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First I'd like to say that I try to steer away from politics on this blog. This blog's primary purpose is for education and I don't think creating a segregation of our political dichotomy is a smart way of encouraging readership. With that said, we have a major problem in Washington. Sure, there are differing views on how to improve the economy, lower unemployment, how to conduct our defense department, so on and so forth. However, one thing that I think most people would agree upon, if presented, is the CARE Bill.

The CARE Bill, known as the Consistency, Accuracy, Responsibility and Excellence in Medical Imaging and Radiation Therapy Bill, will amend and enforce the Consumer-Patient Radiation Health & Safety Act of 1981, which would essentially regulate the certification requirements for people who perform medical imaging examinations and who plan and deliver radiation therapy treatments.

Now, "why is this important?" you might ask. Let's ask a few questions first. Would you go to a physician that wasn't certified by the AMA? Would you go to a mechanic that wasn't ASE Certified? Would you let an unlicensed electrician in your home? My personal answer to all three is a resounding "NO!". Why then, would you let an unlicensed radiation therapist plan your chemotherapy treatment? Or why would you let an untrained Nuclear Medicine Technologist inject you with a radioactive isotope? Or let an unregistered Radiologic Technologist emit ionizing radiation to your body? The truth is, you may not know that this is occurring!

39 states require that a Radiologic Technologist be registered with the American Registry of Radiologic Technologists (ARRT), the gold standard for the field. This means that 11 states do not require national licensure. Those states are Alabama, Alaska, Georgia, Idaho, Michigan, Missouri, Nevada, New Hampshire, North Carolina, North Dakota, and South Dakota. This means that if you want to be a Radiologic Technologist in Atlanta, you can literally have ZERO experience in the medical field, submit an application, and be taking radiographs the next day. To put this in perspective, I don't know a ton about prescription medications but if I were to find a state that didn't require licensure as a pharmacist, I could apply for a job at Walgreens and deliver meds the next day. Scary, isn't it?

A common question is, "Why isn't the Consumer-Patient Radiation Health & Safety Act of 1981 being enforced?" When the bill was presented, there were no legally enforceable penalties for states that choose not to comply, therefore it's as if the bill doesn't even exist. The CARE Bill would simply enforce the laws put forth by this act.

The CARE Bill requires what you would expect, that the person treating you has been through proper training, has been tested, and has proven that they can operate within their scope of practice. This would follow similar guidelines as the Mammography Quality Standards Act that was enacted in 1994 to regulate the quality of care in Mammography. A few examples of the regulations put forth in the MQSA are that under the law, all mammography facilities must: 1) be accredited by an FDA-approved accreditation body, 2) be certified by FDA, or its State, as meeting the standards, 3) undergo an annual MQSA inspection, and 4) prominently display the certificate issued by the agency. These examples are not necessarily proposed in the CARE Bill and pertain to the facilities only, however there are plenty of patient safety issues at risk by not complying to these MQSA standards.

The CARE Bill would ensure that quality information is presented for diagnosis and that quality radiation therapy treatments are delivered, leading to accurate diagnosis, treatment and cure. Poor quality images can lead to additional testing, delays in treatment and needless anxiety for the patient. It would also reduce health care costs by lowering the number of radiologic examinations that must be repeated due to improper positioning or poor technique. Repeated radiologic examinations cost the U.S. health care system millions of dollars annually in needless medical bills. In addition, it would improve the safety of radiologic procedures. Administered properly, radiation is an invaluable tool in the diagnosis, treatment and management of disease. But most radiologic procedures also carry a potential health risk, and radiation can be harmful if misadministered(1).

On September 29, 2009, 135 members of Congress introduced H.R. 3652 with the official title being: To amend the Public Health Service Act and title XVIII of the Social Security Act to make the provision of technical services for medical imaging examinations and radiation therapy treatments safer, more accurate, and less costly. This bill got passed along to the Senate. On August 5, 2010, 9 senators cosponsored this bill, it was read twice and referred to the Committee on Health, Education, Labor, and Pensions, however it sat in the 111th Congress until the elections of November, 2010 and never saw the light of day afterward.

The passing of this bill would open up the job market for a ton of out of work, licensed, radiation workers. It would reduce the operating costs of hospitals, radiation therapy facilities, and outpatient clinics. It would also increase safety to unprecedented levels. The ASRT has also performed a study in South Carolina and Arkansas to predict salaries for registered Radiologic Technologists and results showed that salary levels did not increase above the national norm, meaning costs will not rise to compensate for employing registered technologists. I have yet to find a single negative effect that the health care industry would encounter if this bill were to be passed. All I see is highly qualified, registered technologists seeking optimal, diagnostic imaging while ensuring the safety of all individuals involved. I think that's a good thing, and I hope you do too. If you would like to get more information or get involved, you can check out http://www.asrt.org/ or email governmentrelations@asrt.org.

Curtis J. Carpenter R.T. (R)(CT)

Curtis Carpenter is the founder and president of Reliable Radiography based in Vero Beach, Florida.

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