By Aaron Costerisan, MD


If you are a family physician, I am guessing you have more than once consternated over the situation of family medicine in the United States. The day-to-day demands keep piling up and, at the same time, we sense increasing barriers to fulfillment in our work. (I won’t provoke anxiety by listing them all here.)

I wonder if at the heart of this angst is the feeling of distance between us and our patients. Sometimes our work is driven by external interests, which threaten to crowd out what should be our central motivation — commitment to our patients.

Family physicians are joining physicians from multiple specialties in discovering the ways that “point-of-care ultrasound” (POCUS) can get us back in touch with our patients. When integrated with our other clinical tools, POCUS has the potential to improve our communication with patients — and increase diagnostic efficacy, treatment efficiency and clinical satisfaction.

Our Department of Family and Community Medicine recently purchased the latest ultra-portable ultrasound machine, and we are already impressed with its ease of use and clinical utility. Called Butterfly iQ, it is surprisingly comfortable and maneuverable in one hand. The only other necessary component is an iPhone or iPad, from which high-quality ultrasound images can be easily obtained and saved. As a result, key clinical questions can be answered quickly:

  • Do the lungs have excess fluid?
  • Does a patient with a distended abdomen have ascites?
  • Is red, raised skin is merely cellulitis, or does it point to an underlying abscess?

A device like the Butterfly iQ makes ultrasound accessible at the bedside as a powerful clinical tool that can be integrated into our other diagnostic and treatment tools. In addition, its accessibility is directly related to its drastically reduced cost compared to other ultrasound equipment.

Speaking from my own experience, POCUS is a tangible way to close the distance between us and our patients.

When I use ultrasound in taking care of patients, I move toward being a participant rather than a spectator in their care. I also get in touch again with things I learned a long time ago, like basic anatomy. In so doing, I hope to practice and teach in a way that is true to the philosophy of family medicine.

Whether you ever consider getting your hands on a portable ultrasound device, I hope you will at least consider with me how POCUS might be a way to bring you back to the patient’s side.

ultrasound using Butterfly IQ
ABOVE: A recent scan of a patient’s uterus using the Butterfly iQ shows a baby in utero. Visible are the baby’s abdomen, heart motion, limbs, and face.

About the Author

Dr. Aaron Costerisan is a Clinical Assistant Professor and Associate Director of the Family Medicine Residency.