Author: bbimagingadmin

✓ The opportunity to do my best work

We get it. You didn’t go to sonography school so that you could spend half your time filling out paperwork. Wouldn’t it be nice if you could hand those tasks off to another competent professional? You can. Say hello to the Technical Assistants (TA), BB Imaging’s very own administrative support superheroes! TAs handle administrative tasks, cleanup, room prep, and much more so that you can focus on patient care, scanning, and diagnostics. Our TAs empower you to focus on what you are most passionate about: high-quality ultrasound exams.

✓ Wellness benefits that keep me healthy and happy

We know that to be your best in-clinic, you’ve got to care for yourself outside of clinic. Your physical and mental health are important, and cost shouldn’t get in the way of seeking the care you need. That’s why we offer monthly wellness stipends you can put toward whatever keeps you feeling good. Massages to destress? You know it. Gym memberships to build strength and stamina? Of course. Yoga class to stay zen? Absolutely. Let us help you take care of YOU.

✓ A schedule that works for ME

Our sonographers typically work clinical hours and have nights, weekends, and holidays off. So, if you’re the type who needs a regular schedule that you can depend on, we’ve got it.

What if you’re looking for something a little more dynamic and flexible? As our company grows, opportunities to cover shifts outside of clinical hours are increasing, and we even have travel positions from time to time!

✓ Parental leave so I can put my family first

It should come as no surprise that we’re big proponents of caring for parents and newborns well into the fourth trimester. That care extends to our team members via generous parental leave—even if you both work with us!

✓ Reimbursement for travel costs

Many of our sonographers will work at 2-3 clinics within a regional area. We know driving gets expensive, so we offer mileage reimbursements that get lumped in with your paycheck. We even bump up your hourly wage if you travel 60+ miles outside your normal zone. All you have to do is provide your receipts. And if you’re traveling even further for work (think extended stays and travel gigs), we’ll pick up your expenses there too.

✓ Professional development opportunities that help me reach my goals

From training programs for our sonographers to a regular cadence of reviews and check-ins, we provide lots of opportunities for managers and team members stay aligned on goals and next steps. We also offer financial help for professional development including tuition reimbursement, conference stipends, and AIUM membership fees.

✓ A positive and affirming company culture

We all feel taken for granted sometimes, and that just shouldn’t be the case. An email that says “thanks” is nice and all, but doesn’t cut it when it comes to celebrating you and your accomplishments. That’s why we incorporate celebratory opportunities everywhere we can. We’re talking about weekly kudos that get shared during team calls, our end-of-year STAR Awards, a special celebration or gift for Medical Ultrasound Awareness Month, and lots of internal contests and giveaways throughout the year.

✓ The chance to work with all my besties

If leaving your work bestie behind is stopping you from applying, fear no more! BB Imaging’s sonographer referral program means you can bring your friends and get paid for it too.

So… how’d we do? Did we check off your sonography career Christmas list?

Recently, we’ve been talking a lot about telesonography and how we know it’s the next big thing in ultrasound. But claims like that deserve an explanation, and today we’ve got some explaining to do. Let’s talk about what telesonography is, how it’s performed, and the healthcare pain points telesonography can solve.

We’ll start with…

A Basic Definition

When you combine sonography and telemedicine, you get telesonography. Telesonography is the provision of ultrasound services via a telecommunications link (phone call, video conference, chat message, etc.). It connects a local provider with a remote sonography expert who can perform diagnostics and provide a preliminary report. It may also be referred to as remotely-supported ultrasound or teleultrasound, but we like the term telesonography.

Two Types of Telesonography

Telesonography can be conducted synchronously or asynchronously. While both methods increase access to sonography specialists and eliminate the requirement to travel for a face-to-face consultation, we think one method is just a little bit better than the other.

Asynchronous transmission involves acquiring ultrasound images, storing them locally, and then transmitting them for expert analysis at a later time. The primary benefit of this method is that patient care is not dependent upon sonographer availability—the patient can get examined at a time that is most convenient for them, and the sonographer can review the images when their schedule allows. Asynchronous transmission is currently the most common method of telesonography, and it’s been especially beneficial for rural populations where maternal-fetal care specialists are not readily accessible. It’s also beneficial to sonography trainees, who can perform scans, save the images, and review them when a physician or mentor is available.

