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In this episode of Sonographers After Dark, host Lara Williams sits down with Douglas Richardson to explore the journey from clinical sonographer to healthcare leader.
Doug shares how he progressed from an uncertain start in college to leading accreditation efforts across multiple hospitals and stepping into a system-level strategy role. His experience highlights the realities of growth in healthcare—where clinical expertise must be paired with business insight, leadership skills, and the ability to influence change. The conversation covers:
Watch the full episode here or listen on your favorite platform: Spotify, Apple Podcast, iHeartRadio YouTube: https://www.youtube.com/@SonographersAfterDark TikTok: https://www.tiktok.com/@sonographersafterdark Facebook: https://www.facebook.com/groups/sonographersafterdark Instagram: https://www.instagram.com/sonographersafterdark/
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What does it really mean to be an advanced practice sonographer—and where is the profession heading next?
In this episode of Sonographers After Dark, we explore the evolving role of the sonographer beyond traditional scanning. From clinical expertise and pre-read responsibilities to remote work opportunities and expanded influence in patient care, this conversation dives into how sonographers are stepping into more advanced, high-impact roles across healthcare. Joined by Cherish Hockey, we unpack what it takes to transition into these positions—from building trust with physicians and strengthening diagnostic confidence, to navigating imposter syndrome and embracing continuous learning. We also talk about the realities of moving away from full-time scanning, the growing demand for quality-driven workflows, and how technology is opening new doors for sonographers willing to adapt. If you’ve ever wondered what’s next in your career—or how to position yourself for more—this episode is your roadmap to rising beyond the probe and into your full potential. Watch the full episode here or listen on your favorite platform: Spotify, Apple Podcast, iHeartRadio YouTube: https://www.youtube.com/@SonographersAfterDark TikTok: https://www.tiktok.com/@sonographersafterdark Facebook: https://www.facebook.com/groups/sonographersafterdark Instagram: https://www.instagram.com/sonographersafterdark/ #sonographersafterdark #iheartecho #allaboutultrasound #loveultrasound #AdvancedPracticeSonographer #ultrasound #sonographer In this episode of Sonographers After Dark, Lara sits down with Carlton Hartwell, ACS, RDCS, FASE and they dive into the evolving role of the Advanced Cardiac Sonographer (ACS) and what it truly means to move beyond scanning into leadership, education, and quality-driven practice.
While the ACS credential has been around for years, many healthcare organizations are still trying to define how to fully utilize these highly trained professionals. We explore the real-world responsibilities of the ACS—from protocol development and lab leadership to research involvement and advanced procedures like TEE. They also break down the pathway to credentials like ACS and American Society of Echocardiography fellowship, and why these designations are becoming increasingly important in today’s echo landscape. The conversation expands into:
If you’ve ever wondered what’s next in your career as a sonographer—or how to elevate your role within your lab—this episode is for you. Watch the full episode here or listen on your favorite platform: Spotify, Apple Podcast, iHeartRadio YouTube: https://www.youtube.com/@SonographersAfterDark TikTok: https://www.tiktok.com/@sonographersafterdark Facebook: https://www.facebook.com/groups/sonographersafterdark Instagram: https://www.instagram.com/sonographersafterdark/ #sonographersafterdark #iheartecho #allaboutultrasound #loveecho #loveultrasound #bettercardiology #echoquality #cardiacultrasound In this episode of Sonographers After Dark, Lara Williams dives into the real work behind accreditation, quality improvement, and leadership in the echo lab. While accreditation may be the framework, the true goal is building a culture of quality that improves patient care, strengthens reporting, and creates consistency across the lab.
Lara unpacks the common roadblocks teams face when implementing quality programs, from managing different personality types and navigating difficult conversations to gaining physician and administrative buy-in. She also breaks down the importance of structured reporting, IAC standards, ASE guidelines, timeliness requirements, discrepancy policies, and creating meaningful quality review systems that go beyond simply checking boxes. This episode is a practical discussion for sonographers, technical directors, ACS professionals, and lab leaders who want to better understand how to lead change, improve reporting accuracy, support staff growth, and build a quality program that is both sustainable and effective. Lara also shares insight into using objective scoring tools, peer review, and ongoing education to identify growth opportunities and strengthen lab performance over time. If you are stepping into leadership, preparing for accreditation, or trying to elevate quality in your lab, this episode is for you. 💜🩵 Watch the full episode here or listen on your favorite platform: Spotify, Apple Podcast, iHeartRadio YouTube: https://www.youtube.com/@SonographersAfterDark TikTok: https://www.tiktok.com/@sonographersafterdark Facebook: https://www.facebook.com/groups/sonographersafterdark Instagram: https://www.instagram.com/sonographersafterdark/ #sonographersafterdark #iheartecho #allaboutultrasound #loveecho #loveultrasound #bettercardiology #echoquality #cardiacultrasound This episode of Sonographers After Dark was sponsored by the American Society for Echocardiography, with support from an unrestricted educational grant from Bristol Myers Squibb.
