Open journal

ISSN 2473-0947

License versus Non-License States

Anthony Todd Dotson*

Anthony Todd Dotson, MSRT, RT(R), (CT)

Assistant Professor Department of Kinesiology, Health and Imaging Sciences Morehead University Morehead, Kentucky 40351, USA; Tel. 606-783-5175; E-mail:

Technologists in the imaging modalities (radiology, computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, nuclear medicine, etc.), mostly are required to obtain a certification and state license for whichever state they may work. There are, however, some states that have passed litigation that allow for workers in the imaging sciences to administer ionizing radiation without any formal education or training. There are currently eleven state that do not require any form of qualification to administer ionizing radiation.1 In those states organizations can hire anyone to administer ionizing radiation to the public, as oppose to licensure states that require a minimum of two years of education and certification of a national board exam to do the same. This writing will compare the pros and cons of requiring a license and not requiring one.

State licensure is a common requirement for employment in the field of imaging. Seventy-five percent of the United States require technologists in an imaging department to obtain both a state license and a certification via the American Registry of Radiologic Technologists (ARRT).2 American Society of Radiologic Technologists (ASRT) Vice President of Government Relations and Public Policy, Christine Lung states, “Licensure is a state government’s way of ensuring that personnel meet minimum professional standards before engaging in radiologic technology… prohibit unqualified individuals from performing examinations.”1

The Joint Commission, which is responsible for the accreditation of health care facilities such as hospitals, has a strong stance for licensure and certification of imaging professionals. After introducing the new standard for patient and workplace safety regarding ionizing radiation, particularly in CT, the Joint Commission is hopeful to mitigate the risk at hand and bring a standard across the board regarding licensure.3 The reasoning behind the push from accrediting agencies and professional organizations is to ensure and promote patient safety by requiring technologists be educated so that they are subject matter experts. To sit for the board exam technologists are required to study topics including patient care, radiation safety, image production, and imaging procedures.4 According to a survey by the ASRT, technologists who are not certified are more likely than their peers to rely on managers and other technologists to keep them informed on the latest advancements.5 The lack of current information concerns, in that their peers may fail to inform them of advancements, or could even spread misinformation. Conversely, technologists that are certified are much more likely to cite reputable sources such as professional journals and workshops, and continuing education credits, as their way of staying up-to-date.5

There are also economic reasons that technologists would want to make sure licensure is required to their field. The simple principle of supply and demand dictates that if licensure is required, then the supply of qualified technologists is decreased and the demand will increase. This will cause an increase in compensation to the limited number of qualified technologists.

The reasoning behind non-licensure is that the cost of technologists will decrease for the healthcare organization because they do not have the qualifications that licensure requires. This is less expense for the organization. Going back to the principle of supply and demand, this will increase the supply of technologists and decrease the demand. If that happens, the compensation to the technologists will stagnate or decrease. Of the states that choose not to require license radiation workers, the average pay for a radiologic technologist is lower than the national mean.6 With only 49.4% of technologists nationwide reporting that they are satisfied/very satisfied with their pay, this is an important consideration.6

1. Durning RN, Haar L. Radiologic Technologist Requirements Vary by State. Diagnostic Imagine. 2014. Website. http://www. Retrieved October 20, 2017.

2. State Licensing. (n.d.). The American Registry of Radiologic Technologists. Website. state-licensing. Retrieved October 22, 2017.

3. Snyder C. Aiming Higher. Radiology Today. 2016. Website. Accessed October 24, 2017.

4. Examination Content Specifications. American Registry of Radiologic Technologists. 2017. Website. Retrieved October 22, 2017.

5. Computed Tomography Educational Needs Assessment. American Society of Radiologic Technologists. 2005. Website. https:// Retrieved October 21, 2017.

6. Radiologic Technologist Wage and Salary Survey. American Society of Radiologic Technologists. 2016. Website. http://hshs. Retrieved October 21, 2017.


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