Conversely, synchronous transmission occurs in near real-time. While a local healthcare worker obtains the cine loops, the expert sonographer is available to review the cines and provide feedback as needed. This method is beneficial because it increases diagnostic quality and pathology detection. This is particularly beneficial if the sonographer identifies a concern that requires immediate intervention, as they can begin escalating the level of care while the patient is still present. Historically, synchronous transmission has been hampered by poor Internet connections, but as access to quality broadband increases, we believe the synchronous mode will become more commonplace. In fact, our own telesonography solution, TeleScan®, utilizes synchronous data transmission via a secure, HIPAA-compliant cloud platform.

Solving Problems: The Why of Telesonography

Okay, now that we know what telesonography is and how it works, let’s get down to the why. Why do we think telesonography is the future of ultrasound, and more specifically, what problems will it solve?

Problem 1: Limited Healthcare Resources

We all know there is a shortage of healthcare providers and specialists, and that this problem is exponentially worse in rural areas. Some rural patients have to travel more than 200 miles to the nearest OB/GYN. A scarcity of local resources leads to limited patient access, inappropriate triage, delayed diagnoses, and slow intervention—all of which result in poorer health outcomes for patients.

Solution: Telesonography Uses Local Healthcare Workers

Our version of telesonography leans heavily on the idea that augmented care is better than no care. That’s why TeleScan utilizes local healthcare workers to obtain cine loops and remote expert sonographers to review and perform diagnostics. While we have heard some skepticism regarding this model, we’re not the only ones who think this is an effective method.

Consider one study that examined the feasibility of tele-mentored sonography for identifying the appendix. Results showed “no significant difference between time taken and success rate of image acquisition between onsite and remote mentoring.” Pediatricians who examined tele-radiology found that it produced “reliable and timely diagnoses.” Another study that tested diagnosing pediatric acute appendicitis found that it was highly effective, stating, “The diagnostic performance of tele-mentored ultrasonography was as high as that of onsite expert ultrasonography.”

These, along with other studies, have verified the feasibility of using non-sonographers with medical backgrounds to obtain cine loops. Additional studies have shown users’ perceptions of telesonography are also positive. Telesonography was considered beneficial in several studies, with one study finding 93% of respondents were either satisfied or very satisfied with their telesonography interaction.

Problem 2: Image and Diagnostic Quality are Operator-Dependent

So, utilizing non-sonographers to capture cines is feasible—but does the telesonography model result in quality care? Present-day ultrasound requires a high level of expertise, and image acquisition and interpretation are major challenges. Gaps in image quality between a trained sonographer and a non-sonographer can easily occur due to a deficit in training, a misunderstanding of operational protocols, or confusion regarding the use of ultrasound equipment.

Solution: Telesonography Augments Care

TeleScan, like other telesonography solutions, is not interested in removing expert sonographers from the care equation. However, when sonographers cannot be physically present, telesonography has been shown to successfully augment care to provide reliable, high-quality diagnostics.

Consider Queensland, Australia, a state where 55% of the 3.3 million residents live in rural areas. The entire state is served by only two urban maternal-fetal echocardiography centers. After implementing telesonography and measuring its success, they found it demonstrated diagnostic accuracy and identified 100% of fetal abnormalities in the cases examined. This saved one-third of patients from a trip of up to 932 miles to the nearest specialist.

Or think of South Dakota, where 63.6% of counties are maternity care deserts. A telesonography program designed for neonates with suspected congenital heart disease accurately distinguished between those who needed immediate care and those with a less critical disease. Accurate diagnoses resulted in appropriate levels of care and saved patients with less critical cardiac disease from the unnecessary impacts of emergency transportation.

The successful augmentation of care reported in these studies is only possible because telesonography tools, even in the hands of non-sonographer healthcare workers, provide diagnostically reliable images. In a systematic review of articles, 12 articles describing telesonography image quality were assessed, and only four studies determined that image quality was less than 75% of the quality of the reference standard. Conversely, five studies found image quality was very good (between 75% and 87% of the reference standard), and three studies listed image quality as excellent (above 90% of the reference standard).

