JEFFERSON CITY — Everyone is exposed to radiation in some way, shape or form. Even cellphones give off a form of low-intensity radiation energy. But when it comes to higher levels, exposure can be dangerous.

Missouri is one of five states that has no license requirement for radiologic technologists. This means that anyone in the state could legally administer radiologic treatment, such as an X-ray or CT scan, without formal training.

In a recent joint task force hearing, Missouri lawmakers listened to medical professionals discuss their thoughts about the lack of radiologic technologist licensure. Those who support licensure say it’s necessary to ensure patient safety. Others say it’s a skill that can be learned with practice and that too many requirements would make it hard to recruit technicians.

Jason Young, president of the Missouri Society of Radiologic Technologists, hopes to find common ground for a baseline requirement.

“Part of what we’re trying to do is establish a minimum guideline for providing radiation therapy or diagnosis,” Young said.

This isn’t the first time Missouri has considered implementing this kind of licensure. In 2016, HB 1604 was brought to lawmakers, but it ended up going nowhere.

Now Missouri lawmakers have formed the joint task force to address the issue. Rep. Kathyrn Swan, R-Cape Girardeau, is chairperson and stressed the importance of having medical viewpoints in this discussion.

“We’re starting from scratch here ... , and the reason is we want your input because we would like a solution,” Swan said.

Why radiation poses risks

Radiation is commonly used in the medical profession and is considered much less of a risk than the serious illnesses it can detect. But if the people operating the machines don’t have the proper knowledge or experience, then more risks filter in.

Nuclear medicine technologist Richard Siska voiced his concerns about the danger of radiation and the fact that not all of its impacts are immediately identifiable.

“Radiation has both a deterministic effect, which is an effect that can be readily seen if it’s not administered correctly, and a stochastic effect, which is effectively seen years down the road, which we don’t know what that effect could be,” Siska said.

“There is no zero threshold for risk with radiation because radiation is invisible,” Siska said. “You can’t touch it. You can’t see it.”

The lack of education is most concerning to Siska. He remembers his own experiences of walking into operating rooms and witnessing radiation doses that were being given to patients at too high levels.

“And no one in the (operating room) is aware of it because they think they’re doing it correctly,” Siska said.

Potential problems with legislation

Requiring licensure for radiologic technologists, known as “rad techs,” could be difficult.

Lindsey Kroenke is an administrator of an outpatient surgery center in St. Joseph and is worried about how radiologic technologist legislation would play out.

“We also have to look at what is this impact at a greater scale from a financial standpoint for patients as well,” Kroenke said.

Like other states have done, the possibility of requiring an additional exam along with 100 hours of experience was brought up at the hearing. But the time and costs to train rad techs would be greater in small rural clinics that don’t have the staff or resources.

“In a lot of states, they have the same issues,” Young said. “The rural areas are what they’re worried about. They don’t want to ruin access or cause barriers.”

Requiring further education for radiologic technology could also prevent medical students from being involved altogether.

“To ask them to get that additional degree, a lot of them are going to say, ‘If you want me to go and do this, then I’m going to find a different job, because I’m not going to school more,’” Kroenke said.

Finding a balance

Both medical professionals and lawmakers agreed that patient safety is of the utmost importance. While there may be difficulty in producing a balanced solution, Young is pleased that they are able to have these discussions.

“It’s something we’ve really been advocating for a long time,” Young said. “We’re just finally getting the traction we need to move it up.”

Other topics that were discussed included penalties, exemptions and continuing education for those already in the radiologic technology field.

The next hearing for the joint task force on radiologic technologist licensure is scheduled for Dec. 20. The lawmakers and professionals plan to compare other state licensure requirements while deciding what legislation they would like to pursue in Missouri.

Supervising editor is Mark Horvit.

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