There are many excellent healthcare careers to choose from today, and two of them are Diagnostic Medical Sonographer (DMS) and Physician Assistant (PA). Though both work directly with patients, they are very different healthcare jobs. The sonographer, also called an ultrasound technologist (or commonly known as ultrasound technician), uses special ultrasound imaging equipment to direct sound waves into a patient’s body to produce images used by a physician to diagnose various medical conditions. The Physician Assistant offers primary and specialty care for common problems to patients under the supervision of a physician.
Deciding on a career is an important decision, and it is critical to have all the information needed to make the choice that best fits personal needs. The following sections compare both positions in terms of job duties and responsibilities, salary, education and licensing, and pros and cons.
Table of Content
- DMS vs. PA: Job Duties and Responsibilities
- Ultrasound Salary vs. PA Salary
- DMS vs. PA: Education, Credential and Licensing
- Pros and Cons: Which One is for You?
DMS vs. PA: Job Duties and Responsibilities
A few of the duties of the Diagnostic Medical Sonographer and Physician Assistant are similar because both are healthcare careers, and both provide hands-on patient care. Following is a brief summary of each position’s main duties.
What do Sonographers Do?
Here is a list of job duties of Diagnostic Medical Sonographers:
- Take patient’s medical history
- Prepare and maintain ultrasound equipment
- Assist patient with getting on and off table
- Position patient’s body as necessary to obtain good images
- Take ultrasound images using specialized equipment
- Analyze ultrasound images to determine if quality is acceptable and decide if new images are needed
- Review images to determine if they will provide physician with adequate information to determine if abnormalities are present
- Summarize findings and prepare report for physician review
- Maintain patient medical records
- Abdominal sonographers may assist physician with biopsies
- Musculoskeletal sonographers may assist physician with ultrasound guidance when patients need injections delivering medications to tissues
- Cardiovascular sonographers may assist physician with cardiac catheterization and monitoring patients during surgery
- Assist ultrasound department as necessary
Where do Sonographers Work?
Ultrasound technicians work in a variety of healthcare settings, including general medical and surgical hospitals, physician offices, outpatient facilities, medical and diagnostic laboratories, and specialty hospitals or clinics. There are now sonographers who also work in mobile units to deliver services to patients where there is limited access to medical services. In addition, some sonographers work for medical equipment companies. They are directly employed or work for staffing/employment agencies providing ultrasound technicians for temporary employment.
What do Physician Assistants Do?
The following list contains the job duties associated with Physician Assistants:
- Review patient medical histories
- Examine patients
- Diagnose a patient’s illness or other medical issue
- Order and interpret diagnostic and lab tests as necessary
- Develop treatment plans
- Carry out therapy
- Treat patients with minor injuries with casting, splinting, and suturing
- Prescribe medicines
- Maintain medical history
- Counsel patients and families on preventive health care
- Assist physicians in surgery
Where do Physician Assistants Work?
Physician Assistants work at general and specialty hospitals, physician offices, outpatient centers, colleges and universities, and home health care services. Like sonographers, PAs are employees or they work for employment services. Physician Assistants must work under the supervision of a physician.
Ultrasound Salary vs. PA Salary
Both Diagnostic Medical Sonographers and Physician Assistants earn excellent wages. According to the U.S. Bureau of Labor Statistics, Sonographers earned an average annual wage of $70,880 or $34.08 per hour as of the last wage survey conducted in May 2015. Wages vary significantly by state. The top paying state was California which had an average annual wage of $95,880, while the lowest paying state was Alabama with an average annual wage of $54,470.
Physician Assistants are paid more than sonographers, reflecting longer education requirements and higher level job duties. The same survey conducted by the BLS found that PAs were paid an average annual wage of $99,270 or $47.73 per hour. Once again, location does influence the pay rate. Nevada was the highest paying state at $124,180 average annual wage, and Mississippi had the lowest annual wage at $51,040.
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DMS vs. PA: Education, Credential and Licensing
Physician Assistants require more education than Diagnostic Medical Sonographers. A Physician Assistant must be licensed by the state in which he or she wants to work. Following is a summary of education, credentialing, and licensing requirements for each healthcare profession.