Additionally, in our own testing of TeleScan, we’ve found that as non-sonographers gain experience using a transducer, their image recognition and technical skills improve, and they quickly require little to no intervention from the reviewing sonographer. This finding is mirrored in a telesonography study by Johnson et al., who found only 13% of cases required real-time video conferencing for diagnosis.

Problem 3: Costs Incurred

Imaging systems are not cheap, and the costs incurred are still one of the largest barriers to care for rural communities. Even when considering some of the telemedicine options available, a dedicated system could cost up to $50,000-$100,000 per bed.

Solution: Telesonography Decreases Healthcare Costs Without Large Investments

Many modern telesonography platforms solve the cost issue by opting to utilize off-the-shelf components (like laptops and smartphones) or existing ultrasound machines. TeleScan, for instance, is compatible with laptops and 2D ultrasound machines and transfers cine clips to our secure, cloud-based software via an internet connection. And it’s delivered as a tiered monthly software subscription fee.

Additionally, quality telesonography can reduce healthcare costs by reducing liability and minimizing unnecessary surgical procedures and hospital stays. Ultrasound is also a more affordable imaging modality in general and requires very few consumables (gel, probe covers, etc.).

Problem 4: Security of Health Data and PII

When you talk about any form of telemedicine, you have to address the security and confidentiality of the data you’ll be transmitting. Patients, providers, and vendors all share the aim of keeping personally identifiable information (PII) and health data secure, and the solution has to be a group effort.

Solution: TeleScan is Built Right

Security has been a top consideration as we have developed TeleScan. What we bring to the table is a super-secure cloud platform that is both HIPAA-compliant and FDA-cleared. From there, we collaborate with local security and IT specialists to ensure that we meet each clinic and hospital’s individual requirements as well.

There you have it! Now that you know the what, how, and why of telesonography, do you agree that it could be the future of ultrasound?

We’ve been talking a lot about how telesonography works and why it will benefit patients and practices. But one exciting question we haven’t answered yet is: What benefits will telesonography provide for sonographers?

What Does a Telesonographer® Do?

Before we talk about benefits, let’s review how the telesonographer role works at BB Imaging. Put simply, a telesonographer provides remote diagnostic services to our provider partners via telemedicine. This role is intended to fill care gaps and identify high-risk pregnancies in underserved and rural areas. A telesonographer completes this vital work through a cloud-based software solution called TeleScan®.

Here’s how it works, in a nutshell:

1. The telesonographer logs into TeleScan and selects the exam order.

2. They begin by reviewing provided patient charts, reports, lab results, and medical history.

3. The exam begins, and they evaluate cine loops as they are captured and communicate requests for additional cines as needed.

4. The telesonographer then puts their diagnostic expertise to work, evaluating the cine loops to identify fetal anatomy, take measurements, and rule-out patient/fetus anomalies. They can also tag a few images from the cine loops to share with the patient.

5. To finish up, they prep a preliminary diagnostic report, including any notes or impressions, and send it to the provider for final review.

That’s it! The BB Imaging telesonographer role is currently a hybrid position with opportunities to work in-clinic routinely. Additionally, a telesonographer will need to maintain their credentials by earning CMEs. Now, let’s dive into those benefits!

How Does Telesonography Benefit Sonographers?

1. Career Longevity

Sonographers know better than anyone how quickly and easily pain from scanning can set in. The Society of Diagnostic Medical Sonography found 90% of sonographers are scanning in pain thanks to work-related musculoskeletal disorders. Additionally, the average sonographer will scan for only five years before sustaining an injury. These injuries often result in abbreviated careers, taking sonographers’ specialized knowledge and skillset out of the industry and creating a shortage of highly experienced leaders.

Telesonography provides a way to keep that sonography expertise in the field by reducing physically demanding time with a transducer. Telesonography provides rest for sore muscles and a chance to recover from injury while still seeing patients and meeting a need for underserved demographics. “This is a great way to be able to still do what you love, but not have the strain on your body,” said Alex Knott, RDMS (AB, OB/GYN), RDCS (FE), RVT.

