Few technologies have taken off within family medicine (FM) faster than point-of-care ultrasound (POCUS). The number of FM residency programs offering POCUS training has increased by 500% between 2019 and 2021,¹ with 95% of family physicians now stating that POCUS is important for the field.²  

The problem is many practices struggle to find the staff time or financial resources to offer physicians POCUS training; studies find these two factors hold back wider adoption of the technology.³  

This article explores how these barriers can be overcome, enabling family practices to increase the number of physicians with ultrasound skills—and offer more patients the full benefit of POCUS.

POCUS Training: Understanding the Three Pillars of POCUS

While POCUS training can appear overwhelming, there are three foundational skill areas physicians must cover to start using the technology:

• Image Acquisition: Training physicians to use POCUS devices with confidence and create consistent, high-quality images

• Image Interpretation: Developing physicians’ ability to recognize standard patterns within scans quickly, later learning abnormal patterns to support a range of clinical learning objectives

• Clinical Integration: Equipping students with the skills and knowledge required to leverage POCUS within real-world clinical settings

One of the most persistent barriers to POCUS training and adoption within family medicine is not knowing where to start. But thinking about the process through this lens helps simplify the challenge and make it feel more manageable for physicians.
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3 Steps to Build POCUS Competency

Our experience suggests image acquisition and interpretation skills require at least two of the following three steps:  
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1. Initial Training

Building image acquisition and analysis skills requires hands-on experience, which can be integrated into physicians’ busy schedules more easily than many expect.  

For example, one study found that even a single 4-day training course could significantly improve providers’ POCUS skills, offering a vital set of baseline knowledge and practical experience for physicians who completed their training before POCUS became a standard part of family medicine residency programs. Participants’ confidence using POCUS increased greatly, and their competence with the technology grew to an average of 50%.⁴

For family medicine, we recommend starting with short training courses like this, giving inexperienced physicians a foundation in POCUS image acquisition and analysis. From there, it’s important to create an environment that supports continued growth.  

2. Mentorship

The fastest way of empowering physicians to build POCUS competency is to pair them with a mentor who can offer feedback on their image acquisition and interpretation skills. Studies suggest that this kind of feedback has a considerable impact on students' learning. The same principle applies to established physicians learning POCUS later in their careers⁵⁶

Handheld devices can make this far easier and accelerate skill acquisition. By enabling users to share images via WIFI and get feedback from experienced POCUS users, mentorship is extended beyond physical and geographical confines. Family practices can even utilize the expertise of physicians working in different parts of their health system to offer guidance and mentorship to training physicians.  

3. Peer Learning

Many family practices will have multiple physicians who need to develop POCUS skills, enabling the establishment of peer learning groups. These groups include sharing tips, reviewing each other's images, and developing an environment where practice is encouraged.

While peer learning is often pitched as an alternative to expert-led training, and meta-analyses suggest it produces similar results,⁷ it can also serve as a complement to POCUS mentorship. Learners will inevitably share guidance and nuggets of wisdom they’ve received from more experienced users with their peers, helping the entire group benefit from expert feedback.

These steps will help family physicians build POCUS competency quickly and efficiently. But how do you ensure they are prepared to use those skills within their daily workflows?

How to Integrate POCUS Into Family Medicine Workflows

Our experience suggests three factors are essential in enabling family practices to integrate POCUS within daily practice:  

1. Clinical Guidelines

Practices must have clear protocols about when and how POCUS should be used, ensuring uniformity across all physicians. These guidelines help less experienced physicians identify opportunities to use the technology, such as:

• Abdominal Aortic Aneurysm (AAA) Screening: POCUS can quickly assess the abdominal aorta to screen for potential aneurysms, especially in high-risk patients.

• Focused Assessment with Sonography for Trauma (FAST) Exam: Although more common in emergency settings, a modified FAST exam can be used to quickly evaluate and rule out internal bleeding in primary care, especially for patients presenting with abdominal pain.

• Gallbladder Assessment: Checking for gallstones or cholecystitis in patients with right upper quadrant pain can be quickly accomplished with POCUS.

• Obstetric Ultrasounds: In a family practice, simple scans can confirm early pregnancy and fetal viability, as well as assess fetal position in later stages.

• Evaluation of Deep Vein Thrombosis (DVT): For patients with symptoms like leg swelling or pain, POCUS can be used to assess for DVT as a preliminary check before potentially referring for further diagnostics.

• Soft Tissue and Musculoskeletal Exams: POCUS can help with assessing joint effusions, abscesses, or guide procedures like joint aspirations or injections.

• Cardiac Assessment (Focused Cardiac Ultrasound): This is used to quickly assess cardiac function, look for pericardial effusion, or check for signs of heart failure.

• Lung Ultrasound: Especially helpful for detecting pleural effusions, pneumothorax, or consolidations in patients with respiratory symptoms.

2. Set Up Billing Systems

While POCUS can generate strong revenue within family medicine, just 6% of practices currently bill for procedures, with a majority of survey respondents stating that they find billing difficult to establish.⁸ This is unsurprising, given that an effective POCUS billing system requires practices to:

• Understand the relevant CPT codes

• Develop documentation processes

• Establish systems to evaluate and verify that patients’ insurance coverage extends to POCUS

However, there is a range of third-party partners that can make this process substantially easier, allowing family practices to start billing for POCUS faster.  For example, Vave Health’s handheld ultrasound systems integrate seamlessly with your PACS systems – enabling scans to sync with your patient’s records and make billing for applicable scans simple.

3. Encourage Ongoing Training

Physicians should not stop building their POCUS skills once they are ready to start using it on patients. Instead, family physicians must be encouraged to see POCUS training as an ongoing process – especially given that the technology itself is still evolving and developing new and powerful use cases.

For example, the introduction of handheld POCUS devices has fundamentally changed what is possible for family physicians. Free from cart-based systems and cords, physicians can use POCUS in a far wider range of scenarios – from home visits to rural locations.  

Introducing Vave Health: Simple, Portable, Affordable Ultrasound

Vave Health is the world's first wireless, handheld, whole-body ultrasound with a single PZT transducer. It equips family medicine practices with everything they need to train their physicians to use POCUS with confidence – and start billing faster using:

• Built-in training programs to develop POCUS proficiency

• Seamless image sharing to enable asynchronous practice

• Expert support to help integrate the technology within your workflows

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