Sonography Education and Certification
One of the attractive features of choosing a Diagnostic Medical Sonographer career is that it only takes 12-18 months of study to earn an ultrasound tech certificate or diploma and only two-years to earn an ultrasound associate degree. Another option is to earn a 4-year ultrasound baccalaureate degree which is usually chosen when the student intends on pursuing a sonography career as a supervisor or department head, or wishes to pursue a career in a medical research facility or a business, such as one selling medical equipment.
A sonography program that is certified by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) is similar from school to school because certain minimum educational requirements must be met. Typical prerequisites include classes like algebra, composition, and introduction to psychology. Once these requirements are met, a student will complete a sonography program consisting of classroom, lab and clinical training:
- Anatomy and Physiology
- Introduction to Sonography
- Sectional Anatomy and Normal Sonographic Appearance
- Sonographic Physics and Instrumentation
- Abdominal Sonography
- Obstetrics and Gynecology Sonography
- Introduction to Vascular Sonography
- Introduction to Echocardiography
- Specialized Sonographic Procedures
- Clinical Training
Not all programs offer general sonography training. Some programs offer specialized sonography training, including pediatric sonography, cardiac sonography, and vascular sonography. In that case, the curriculum includes appropriate classes. For example, a Pediatric Echocardiography concentration would include classes like Intro to Pediatric Echocardiography Techniques, Neonatal/Pediatric Patient Care Skills, and Echocardiography Evaluation of Congenital Heart Disease.
Credentialing and State Licensing for the DMS
After completing the ultrasound technician program, it is imperative to earn certification by taking the exams offered by the American Registry for Diagnostic Medical Sonography (ARDMS). After passing the exams, the applicants name is entered into the ARDMS registry which serves as the equivalent of a license in most states and in the eyes of employers. The credentials include:
- RDMS – Registered Diagnostic Medical Sonographer
- RVT – Registered Vascular Technologist
- RMSKS – Registered Musculoskeletal Sonographer
- RDCS – Registered Diagnostic Cardiac Sonographer
Updates for ARDMS 2017
It is anticipated that a new credential will become available in spring 2017 – the Midwife Sonography Certificate. Exams consist of testing on Sonography Principles and Instrumentation (SPI) plus one or more specialty exams. It is important to consider the preferred sonography field before choosing a program. All the CAAHEP programs prepare students to earn the RDMS credential and pass the SPI physics examination, but there is a choice of specialty examinations which include abdomen, breast, fetal echocardiography, obstetrics and gynecology, pediatric sonography, vascular technology, adult echocardiography, pediatric echocardiography, and musculoskeletal sonography.
Ultrasound Continuing Education
Maintaining ARDMS certification requires completing a certain number of continuing education credits every three years. Currently, it is 30 CMEs for the RDMS and/or RDCS and/or RVT credentials. It is 10 CMEs in musculoskeletal ultrasound and 20 CMEs for the RMKS plus RDMS and/or RDCS and/or RVT credentials. At this time, there are two states requiring licensing of sonographers:
Physician Assistant Programs and Certification
Physician Assistant programs are accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) or the Physician Assistant Education Association (PAEA). Students can apply to multiple educational programs through the Central Application Service for Physician Assistants (CASPA) by submitting a single application.