We have received some skeptical feedback suggesting that the telesonographer role minimizes a sonographer’s unique skillset, but we disagree. Amber Blair, RDMS, RDCS, says it best:

“Nothing can compare to the quality of highly-skilled, traditional MFM sonographers, but that level of specialized care comes at a cost to many of our arms, shoulders, and wrists. Telesonography gives our upper bodies a breather so that we can continue to provide that irreplaceable hands-on MFM care without all of the pain.”

2. Work-Life Balance

Again, sonographers know better than anyone how long some commutes can be. Some of our own team members travel to outreach clinics scattered throughout the large state of Texas, and providing a break for them was one of our goals with telesonography.

Since a telesonographer works from home on some days, they’ll be saved from those long commutes, giving them more time to spend with family, friends, and pets—or on themselves! Like other work-from-home positions, we’re hoping this provides the opportunity for sonographers to take more time for healthy habits like homemade meals, working out, breathing in some fresh air during a walk, or taking time to stretch or meditate.

And while we can’t make any promises, we’re keeping an open mind toward other work styles too. Maybe in the future, we can join the gig economy or provide ways for sonographers to earn supplemental income via an “Uber model.”

3. Ideal Workspace

Historically, sonographers haven’t had much of a say in how their work environment is designed, but a telesonographer gets to create their ideal workspace. From space heaters to ergonomic chairs to height-adjustable desks, all the swoon-worthy remote work accessories can be theirs. Plus, they can ditch the scrub bottoms and sneakers and break out their best (or worst, we’ll never know!) sweatpants and slippers.

The other plus here is location independence—the ability to work from anywhere. Just ask Melissa Mercado, RDMS (OB/GYN, FE), who performs telesonography from sunny Puerto Rico:

“I’m able to spend more time at home since there’s no commute. And I love working from my back patio in the sun versus being in a dark room all day.”

4. Healthier Environment

We all know by now that a key benefit of working from home is limiting the spread of disease. And even when a pandemic isn’t the primary threat, a telesonographer can still avoid the colds and flus clinical settings often expose them to.

Conversely, a telesonography position presents the opportunity to continue earning income, even if the sonographer is feeling under the weather or recovering from injury. Although we’ll be honest, we have great benefits and prefer sonographers to take time off when they need it!

5. Expanded Reach 

A telesonographer has the unique benefit of reaching underserved areas with their specialized expertise. Sometimes these clinics are in dense urban areas, struggling to meet patient volume demands, and sometimes they’re in rural areas where prenatal care isn’t available or accessible. Either way, a telesonographer is empowered to provide care to patients who wouldn’t receive it otherwise.

“I have had the privilege to work with TeleScan and love it,” said Sonia Graham, RDMS (OBGYN, FE). “Sure, nothing takes the place of scanning a patient in person, but this new technology helps our expertly trained eyes help more people in rural areas. In some areas, ultrasounds done by untrained medical professionals are the only accessible prenatal care mothers have. Most of these medical professionals don’t have the time or skills to pick up subtle abnormalities like we do. TeleScan helps us use our experience and knowledge as MFM sonographers to help more patients.”

Patients aren’t the only ones benefiting from the reach of telesonography, though. Onsite sonographers love having TeleScan services in their clinics because it reduces their patient volume and gives their arms more of a break too!

6. Support Leading-Edge HealthTech

Telesonography is a new, innovative technology, and it’s just getting started. Our software engineers are working hard to continuously update and improve the software, and most of these improvements come directly from clinical feedback. For a telesonographer, that means having the opportunity to assist in the creation of a great product through ideas, creativity, and constructive criticism. This role isn’t just on the frontlines of healthcare. It’s on the frontlines of the future of ultrasound.

“One of the core responsibilities of a sonographer is being the ‘eyes’ for the reading physician,” said Kate O’Brien, RDMS (AB, OB), RDCS (FE). “In a similar way, working on the clinical side of a new healthcare technology allows me to be the ‘eyes’ for the developers. I’m able to give suggestions and feedback about what works and what improvements can be made that only a medical professional or sonographer could give. Being able to use my experience in ultrasound to contribute to a product that will directly improve access to care and likely reduce maternal mortality gives an even greater sense of purpose to my career. No two days are ever the same in ultrasound and working with TeleScan is no different.”