In this episode, Lara Williams sits down with Margaret Kurnides, ACS, RDCS, FASE, and Amy Dillenbeck, MS, ACS, RDCS, RCS, FASE to discuss the growing adoption of goal-directed Valsalva in echocardiography and why it is transforming how sonographers evaluate patients with hypertrophic cardiomyopathy (HCM). The conversation explores how the traditional Valsalva maneuver often varies between sonographers, leading to inconsistent results. By contrast, the goal-directed approach creates a standardized and reproducible maneuver that can reliably unmask latent LVOT obstruction, which may be present in up to one-third of HCM patients who show no obstruction at rest. Margaret and Amy share practical insights from implementing the technique in clinical labs, including setup tips, infection-control considerations, and strategies for gaining physician and administrative buy-in. They also discuss imaging challenges, differentiating LVOT signals from mitral regurgitation, and the importance of correlating Doppler findings with the broader physiologic picture. The discussion takes on new urgency in the era of myosin inhibitor therapies, where accurate echocardiographic measurements—particularly LVOT gradients and ejection fraction—are critical for diagnosis, treatment selection, and medication titration. The group emphasizes why sonographers must understand the physiology behind HCM, not just the imaging protocol. The episode closes with a look at upcoming ASE micro-lessons on goal-directed Valsalva. If you scan echo—or teach it—this is a conversation about technique, physiology, and the evolving role of the sonographer in modern HCM care. Watch the full episode here or listen on your favorite platform: Spotify, Apple Podcast, iHeartRadio YouTube: https://www.youtube.com/@SonographersAfterDark TikTok: https://www.tiktok.com/@sonographersafterdark Facebook: https://www.facebook.com/groups/sonographersafterdark Instagram: https://www.instagram.com/sonographersafterdark/ #sonographersafterdark #iheartecho #allaboutultrasound #loveecho #loveultrasound #bettercardiology #echoquality #cardiacultrasound #hocm #hypertrophiccardiomyopathy #hcm #goaldirectedvalsalva It’s been almost a decade since Lara Williams and Judith Buckland, MBA, RDCS, FASE, last taught together (yes… the legendary “quack like a duck” kinetic learning moment is back). In this Sonographers After Dark episode, they reconnect to unpack how the ultrasound and echo world has transformed since 2016—through COVID-era shifts, remote education becoming the norm, and the rising demand to streamline the nonstop pressure on sonographers and physicians. Judith shares the real story behind her evolution from accreditation consulting to building process-driven quality systems—and why her biggest “aha” was that accreditation isn’t the destination… it’s the leverage that finally gets buy-in for standardization, peer review, and better outcomes. Together, they dig into the grind (and cost) of pursuing ACCME, the vision of bundling accreditation + QI + CME + credential requirements into one workflow, and the entrepreneur brain that keeps dreaming bigger. They also talk AI in echo (including vendor-agnostic automation, real-world “messy” data, and why this tech won’t replace sonographers—but can reduce burnout), plus what’s next: HOCM accreditation changes, goal-directed Valsalva, ICE/4D ICE advances, and the behind-the-scenes work of building platforms that make “better cardiology” possible.
Watch the full episode here or listen on your favorite platform: Spotify, Apple Podcast, iHeartRadio YouTube: https://www.youtube.com/@SonographersAfterDark TikTok: https://www.tiktok.com/@sonographersafterdark Facebook: https://www.facebook.com/groups/sonographersafterdark Instagram: https://www.instagram.com/sonographersafterdark/ #sonographersafterdark #iheartecho #allaboutultrasound #loveecho #loveultrasound #bettercardiology #cardioserv #echoaccreditation #echoquality #cardiacultrasound #hocm #hypertrophiccardiomyopathy #hcm In this powerful episode of Sonographers After Dark, Lara sits down with Joy Guthrie, PhD., ACS, RDMS, RDCS, RVT, FSDMS, FASE, to discuss the evolution of advanced practice sonography and what it truly means to elevate our profession.
