Dr. Don Buford, a board-certified orthopaedic surgeon specializing in sports medicine and regenerative medicine, was an early adopter of Clarius wireless ultrasound in 2017 and now uses the Clarius C3 HD3 and Clarius L7 HD3 at his practice in Texas. He runs one of the longest-running private MSK ultrasound and Regenerative Medicine courses, offering ultrasound scanning training for everyday clinical practices over two days.
We recently caught up with Dr. Buford over Zoom to talk about how Clarius technology has advanced dramatically from the first to third generations and his passion for advancing the use of ultrasound guidance among his colleagues.
What impresses you about the third-generation Clarius?
The biggest difference I’ve seen is the change in form factor. Your team has nailed it in terms of weight and size. The software has continued to improve and really puts to shame what’s available on some of the other laptop machines. And the image quality is fantastic. The linear scanner is on par with compact systems, no question.
Clarius is lowering the barrier to using ultrasound. I’m amazed by how intuitive it is to use. You don’t have to memorize buttons. Most doctors don’t need to do much more than zoom in and out, turn the gain up and down, and measure the length of anatomy every once in a while.
The Clarius Cloud is a nice way to organize things. Clarius can go to PACS too like other ultrasound systems. But with Clarius Cloud, I put in a couple of keywords or I can annotate exams, which allows me to pull up a group of videos that are all on the same topic, for example. I can also use the Cloud at home. It’s pretty flexible and seamless once you set it up.
Working without wires is slick. It’s easy to keep the transducer clean and you don’t have to worry about infections from cords draping across the patient.”
When do you use Clarius in your practice?
I use Clarius any time I go to the OR. I’m doing a lot of regenerative medicine and I use it for all of my bone marrow aspirations. I generally take the curvilinear scanner to the OR for hip procedures.
I also have Clarius in one of my three exam rooms to guide injections. I have older cart-based systems in the other rooms. One of the unique benefits of using Clarius is that it automatically transfers images and videos to the Clarius Cloud. Once the images are saved, it’s really easy for me to retrieve images for teaching or reviewing. I just go to the Cloud and can quickly find examples of an ultrasound-guided PRP injection for tennis elbow or an ultrasound-guided bone marrow concentration injection for knee osteoarthritis for example.”
Are the benefits of ultrasound guidance still a hard sell for orthopaedic clinicians?
I would say that almost everyone gets it at this point. The problem has moved from “does ultrasound make sense?” to “how do I structure my practice to do it.” The cost factor has gone away because now you can get a high-quality system like Clarius for under 5000 USD. Plus, we do still get paid for using ultrasound for diagnosis or guiding procedures.
It now comes down to training and workflow. I think one clinical approach is that whoever is making the ultimate clinical decision is the one doing the diagnostic exam or the ultrasound-guided injection. That’s the way I’ve always run my practice. But some orthopaedic surgeons rely on PAs to do injections in their office, because they feel their time is better served seeing the next patient or doing something else. I know that works well in many clinics.
We’ve trained a lot of PAs over the years – our course is now probably 40% PA and 40% doctor. In some clinics, both the surgeons and the PAs are trained. With their knowledge of anatomy, surgeons pick up ultrasound quickly. PAs in surgical practices are also quick to learn. With the growing evidence for using regenerative medicine in orthopaedics, there is a growing need for clinicians skilled with ultrasound.”
Is ROI on the ultrasound equipment a factor?
Investing in Clarius is a no-brainer because the payoff for Clarius is fast. You’re paying under 5000 USD compared to laptop machines with comparable image quality that are in the 25,000 to 35,000 USD range.
I crunch the numbers every six months for our course. The average current reimbursement for MSK ultrasound, for diagnostic and ultrasound-guided procedures, is about 80 USD. So even if you do just use it once per clinic day, you’ll pay off the system in less than three months.
Some practices are concerned they’ll lose revenue during the training phase, but most people ramp up quickly and then using ultrasound becomes an additional source of revenue. Most start with ultrasound-guided procedures and then become more and more adept at using ultrasound for diagnosis too.”
Would you recommend Clarius to an orthopaedic surgeon who is not using ultrasound today?
Yes, for a physician who has a sports medicine, orthopaedic, or physiatry practice. It’s an advanced device at an entry-level price, and that’s rare. Traditionally there’s been a direct correlation between the money you spend and the image quality you get on laptop machines ranging from 28,000 to 60,000+ USD. Now, with Clarius, for about 5,000 USD all in, you’ll get a device with the image quality you need that will carry you all the way through your orthopaedic career until you want to do more advanced diagnostics and procedures.”
Could you tell us more about your MSK Ultrasound Training Program?
We hold our course twice a year. It’s a hands-on training program with a cap on attendance at 75 to maximize the learning experience. We have 35 ultrasound machines and 35 models so it generally works out to 2 people per machine, which provides an in-depth experience for participants. Nobody leaves our course not being able to do something they want to do or not being able to see something they want to see!
During the first day, we focus on regenerative medicine and we cover practice management. The second day is the upper extremity, including the shoulder, elbow, hand, and wrist. And then a little more on practice management, like the financial return we’ve talked about. And then we break for lunch. The entire afternoon from about 1 pm to 5 pm is all hands-on and includes live demos.
On the last day, we cover the lower extremity, including the spine, pelvis, and hips. In terms of the pelvis and spine, we’ll cover facet joints, caudal epidurals, SI joints, and piriformis. We also cover knee, foot, and ankle. And it’s a similar format to Friday, where we break for lunch, and then we do our hands-on and live demos. We have also had a great response to our shockwave stations where participants get to learn the science and clinical applications…and then actually use the machines on real patients.”
You’ll find details of Dr. Buford’s upcoming course at https://orthosono.com/.
6 Reasons to Choose Clarius Wireless Ultrasound Over a Compact System for Guiding Safe, Effective Procedures
Here are six key advantages to selecting a Clarius high-definition handheld for your practice:
- Improve patient safety with superior MSK imaging
- Save time and streamline workflows with AI
- Protect your sterile field with wireless ultrasound
- Save space and improve patient engagement
- Keep records on the Cloud or DICOM
- Save up to 85% over compacts
Visit our compare page to learn more about these advantages for your orthopaedic, pain management, or anesthesiology practice.
About Clarius Wireless Ultrasound for Orthopaedic Medicine
Diagnose injuries with confidence and ensure procedural safety, both in the office and on the field, with Clarius wireless ultrasound in hand for instant high-definition MSK imaging. Visit our Orthopaedic Specialty page to learn about the scanners available for your practice. Or book a virtual demo with a Clarius expert in your area.