Empower Excellence in Ultrasound Education

Understanding Causes and Protecting Patients and Sonographers

Risk of Complaints in Medical Sonography

Understanding Causes and Protecting Patients and Sonographers

NYCIconsult Professional Educational Article

Author: NYCIconsult Medical Imaging Education

Publication Date: March 2026

This article explores the psychological, clinical, and institutional factors that lead to complaints in

medical sonography and provides practical strategies to prevent and manage them while protecting

both patients and healthcare professionals.Introduction

Medical sonographers work in a clinical environment where technical expertise, patient communication,

and human perception intersect. Ultrasound examinations often involve close physical contact and

situations in which patients may feel vulnerable or anxious. Even when examinations are performed

according to established clinical protocols, misunderstandings or perceived negative interactions may

lead to complaints. Research in healthcare communication shows that complaints frequently arise from

communication gaps, emotional stress, and expectation mismatches rather than purely technical errors.

For sonography students and practicing professionals, understanding the psychological and situational

drivers of complaints is essential. Preventing complaints requires technical competence, effective

communication, professional conduct, and supportive institutional systems.

Why Complaints Occur in Sonography

• Lack of explanation during the examination

• Misinterpretation of routine professional behavior

• Patient anxiety or fear regarding medical results

• Cultural differences affecting communication expectations

• Perceived disrespect or discomfort during the examination

• Long waiting times and system frustration

• Students performing examinations without clear explanation or consent

Psychological Factors Behind Complaints

Patients undergoing medical examinations are often experiencing stress, uncertainty, or fear related to

their health. These emotional states influence how interactions with healthcare providers are

interpreted. Cognitive biases can affect patient perception, including:

• Attribution bias – assuming discomfort or misunderstanding was caused intentionally by the

provider.

• Confirmation bias – interpreting neutral behavior as evidence supporting a negative belief.

• Availability bias – recalling stories from media or social networks and applying them to the clinical

situation.

Institutional Challenges in Complaint Management

Healthcare institutions face increasing demands related to patient volume, efficiency, and quality

metrics. Busy ultrasound departments may perform many examinations each day, which can create

pressure on both staff and administrative systems. Under these conditions, complaint management

processes may sometimes become reactive rather than structured. Without consistent investigation

procedures, important clinical context may be overlooked. Effective complaint management must

balance two responsibilities: • Protecting patient safety and dignity • Ensuring fair evaluation and due

process for healthcare professionals

Practical Recommendations for Sonographers1 Introduce yourself clearly and establish eye contact with the patient.

2 Explain the purpose and steps of the examination before beginning.

3 Communicate during the exam to reduce patient anxiety.

4 Maintain professional body language and respectful interaction.

5 Inform patients when students participate in examinations.

6 Document important interactions and unusual situations carefully.

Recommendations for Healthcare Institutions

1 Develop standardized complaint investigation protocols.

2 Ensure adequate supervision for students and trainees.

3 Provide communication training for healthcare staff.

4 Maintain clear documentation policies.

5 Evaluate complaints through objective clinical review.

6 Use complaints as opportunities for system improvement.

Conclusion

Complaints in sonography are often driven by communication gaps, emotional stress, and systemic

factors rather than technical errors. Understanding these dynamics allows healthcare professionals to

anticipate misunderstandings and respond proactively. By combining professional communication,

structured institutional protocols, and objective investigation procedures, healthcare systems can

create safer environments for both patients and sonographers. In medical sonography, where technical

precision and patient vulnerability intersect, trust, transparency, and professionalism remain the most

effective safeguards against complaints.

References

• American Institute of Ultrasound in Medicine (AIUM). Practice Parameter for Documentation of

Ultrasound Examinations.

• American Registry for Diagnostic Medical Sonography (ARDMS). Code of Ethics.

• Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century.

• Levinson W., & Gallagher T.H. Physician–Patient Communication and Malpractice Risk. JAMA.

• Reason J. Human Error: Models and Management. British Medical Journal.

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