How Can a Sonographer Get Involved with Telesonography?

These are compelling benefits, and we’ve seen a lot of excitement from the sonography community about this role. For sonographers who are interested in this opportunity, here’s what we’re currently looking for:

• Graduate of a CAAHEP-accredited Diagnostic Medical Sonography program

• Registered Diagnostic Medical Sonographer (RDMS)

• Currently certified with ARDMS

• OB/GYN and Fetal Echo specialties

• Credentialed in Nuchal Translucency and Nasal Bone and Cervical Length Education and Review (CLEAR)

• 2+ years of MFM, high-risk OB sonography experience

We encourage those who are interested or want to learn more to fill out an application for the OB Telesonographer position. We’ll begin hiring this year; we’re building out a bench and beginning to interview for future roles. Our goal is to create a pipeline of sonographers who are ready to take on this new opportunity so that when a facility signs on the dotted line, we’re ready to service it.

Last year, we published an article entitled Telemedicine, Rural Pregnancy, and Decreasing the Maternal Mortality Rate. That article cites data from five years ago, which said that for every 100,000 U.S. births, 17 women die from pregnancy complications. Since then, data from 2020 has been published, which shows the ratio has increased by 40%, from 17 to 23.8, a rate three times higher than other high-income countries.

The national average is bad, but when we look closer, we see the maternal mortality risk is not equal across populations. In our previous article, we focused on the rural demographic. Here, we will compare the level of risk between races and ethnicities.

Key Issues

We are not going to deal directly with systemic racism, implicit bias, and social determinants of health (SDOH) in this article, but it is vital to understand these issues and their ties to the challenges that we will discuss. If you are not familiar with these topics, we encourage you to visit the following resources:

• Health Affairs: Structural Racism in Historical and Modern US Health Care Policy

• The Commonwealth Fund: Reducing Racial Disparities in Health Care by Confronting Racism

• March of Dimes: Health Disparities and Pregnancy

• The American College of Obstetricians and Gynecologists: Importance of Social Determinants of Health and Cultural Awareness in the Delivery of Reproductive Health Care

• Journal of the American Heart Association: Social Determinants of Suboptimal Cardiovascular Health Among Pregnant Women in the United States

1. Timely Care

2. Quality Care

Even when non-white patients do access timely care, the second problem we need to consider is the quality of care they receive.

We support and appreciate all our nation’s healthcare workers (including our own incredible team), but we must admit that not all hospitals are equal. Research shows women of color suffer more often from a lack of high-quality care. Hospitals with higher percentages of non-white patients tend to have higher mortality rates and lower rates of effective, evidence-based care. They also perform poorly on delivery-related indicators when compared to other facilities.

3. Risk Factors and Likelihood of Complication

Lastly, let’s consider risk factors and the likelihood of complications during pregnancy. A recent study indicates the leading causes of maternal death are obstetric embolism and eclampsia and preeclampsia. (For the clinical folks in our audience, the authors note amniotic fluid embolism, pulmonary embolism, and any other type of embolism occurring during pregnancy or the postpartum period were included in the obstetric embolism category.)

Women with pre-existing conditions like asthma, diabetes, and high blood pressure are at a much higher risk for pregnancy complications, and according to Blue Cross Blue Shield, and are more likely to identify as a minority. One study showed Native American, Native Alaskan, and Black people are 1.5-2 times more likely to have diabetes. The American Heart Association found Black women are twice as likely to have high blood pressure. Additionally, a Black or Hispanic woman who develops pregnancy-induced high blood pressure is six times more likely to die than a White woman.

Review of Telemedicine

Now, let’s turn to the technology we believe can reduce racial disparities and maternal mortalities: telemedicine. Defined simply, telemedicine uses telecommunication technologies to deliver medical, diagnostic, and treatment-related services. Examples include remote monitoring devices, virtual appointments, and remote diagnostics. With its many benefits, and the potential to increase access to care, telemedicine is poised to impact every area of healthcare, including maternal-fetal care.

So, how can telemedicine positively impact the key issues we’ve outlined?

