{"id":103905,"date":"2023-08-08T13:29:48","date_gmt":"2023-08-08T20:29:48","guid":{"rendered":"https:\/\/clarius.com\/?post_type=podcast&#038;p=103905"},"modified":"2024-08-22T09:10:17","modified_gmt":"2024-08-22T16:10:17","slug":"ep7-dr-larry-istrail-on-forwarding-the-manifesto-for-revolutionized-patient-care-with-pocus","status":"publish","type":"podcast","link":"https:\/\/clarius.com\/ja\/podcast\/ep7-dr-larry-istrail-on-forwarding-the-manifesto-for-revolutionized-patient-care-with-pocus\/","title":{"rendered":"EP7: Dr. Larry Istrail on Forwarding the Manifesto for Revolutionized Patient Care with POCUS"},"content":{"rendered":"\n<h2 class=\"wp-block-heading\">Dr. Larry Istrail on Increasing Point-of-Care Ultrasound Awareness for Improved Patient Care<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Dr. Larry Istrail, one of the foremost advocates of ultrasound, is a hospitalist in Northern Virginia, and treats patients who are admitted to the hospital for various non-surgical reasons, like pneumonia and heart attacks. He brought point-of-care ultrasound into his practice about six years ago, when he witnessed a colleague &#8220;doing a full body head-to-toe exam and getting the answers to the questions I had, which traditionally would take two to three days.&#8221;&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">&#8220;That really started me on this journey to see how incredible POCUS is, how it really gives you the superpower of looking inside people&#8217;s bodies and seeing their organs function in real time.&#8221;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Since then, Dr. Istrail has been on a journey to improve his ultrasound skills, and raise awareness around the benefits of POCUS to others around him.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">On a recent episode of our Medical Imaging for All podcast, Larry shared what prompted him to write <a href=\"https:\/\/www.thepocusmanifesto.com\/\"><em>The POCUS Manifesto: Expanding the Limits of the Physical Exam with Point of Care Ultrasound<\/em><\/a>, how point-of-care ultrasound awareness and education can increase, and what the future holds for POCUS.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>The Origins of <\/strong><strong><em>The POCUS Manifesto<\/em><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">It started with COVID, and the shifts around social distancing within the hospital. In addition to keeping themselves distanced from their patients, Larry noticed that clinicians stopped using a stethoscope. &#8220;They just decided to stop using that,\u201d which he saw as \u201ca tacit admission that maybe it wasn&#8217;t helping very much to begin with. But people were still using a lot of ultrasound,\u201d which he saw could provide more information about the patient, especially for COVID.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This observation prompted Larry to write an article that appeared on <em>STAT<\/em> entitled &#8220;<a href=\"https:\/\/www.statnews.com\/2020\/07\/15\/point-of-care-ultrasound-replace-stethoscope\/\">Will Covid-19 be the straw that breaks the stethoscope\u2019s back?<\/a>&#8221; in July 2020, which argues that &#8220;we are entering the era of point-of-care ultrasound.&#8221; But the response to the article was less than positive, with comments saying he was a technologist with no idea about medicine tradition, that medicine was going into the dumps, or fear that they would be taken care of by someone using ultrasound. &#8220;Like, crazy stuff when I&#8217;m trying to just argue for a technology that has better accuracy than a stethoscope,\u201d he says.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">But that was the eye opener that there was a general lack of understanding of what point-of-care ultrasound even was, or the benefits it could offer. So he decided to write a &#8220;short call-to-action manifesto to explain briefly the history and how it, in my opinion, is a transition from the auditory stethoscope exam into the visual exam. Just like radio to TV.&#8221;<a href=\"https:\/\/www.thepocusmanifesto.com\/\"> <em>The POCUS Manifesto: Expanding the Limits of the Physical Exam with Point of Care Ultrasound<\/em><\/a> was published in October 2021.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Solutions for Greater POCUS Adoption<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">What needs to change for an increase in POCUS adoption? It starts with a general increase in awareness, as &#8221; older clinicians are more resistant in general. I haven&#8217;t had a lot of people who, in person, don&#8217;t understand or don&#8217;t appreciate it. It&#8217;s more they just haven&#8217;t experienced it.&#8221;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Then, after awareness comes education. Today, it&#8217;s a challenge for a busy clinician to learn it in their spare time, so &#8220;if it&#8217;s integrated into medical school, PA school, other school curriculum, then that is really what is needed.&#8221; This can happen more easily with today\u2019s lowered price point on more portable devices.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Finally, there may need to be a rebranding of what POCUS is, as well as a reevaluation of the nature of the physical exam. As Larry explains, if you go to the doctor with a rash, they look at your rash, and inspect the skin. If you have pain in your wrist, a clinician would palpate it. &#8220;But what if you have chest pain? Right now, they just listen to it and then send you to get some testing. But why don&#8217;t you just look at it?&#8221; he asks. &#8220;A better name for appealing to people who don&#8217;t know what [POCUS] is would be \u2018internal organ inspection,\u2019 because that&#8217;s all you&#8217;re doing.&#8221; He argues that today, you don\u2019t have to guess at the manifestations of an issue \u2014 you can simply look at it.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>The Future of POCUS<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">One technology that can help close the education gap is artificial intelligence. As Larry explains, &#8220;to have an AI system that&#8217;s an assistant there for you to, say, move the probe left, rotate right, tilt up, or even to say, okay, this is a good quality image, or this is not a good quality image&#8221; would be a great benefit to clinicians.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">There are also at-home and everyday possibilities for ultrasound as well. Larry cited a study where heart failure patients were given probes, taught how to use them, and were sent home to scan their own chest. \u201cThen the images would be reviewed by someone.&#8221; Other at-home options could be scanning for pneumonia or even using ultrasound to check a fetal heartbeat, saving time, effort, and cost going to the hospital.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Dr. Larry Istrail on Increasing Point-of-Care Ultrasound Awareness for Improved Patient Care Dr. Larry Istrail&#8230;<\/p>\n","protected":false},"featured_media":103914,"template":"","ultrasound_category":[],"season":[806],"class_list":["post-103905","podcast","type-podcast","status-publish","has-post-thumbnail","hentry","season-season-2"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.6 (Yoast SEO v28.6) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>EP7: Dr. Larry Istrail on Forwarding the Manifesto for 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