportunity to cut down on costs and time.

Primary care — and the healthcare industry as a whole — has often been hesitant to adopt emerging technologies. And for good reason; doctors hold the lives of their patients in their hands, and every new tool could be considered a gamble. But given the trove of reputable data and feedback from professionals using them in their practices, the benefits of handheld ultrasound have moved past speculation, and into certainty. Just as the stethoscope once changed the landscape of medicine, handheld ultrasounds have the power to create an immense shift across the entire healthcare continuum. Doctors just need to start recognizing their value, and the benefits will follow.

About the author: David graduated from the University of California Irvine School of Medicine, where he was part of a new, innovative curriculum providing longitudinal point-of-care ultrasound teaching throughout his 4 years. He took opportunities to learn more about ultrasound during that time, providing teaching to the junior medical students and acted as an ambassador to a sister school in Australia to help bring the ultrasound curriculum there. David attended the Family Medicine Residency Program at Tripler Army Medical Center in Hawaii where he built a residency ultrasound curriculum from the ground up. He taught point-of-care ultrasound to residents as well as surrounding clinics, and paved the way for some of the first family medicine residents to join Emergency Medicine Ultrasound Fellowships in the Army. David still utilizes point-of-care ultrasound in his daily practice as a family physician and continues to advocate for and publish on the topic of point-of-care ultrasound in primary care.