My state doesn’t have licensure for imaging. Does that mean just anyone can perform these procedures?
ASRT often gets this question, and the simple answer is: it’s complicated.
The ASRT Government Relations and Public Policy Department categorizes the laws and policies that govern medical imaging and radiation therapy at the state level into three main buckets: licensure, standards and equipment regulations. While every state may use different verbiage, for the sake of consistency and ease of understanding, we use the following generalizations.
On the newly designed States That Regulate page, ASRT defines the categories as:
Licensure is any form of permission granted by a state to practice; states vary in terminology: license, certificate, permit.
Standards mean that a regulatory board has required some education and training to be allowed to practice (usually national credentials).
Equipment Regulations mean that there are operator requirements included in the regulation of the operation of specific equipment.
The main differences here are that a licensure program typically requires a board or oversight committee made up of medical imaging and radiation therapy professionals who have the authority to set scope of practice and ensure compliance. A standard will not create an oversight board, and you are not issued any kind of permit, rather you must submit proof that you are educated and trained, and you are allowed to practice. Both licensure and standards generally require a legislative effort to be established. On the other hand, an equipment regulation is often put forward through radiation control — the state department that handles the operation of equipment that emits or utilizes radiation.
Although licensure is the ideal policy solution for laws governing the practice of medical imaging and radiation therapy, every policy solution ASRT advocates for ensures every individual meets nationally recognized standards for education and training, whether that’s ASRT or our partner organizations.
If licensure is best, why isn’t that the only policy solution we work toward?
As much as we would love all state governments to do exactly what we want, the reality is each state has the authority to regulate health professions as it sees fit, and political philosophies around licensure vary as greatly as the states themselves. Although licensure, and the accompanying government oversight, is an easy sell in some places, in others, any licensure (and the accompanying oversight) is considered a hindrance to access to jobs. In those states, standards or equipment regulations are more likely to be successful.
One of the best examples of a successful standard is in Colorado. This state requires medical imaging and radiation therapy professionals to submit their national credentials (e.g., ARRT, NMTCB) to the Colorado Department of Public Health and Environment Radiation Management to register with the state. From there, a technologist is only required to maintain their national credential to remain in good standing.
Equipment regulations are the third and final option for a policy solution. Because they do not require legislative effort, equipment regulations are often the easiest solution for state governments and advocates to implement. Advocates do not have to wrangle a bill through the representative government, and state governments are only expanding on the authority they already have, not expanding the size of the government. Unfortunately, because equipment regulations are the easiest to accomplish, they are also the easiest to rescind.
Bottom line: any policy solution that guarantees only those who are appropriately educated and trained are performing medical imaging and radiation therapy procedures is a good policy solution. Each solution discussed has pros and cons, and there is not a one-size-fits-all approach for state governments.