Cytopathology
Ultrasound Guided Fine Needle Aspiration (USFNA)
Credentialing, Credentialed, Privileged and Accreditation in US and USFNA

Author: Joe D. Jakowski, M.D., Susan Meanor, R.D.M.S., R.T. (see Authors page)

Revised: 6 February 2018, last major update March 2013

Copyright: (c) 2002-2018, PathologyOutlines.com, Inc.

PubMed Search: Credentialing ultrasound guided fine needle aspiration

Cite this page: Jakowski, J. D.; Meanor, S. Credentialing, Credentialed, Privileged and Accreditation in US and USFNA. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/cytopathologyusfnacredentialing.html. Accessed May 25th, 2018.
Credentialing
  • Process by which a physician's training, experience and ability to perform USFNA are reviewed to obtain privileges from their hospital or medical group to be entitled to perform this procedure
Credentialed
  • An award of achievement as, for example, to be designated as a Registered Diagnostic Medical Sonographer (RDMS) through the American Registry for Diagnostic Medical Sonography (ARDMS) by:
    • Meeting educational prerequisites (a number of pathways are available and may require, for example, a certain number of US exams, months of US experience, CME credits and a documentation log of experience)
    • Passing two comprehensive examinations:
      • Physical principles exam
      • US instrumentation exam
    • Passing at least one corresponding US specialty examination (e.g. in breast, abdomen)
    • Maintaining credentials as a RDMS involves:
      • Annual compliance with CME requirements (e.g. 30 CME credits per 3 years)
      • Paying a renewal fee
      • Completing a recertification assessment
Privileged
  • Granting of the practitioner's ability to perform USFNA as recognized by their hospital or medical practice by successfully completing the credentialing process
  • Just as one must apply for privileges to perform autopsies or sign out surgical pathology specimens, point of care US and USFNA is typically defined as a hospital privilege
  • The American Medical Association adopted a resolution entitled "Privileging for Ultrasound Imaging (H-230.960)" in 1999 and reaffirmed it in 2000. It is summarized below:
    1. American Medical Association affirms that US imaging is within the scope of practice of appropriately trained physicians and acknowledges that broad and diverse use and application of US imaging technologies exist in medical practice
    2. American Medical Association policy on US imaging affirms that privileging of the physician to perform US imaging procedures in a hospital setting should be a function of hospital medical staffs and should be specifically delineated on the department's delineation of privileges form
    3. American Medical Association policy on US imaging states that each hospital medical staff should review and approve criteria for granting US privileges based upon background and training for the use of US technology and strongly recommends that these criteria are in accordance with recommended training and education standards developed by each physician's respective specialty
Accreditation
  • Is granted by a national organization to a specific facility (a hospital department or medical practice)
  • It implies that the facility has met all of the relevant guidelines / policies / procedures in US medicine with regards to equipment, safeguards, training, quality assurance, records and reports
  • Currently there is no accreditation process specifically for pathology practices that perform USFNA as there are for many but not all of the other medical subspecialties that use US in medicine
  • The major limiting factor for the accreditation of pathology practices in the current national US accrediting scheme (i.e. from the American Institute for Ultrasound in Medicine) is the requirement of performing a certain number of diagnostic US examinations which is not typically how a pathologist uses US
  • In lieu of the absence of accreditation of pathology practices that use US, the applicable US practice standards already established by the American Institute of Ultrasound in Medicine (AIUM) and the American College of Radiology (ACR) should be followed