Fluoroscopy Scope Expansion

Background

Fluoroscopy is a technique that provides real-time X-ray imaging that is especially useful for guiding a variety of diagnostic and interventional procedures. In some cases, fluoroscopic images may be stored as part of the patient examination. Fluoroscopy is frequently used to assist in a wide variety of medical diagnostic and therapeutic procedures, both within and outside of radiology departments.

Proposed legislation in several states would extend the right to order, perform, supervise, and in some instances interpret radiographic examinations to non-physician health care professionals.

As states consider legislation and regulations on the use of fluoroscopy, its scope of practice is becoming increasingly expansive to include APRNs. Especially in states with rural areas where physician access is scarce.

Regulatory Requirement

Licensure requirements vary extensively throughout the country, with some states requiring training and others solely requiring evidence of competency. Non-physician medical personnel in several states continue to pursue an expansion for scope of practice that would allow them to operate (or supervise use of) X-ray equipment. In particular, registered nurses and nurse practitioners seek to expand the scope of their authorized medical privileges for use and supervision of fluoroscopy in pain management settings. As of 2018, 22 states included APRNs within their scope of fluoroscopy practice. 23 states included APRNs within their scope of operating x-rays.

ACR Concerns

The American College of Radiology is concerned with the increase in expansion of the scope of practice of fluoroscopy.

The College stresses the importance of working with stakeholders to assure that such legislative proposals are carefully considered for their potential to adversely affect patient care.