PA Education Overview
Most PA programs take two to three years to complete. Here are two accredited PA school directories: http://directory.paeaonline.org and http://www.arc-pa.org/accreditation/accredited-programs. Like the Diagnostic Medical Sonography programs, students must complete classroom instruction, lab training and clinical training. However, most Physician Assistant programs lead to a master’s degree. As a minimum for program entrance, the programs require students to have a bachelor’s degree, with a heavy emphasis in science courses, and prior hands-on patient care healthcare experience. The definition of “hands-on experience” differs from program to program, but falls under one of three categories:
- Patient care as a paid employee
- Patient care as a volunteer
- Experience shadowing a physician or PA
Prerequisites for Physician Assistant Programs
PA educational prerequisites include courses like physiology, chemistry, anatomy, biology, physiology, microbiology, psychology, and statistics. Typical programs include classes in:
- Gross Anatomy
- Mechanisms of Disease
- Medical Interview and Counseling skills
- Microbiology and Immunology
- Physical Diagnosis
- Pharmacology and Therapeutics
- Behavioral Health
- Emergency Medicine
- Clinical Decision Making
- Clinical Rotations (among major medical specialty departments)
Prior Healthcare Experience
Prior healthcare experience that is recognized by the PA schools includes a variety of careers. They include Medical Assistant, Lab Assistant, Surgical Technician, Emergency Medical Technician, Paramedic, Registered Nurse, and Certified Nursing Assistant. A common question concerns whether a Physician Assistant program will consider the work as a sonographer as qualifying for health care experience. It depends on the PA program, so it is important to ask before selecting a program. However, sonographers do touch patients, take vital signs, and make diagnostic decisions concerning images. Some assist physicians in surgery. There is a likelihood that sonography experience will qualify in many cases.
PA Certification and Licensing
Accredited Physician Assistant programs prepare students to take the Physician Assistant National Certifying Exam (PANCE) after graduation. The exam is administered by the National Commission on Certification of Physician Assistants (NCCPA). To maintain Physician Assistant certification, PAs (now on the 10-year cycle that began in 2014) must earn 100 CME credits during each of five two-year cycles. During the ninth or tenth year, it is necessary to take and pass a PA recertification exam called the Physician Assistant National Recertifying Exam (PANRE).
Upon earning certification, one final step is required before practicing as a Physician Assistant. The PA-C must obtain a state license in order to be employed.
Pros and Cons: Which One is for You?
Pros as a Diagnostic Medical Sonographer:
- Enjoy direct patient care
- Varied work since each patient has unique needs and medical conditions
- Employment projected to grow 26 percent from 2014-2024
- Can enter the job field in one to two years, depending on the certificate or degree program completed
- Expanding job opportunities as technology advances
- Able to add specialties to certification with additional training and passing appropriate exams
- Only ARDMS certification is required, except in four states that also require a license
- ARDMS certification is recognized by employers in all 50 states
- Excellent pay, including at the entry level
Cons as a Diagnostic Medical Sonographer:
- May require shift work and regularly being on call
- Requires physical strength and stamina to move and position patients and move medical equipment
- Repetitive motion injuries are common
- Requires standing most of the work time
- Work can be stressful when there are many patients or patients are difficult
- Not many opportunities for advancement with a certificate or associate degree unless more education is completed, such as a bachelor’s degree or additional specialization training
Pros as a Physician Assistant:
- Varied patient work that is very rewarding
- Always have physician available for consultation which means lower stress compared to a physician
- Telemedicine expected to expand job opportunities
- Increasing job opportunities in institutional settings. Such as hospitals and public clinics
- Perform higher level duties than sonographer, such as prescribing medication
- Trained in all specialties so have a wide variety of skills
- Employment projected to grow 30 percent from 2014-2024
- May obtain a Certificate of Added Qualification (CAQ) with additional focused experience, completion of relevant CMEs, and passing exam in the specialty area
- Does not take as long as it does to become a physician
Cons as a Physician Assistant:
- There are limitations of practice as determined by law so the Physician Assistant has less authority than a physician
- Must work under the supervision of a physician so cannot operate an independent practice
- Work may be stressful
- PA must be nationally certified and have a state license
- Programs only offered at universities, colleges, and medical schools
- Takes two years’ post-graduate education (master’s degree) to obtain Physician Assistant degree
- All states require a license
- May work a variety of shifts and regularly be on call
Anyone who wants to start a healthcare career quickly will find Diagnostic Medical Sonography is a good choice because it requires less training. It also lays the groundwork for completing additional education in the future because the prerequisites and many of the associate degree courses are required for advanced degrees or other healthcare programs, such as nursing. The Physician Assistant program is a post graduate program so students may spend up to 6-7 years in college before working. However, both careers are fulfilling, interesting and in demand.