Joy shares the story behind launching one of the first Advanced Cardiac Sonography programs in 2016—and how it expanded to include Advanced Perinatal Ultrasound and Advanced Vascular tracks. Designed for experienced sonographers with at least three years of clinical practice and a bachelor’s degree, these hybrid programs combine online coursework with immersive on-campus residency. The result? Graduates who return to their institutions with increased responsibility, new job descriptions, and higher compensation. Together, Lara and Joy explore: • The shift toward advanced roles in cardiac, vascular, and perinatal imaging • Why many “advanced” roles aren’t labeled that way—but function at a higher clinical level • How accreditation and positions like Technical Director have reshaped expectations (often requiring ACS-level expertise) • The development of the CAAHEP Pathway program for advanced practice • Gaining physician buy-in and aligning with collaborative, extender-style practice models • Practical application tips for competitive advanced program admission • The unique challenges of pediatric echocardiography training and why hands-on experience is non-negotiable This episode is more than a conversation—it’s a roadmap for sonographers who are ready to expand their scope, elevate patient care, and help define the next generation of our profession. If you’ve ever wondered what the future of advanced sonography looks like… this is it. #SonographersAfterDark #AllAboutUltrasound #iheartecho #LoveUltrasound #LoveEcho💜 Watch the full episode here or listen on your favorite platform: Spotify, Apple Podcast, iHeartRadio YouTube: https://www.youtube.com/@SonographersAfterDark TikTok: https://www.tiktok.com/@sonographersafterdark Facebook: https://www.facebook.com/groups/sonographersafterdark Instagram: https://www.instagram.com/sonographersafterdark/ In this episode of Sonographers After Dark, Lara sits down with Dr. Judy Hung (Mass General Hospital, Boston) for a candid, sonographer-focused conversation on valvular heart disease—and why high-quality echocardiography drives real clinical decisions in today’s structural heart era. Dr. Hung shares what drew her to valve disease through the lens of physiology and hemodynamics, and why echo is the frontline tool for determining whether stenosis or regurgitation is truly hemodynamically significant. The discussion dives into common valve-assessment pitfalls—like failing to chase the highest aortic stenosis gradients with multiple windows, skipping the non-imaging (Pedoff) probe, and missing key steps in MR quantification (zoom, baseline shift, and PISA setup). They also unpack how echo data influences heart team decisions for TAVR, why sonographer training and career pathways matter for retention, and how the profession may evolve with AI-assisted measurements and improving 3D transthoracic imaging—without replacing the need for skilled sonographers. Plus: a few fun rapid-fire moments (equitherapy with "donkeys,” talking to chickens, and an echo myth Dr. Hung is ready to retire for good). If you’re ready to level up your valve game—this one’s for you. 💜💙🩵
Watch the full episode here or listen on your favorite platform: Spotify, Apple Podcast, iHeartRadio YouTube: https://www.youtube.com/@SonographersAfterDark TikTok: https://www.tiktok.com/@sonographersafterdark Facebook: https://www.facebook.com/groups/sonographersafterdark Instagram: https://www.instagram.com/sonographersafterdark/ What really goes into building an echocardiography training program from scratch?
In this episode of Sonographers After Dark, Lara sits down with Daniel Bourque for an honest, behind-the-scenes conversation about launching and sustaining a hospital-based echocardiography program at Orlando Health. Daniel shares the five-year journey of developing an employer-backed echo program—from navigating state licensing, board reviews, and massive documentation requirements to selecting students, building clinical rigor, and fostering real-world decision-making at the bedside. With over 1,300–1,500 clinical scanning hours, early hands-on exposure, and strong internal recruitment, this program is a powerful example of what’s possible when education stays rooted in clinical reality. Together, Lara and Daniel unpack:
Because strong programs don’t happen overnight—and the work behind them deserves to be seen. 💜💙 Watch the full episode here or listen on your favorite platform: Spotify, Apple Podcast, iHeartRadio YouTube: https://www.youtube.com/@SonographersAfterDark TikTok: https://www.tiktok.com/@sonographersafterdark Facebook: https://www.facebook.com/groups/sonographersafterdark Instagram: https://www.instagram.com/sonographersafterdark/ In this episode of Sonographers After Dark, Lara sits down with Kelly Thorson, DHSc, MSRS, MS, ACS, RDCS, FASE, to talk about what it takes to build—and sustain—excellence in pediatric and fetal echocardiography. Kelly shares practical insight on recruiting and training pediatric echo sonographers, why mentorship and lifelong learning matter, and how sonographers can grow into research, education, and leadership pathways. They also dive into the real-world integration of 3D echo and strain in pediatric labs—how to train teams, improve consistency, and expand access to advanced imaging even outside academic centers.
💜💙#SonographersAfterDark #iHeartEcho #AllAboutUltrasound #LoveUltrasound #LoveEcho Watch the full episode here or listen on your favorite platform: Spotify, Apple Podcast, iHeartRadio YouTube: https://www.youtube.com/@SonographersAfterDark TikTok: https://www.tiktok.com/@sonographersafterdark Facebook: https://www.facebook.com/groups/sonographersafterdark Instagram: https://www.instagram.com/sonographersafterdark/ |
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