Overcoming Key Issues with Telemedicine

1. Telemedicine and Providing Timely Care

One type of telemedicine, dubbed the hub-and-spokes model, uses technology to connect centrally located experts with remote and underserved areas. This model provides patients with both a local touchpoint and an expert provider. For example, one fetal telecardiology program connected underserved patients with a cardiologist who practiced 243 miles away. When surveyed about their experience, all patients preferred the telecardiology appointments due to saved time and costs.

In a 2012 analysis, which was completed years before telemedicine use skyrocketed, researchers asked low-income, urban-located Black and Hispanic people about their feelings toward telemedicine. Both groups indicated telemedicine provided increased access and reduced wait times compared to non-telemedicine options.

We also have evidence that telemedicine can result in increased efficiency, which increases a clinic’s ability to provide timely care. One clinical location implemented our telesonography® solution, TeleScan®, and was able to provide 20% more patients with an ultrasound appointment. That resulted in a 50% reduction in the time until the next available appointment.

2. Telemedicine and Increasing Quality of Care 

By connecting underserved patients with expert care, telemedicine can also improve the quality of care they receive. Increased access to maternal-fetal medicine specialists is associated with improved health outcomes among pregnant patients with chronic illness and complications. In a 2022 study of high-risk obstetric patients (of which 72% were Native American/Alaskan and 23% were Hispanic) 94.7% were satisfied with the quality of service being provided via telemedicine and 71.5% would consider receiving telemedicine care again.

Better outcomes from telemedicine persist outside of obstetrics as well. One systematic review assessed the effectiveness of telehealth and patient satisfaction and found improved outcomes made up 20% of success factors. And 75% of clinicians believe telehealth enables them to provide quality care.

3. Telemedicine and Caring for Risk Factors

Finally, what about the risk factors that minority patients are more likely to experience—conditions like diabetes and high blood pressure?

Diabetes, especially gestational diabetes, has been widely studied. Telemedicine patients reach optimum glycemic control sooner and with fewer insulin doses than those without telemedicine—and experience up to a 66% decrease in both planned and unplanned appointments. A study from the University of Arkansas for Medical Sciences found telemedicine also improved the utilization of prenatal care among pregnant women with pre-existing diabetes, more than one-third of whom were Hispanic. Patients experienced fewer inpatient admissions, lower insulin use rates, and lower costs.

Regarding high blood pressure, one study found both clinic-based care and telemedicine care were successful in lowering blood pressure. However, after six months, patients supported by telemedicine were more satisfied with their treatment than clinic-based patients, more likely to rate their care as high quality and convenient, and more likely to take their blood pressure at home.

It’s time for Telemedicine

The data is clear: maternal mortality is a huge problem for our nation, and it disproportionately impacts minority demographics. The good news is, we have the technology to take a big step forward in providing equitable care. The pandemic accelerated our adoption of telemedicine, and legislative efforts are under way to keep it accessible and affordable. That means the time for telemedicine is now.

Are you looking for all the sonography career advice you could ever want? You found it!

We’ve curated our best content and resources into one easy-to-use reference article. Just find the statement that best describes you, click the link, and discover helpful information specifically for your stage of the sonographer journey.

1. I’m Considering It

Sonography is an attractive career path for many reasons. It usually requires only two years at an accredited school, offers a comparatively high salary, and keeps you engaged through unique challenges and variety in your day-to-day work. As you consider this field, see if these resources come in handy.

• I need more information. We highly recommend you start with How to Become a Sonographer from the American Registry for Diagnostic Medical Sonography (ARDMS). It answers the why and how of becoming a sonographer and introduces the specialties you can pursue.

• I want to apply to a school. We have lots of tips for getting accepted to a diagnostic imaging program. These programs are highly competitive, and we don’t want you to miss the chance to gain an edge. If you haven’t chosen a program yet, we have some advice for that too!

2. I’m Just Getting Started

We’re so excited for you! Sonography is a highly rewarding career, and many of our team members find their purpose and fulfillment in this profession. We can’t wait to watch you learn, grow, and excel in this incredible field.

• I’m a new grad—or about to be. Congratulations! You’ve taken a huge step by getting through classes and clinical hours, and the best is yet to come. We’ve gathered the best advice for graduating sonographers from our clinical team to help you start strong.

