By Makenna Donahue
Somewhere down a long hospital corridor, a sonographer endures another scan, accompanied by strained shoulders and aching wrists. The image quality is not the issue, the machine functions perfectly well. Yet still, her body is withering. Why? Because no one asked how she uses it.
In the intricate world of HTM, clinical engineers are entrusted with managing, evaluating and integrating the devices that sustain modern medicine. Yet amid this technical excellence, one critical voice is often excluded: the user. Diagnostic medical sonographers, though highly trained specialists, are rarely invited to contribute to decisions about the ultrasound systems that shape their daily practice.
This silence comes at a cost, one that sonographers have borne through chronic injury, inefficient workflows and professional disillusionment. It raises a question that clinical engineers can no longer afford to overlook: “At what point does observation without intervention become complicity?”
Philosopher Parker J. Palmer once wrote, “The human soul doesn’t want to be advised or fixed or saved. It simply wants to be witnessed.” This moment calls for reflection for clinical engineers to ask: “Have we genuinely witnessed the daily realities and needs of the sonographer, or have we been content with technical success alone?”
This discussion explores the consequences of the communication gap between clinical engineers and sonographers, as well as the potential of collaborative dialogue to drive meaningful change. It also presents a structured approach that repositions the user as a central voice in the engineering process.
For decades, research has consistently revealed an alarming truth: musculoskeletal injuries are endemic among sonographers. Studies show that “the prevalence of musculoskeletal injuries among sonographers exceeds 90%,” with many developing chronic conditions that jeopardize their careers.
We have witnessed a system that continues to measure suffering without intervening. Statistics are updated. Percentages are published. Yet meaningful change remains elusive. When procurement decisions are made without sonographers at the table, the result is predictable: machines that satisfy budgets and specifications but not bodies. The end user is left to adapt, to endure, to improvise around design flaws that could have been prevented through one simple act: a conversation.
This form of communication does not dilute the engineer’s role, it elevates it. When equipment is designed and managed in partnership with those who use it, the work becomes not merely functional but profoundly meaningful.
So, how should we proceed?
The answer lies in structured, intentional collaboration, not as a one-time event, but as a sustainable practice. A practical step forward would be to establish brief quarterly meetings in which feedback is collected, equipment concerns are addressed and upcoming changes are discussed transparently.
Such collaboration would enable engineers to track trends in user feedback while providing a low-cost, high-impact forum for cooperative problem-solving. Institutions might even integrate digital reporting platforms, allowing ergonomic issues to be logged by sonographers and analyzed by engineers.
These solutions are not costly. They are not radical. They are simply overdue. Yet we must acknowledge that most clinical engineers, as individuals, do not possess the authority to alter hospital policy alone. They are part of a much larger system shaped by capital planning boards, department heads and administrators.
Even so, their position carries significant influence. Radical change does not begin with permission; it begins with assertion. Progress belongs to those willing to advocate, not merely to those in charge.
A clinical engineer may never place a probe on a patient or feel the ache of maintaining an awkward position to capture the perfect image. Yet they shape the environment in which those experiences occur, and that makes them responsible for the outcome.
Let this be the moment we stop observing the numbers climb and start bringing them down. The solution begins not with a new machine but with a new mindset; one that listens, collaborates and bears witness.
Makenna Donahue is a diagnostic medical sonographer student.
