Radiologist Assistants (RAs) and RPAs: Questions and Answers

I’ve had some questions from radiography students, about RA ( radiologist’s assistant’s).

ARCBelow are some questions and answers from the American College of Radiology I’ve collected, and a link to a white paper about radiology assistant’s. Comments welcomed.

Question: What is a radiologist assistant?

Answer: As envisioned by a working group of the ACR and ASRT, a Radiologist Assistant (RA) is an advanced-level radiologic technologist who works under the supervision of a radiologist to enhance patient care by assisting the radiologist in the diagnostic imaging environment. The radiologist assistant would be an ARRT-certified radiographer who has successfully completed an advanced academic program encompassing a nationally recognized radiologist assistant curriculum and a radiologist-directed clinical preceptorship. Under radiologist supervision, the radiologist assistant would perform patient assessment, patient management and selected exams. The radiologist assistant will not perform interpretations (preliminary, final or otherwise) of any radiological examinations, nor will he or she transmit observations other than to the supervising physician.

The term was developed during a series of meetings between the American Society of Radiologic Technologists (ASRT) and the ACR during the spring and summer of 2002. The two groups have been meeting to consider the development of an advanced-level radiologic technologist to address workforce shortages among radiologic technologists and radiologists.

Question: What is an RPA?

Answer: The term RPA refers to a Radiology Practitioner Assistant. The term was coined through a program developed at Weber State University. According to a recent study, among some of the common procedures performed by RPAs are GI barium studies, fistulograms, genitourinary studies, arthrograms, thorocentesis, paracentesis, ultrasound and CT-guided biopsies and drainages, peripherally inserted central venous catheter line placement, angiography, and venography, Dobhoff tube placement, lumbar punctures and myelograms. Among the preliminary image evaluation reports being generated to the supervising radiologist are reports of the chest, abdomen, pelvis, othopedics, spine and skull, as well as barium and interventional studies, CT, MRI, ultrasound, nuclear medicine, vascular/cardiac procedures, and mammograms.1

Question: Does the ACR recognize RAs or RPAs?

Answer: At present, the ACR only recognizes Radiologist Assistants under the terms and conditions contained in the 2003 ACR/ASRT Joint Statement on the Roles and Responsibilities of the Radiologist Assistant.

Question: Why did the ACR considering recognize RAs?

Answer: The profession of radiology is experiencing workforce shortages among diagnostic radiologists and radiologic technologists. Indeed, many groups have begun hiring nurse practitioners and physician assistants to fill efficiency gaps in their practices. Many academic institutions are in the process of considering programs to initiate advanced-practice status for radiologic technologists. In addition, several state legislatures are currently considering laws that would provide extended scope of practice for radiologist extenders. The ACR and ASRT sought to establish a balanced approach that recognizes the human resource shortages, the current environment for hiring physician extenders, the status of academic programs and the uncertainty that exists from the evolving state legislative and regulatory environment. In addition, the ACR and ASRT were looking to provide a professionally satisfying career pathway for radiologic technologists. The RA is an outgrowth of those discussions.

Question: Does acceptance of the RA pose a future risk to the practice of radiology?

Answer: The profession of radiology is ever-evolving. The ACR is concerned about the potential effect of this position on the future of our members. However, the only thing that seems certain at this point is change. By considering this issue, the ACR chose to promote the development of the RA. We are aware of the acrimonious scope-of-practice battles that have occurred between other physician and ancillary provider groups. By developing the RA roles and responsibilities document, the ASRT and the ACR sought to improve patient care while addressing some of the human resource shortfalls that were occurring in the radiologic technologist field at the time.

Question: Should states enact legislation or regulations instituting an RA or RPA designation?

Answer: The ACR supports state legislation or regulation that embraces the development of the RA consistent with the roles and responsibilities developed by the ACR Council. The ACR will work with its chapters and the ASRT to ensure that state scope of practice does not exceed that envisioned by the two groups. The ACR does not recognize either the scope of practice or designation of an RPA. For more information on RA state legislative and regulatory issues, please contact Ariel Gonzalez at 800-227-5463 ext. 4488 or at or visit the ACR State Legislative Web site at.

1Burton, Samuel Scott, “Radiology Practitioner Assistant: Utilizing this New Role in Imaging Could Help Win Turf War,” ADVANCE for Imaging and Radiation Therapy Professionals, November 4, 2002, pages 20-21.

And the link to ARC’s white paper:

White Paper on the Radiologist Assistant

I hope this helps anyone looking for this information.



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