• My next step is board exams. Passing boards can feel like a monumental task, but we’re here to help you break it down into manageable steps. From studying to practicing to testing with confidence, we’ve got all the tips and tricks you need.

• I’m looking for a job. You’ve got the skills, you’ve got the knowledge, and now it’s time to get paid. We can help you prepare for an interview and ace a speed interview. Plus… we are almost always hiring sonographers. If you haven’t checked our job board yet, please do! We’d love to see your application.

3. I’m Working My Way Up

A sonography career presents so many exciting opportunities that it can be difficult to decide which ones are most worth pursuing. We encourage you to embrace different seasons as you experience them and remember you always have the power to stop what isn’t serving you, start something new, or pause to rest and reevaluate.

• I just want to maintain my current skillset. This is a great place to be. What you already know is highly valuable and deserves to be maintained at the highest level. If you need any help with that, check out these CME and learning resources.

• I don’t know what to pursue next. If you’re starting to feel like it’s time for something new, try using these six steps to help you set a professional goal.

• I’m overwhelmed and burned out. Unfortunately, this does happen. While working hard and pursuing goals is important, finding ways to rest is vital for a long, successful career. If that feels easier said than done, we recommend reading How to Take a Break Without Taking PTO. Take your favorite idea or two and staring building some rest into your week.

4. I’m a Seasoned Professional

It’s such an honor to sit at the pinnacle of your profession—but don’t let it get lonely at the top! Knowledge is meant to be shared, and there are so many who can benefit from your hard-earned wisdom.

• I want to set an example. Young professionals look up to you, and not just for scanning guidance. Help them become well-rounded leaders by demonstrating how to balance confidence and humility in the workplace.

• I want to provide advice. You might be surprised by how many people want career advice, but don’t know how to ask for it. Start with this article to see our tips for participating in mutually fulfilling sonography mentorships.

• I want something more. If you’re looking for a way to take your advanced skillset in a different direction, have you considered remote work? Telesonography is touted as a great solution for providers and patients, but it also benefits sonographers.

5. Bonus Goodies for Everyone

No matter what stage of the sonographer journey you find yourself in, you’ll benefit from brushing up on these timeless topics.

• You can create a long and healthy career by embracing healthy ergonomics.

• You can practice effective communication whether you’re in-clinic, across the digital divide, or wading through a tough conversation.

• You can be confident in your value. If you ever doubt it, here’s a love letter to sonographers that will convince you otherwise!

We hope you find this article useful as you progress in your sonography career, and we’d love to hear from you. What advice can you add? Drop it in the comments below!

1. Communicate Your Goals and Expectations

The first step to self-advocacy is articulating your goals. Answer the question, “What do I want?” Here are some examples of how you might answer:

• I want a title change or a pay raise.

• I want to obtain a new registry or certification.

• I want to become a mentor or teacher to young professionals.

• I want to grow my reputation as a thought leader.

If you can’t answer this question right away, that’s okay. It’s best to take your time as you set your professional goals and gain career clarity.

Once you’ve determined what you want, it’s time to communicate this goal to your manager. Don’t think of this as an adversarial conversation but as the formation of a partnership. You want to partner with your manager to become a better asset to the organization. Your manager wants to partner with you so that you continue to grow and add value to the organization. Schedule a dedicated time to have this conversation and be sure to write your goals down—perhaps in a dedicated human resources program. This will prevent confusion while keeping you and your manager accountable.

As you discuss your goals, request the specific support you need to achieve them. This might include:

• Monetary support like educational or industry conference stipends

• Dedicated time for learning and development

• Inclusion in upcoming projects

Your manager may also be able to help identify the steps and milestones you’ll need to reach. As you form this plan, make sure to write it all down in the same place where you record your goal.

Result: Defining and communicating your goals creates accountability, helps you form a plan, and enables your supervisor to act as an advocate for your growth.

2. Express Your Accomplishments

Talking about your accomplishments can be a tricky task. Again, most people save this topic for yearly reviews, but some will depend on team members and supervisors to identify and acknowledge their achievements. Both of these options are a gamble. Thankfully, there is a better way to get noticed without being seen as arrogant.

Share your contributions regularly. Yes, really! Keeping your manager updated on your growth and impact is the best way to demonstrate your progress and accomplishment. Here are some tips for success:

• Select a dedicated time and place for this discussion, then repeat on a consistent cadence.

• If you have a 1-1 with your manager, designate a time for identifying recent wins.

• Suggest adding an agenda item to your team meeting for sharing celebrations and kudos—this gets everyone involved!

• If you have to share in a less structured way, frame your communication in a humbler light. You can discuss your accomplishments in terms of what you’ve learned, how you’ve grown, or why it was so meaningful to you.

And don’t forget to write it down! When you keep track of your contributions and the value you’ve added, you have indisputable evidence of your progress. If you haven’t done this before, check out this information on hype docs and get ideas for filling yours out.

Result: When you share regularly, your supervisor has a better idea of your contributions and can make better decisions regarding your progress and readiness for the next step.

3. Seek Feedback and Act on It

Self-advocacy is not all about tooting your own horn—it takes a lot of humility too. You’ll need to actively seek feedback about your performance from supervisors, peers, and/or clients. Asking for criticism is never easy, but it helps you identify areas where you can improve. Demonstrate your willingness to listen by staying open to others and asking questions.

Asking isn’t enough, though. When you receive feedback, you have to act on it. Be willing and ready to take on a new task, change a process, take on a new project, or make adjustments to the way you work. Change isn’t easy either, but when you’re open to it, you can change yourself, your team, and your organization for the better.

Result: By seeking out and incorporating feedback, your peers and supervisor will be active participants in your growth and have a front-row seat to your achievements. Plus, listening to others makes them more apt to listen to you when you advocate for what you want.

4. Take on New Challenges

Plenty of new challenges might emerge from seeking feedback. If they don’t, you can still proactively seek out opportunities for growth and volunteer for those that align with your goals. This is important—don’t wait for opportunities to come to you or depend on your manager to identify them for you.

Don’t be afraid to be audacious. Reach beyond your comfort zone (that’s why they’re called stretch projects!), and remember to communicate your desire to learn, grow, and contribute through these experiences.

Then be heard. Don’t engage in these opportunities only to stay quiet and take a back seat. Ask questions, make suggestions, and be willing to provide a different point of view from those around you. Even without seniority or depth of experience, you can be a catalyst for success.

Result: By taking on new challenges, you will increase your depth of experience in the type of work you want to do and demonstrate your drive and ability.

5. Build a Network

Career growth doesn’t happen in a silo. It takes cultivating relationships with colleagues and mentors—people who can offer guidance, provide support, and help you find new opportunities for advancement. You can find these people within your organization, through professional institutions (ARDMS, SDMS, AIUM), by attending industry events (UltraCon, SDMS Annual Conference), and by engaging in conversations (in person, forums, social media groups).

As you build relationships, remember they’re a two-way street. When you connect with peers and mentors, be ready to help them when you can. Don’t step on or over people on your way up—you’ll go farther by becoming a dependable resource for others.

Result: Building a network grows your reputation, expands your visibility, and amplifies your voice.

6. Negotiate

This is the last step for a reason. We all know some people skip straight to this one, sometimes out of enthusiasm, sometimes out of a sense of entitlement. Don’t be that person.

After you’ve done the hard work in the other five steps, it’s appropriate to demonstrate your progress and negotiate terms for the goal you set. If you were specific about your goals previously, this conversation should hold no surprises for your manager. Rather, it will be time to celebrate a hard-won achievement.

Result: By following these steps, you have successfully advocated for yourself and have all the evidence needed to reach your goal.

But… what if I don’t get what I worked so hard for?

It’s terrible to feel like you’ve reached your goal, only to be told “no.” Don’t despair, though—all your hard work is not in vain. There could be at least two things happening:

1. While you’ve made significant progress, you may not have fulfilled all the requirements to meet your goal. Maybe there was a miscommunication (this is why writing things down is so important), but with a little more effort, you can still reach your goal.

2. Unfortunately, growth isn’t always rewarded the way it should be. If this is your experience, it may be time to make a difficult decision about your employment. The good news is all the experience you’ve amassed will help you negotiate for your next position. This article provides some advice on whether it’s time to quit.

 Do you have any advice to add? How have you successfully advocated for yourself at work?

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