No technology has had a greater impact on the practice of a medical specialty than ultrasound as used in obstetrics. In a relatively brief time, technologic innovations in sonography have facilitated its assimilation into the daily practice of obstetrics and gynecology. Clinicians now routinely rely on ultrasound to help assess fetal growth, development, and well-being. The most complete physical examination of a second-trimester fetus is achieved through ultrasound evaluation.

The information presented in the preceding articles may lead the reader to conclude that the purchase or lease of an ultrasound system is warranted. If one already has access to an older machine, it may be time to purchase or lease a system with better microprocessor and transducer technology. Fundamental knowledge of the physics of ultrasound and kinetic energy is needed in these acquisitions. In addition, the business profile of a practice may dictate the feasibility and preference of owning or leasing an ultrasound system. The type of obstetric and gynecologic patients seen in a practice setting and the anticipated utilization frequency impact on the advisability of such an investment. If these practice variables are not known, an initial step is to ascertain this information. Several other questions should be addressed, such as the following: What features are essential for the system to optimize care to patients in a routine obstetric and gynecologic practice? What features are available, convenient, but not essential? What features are available but not only not essential but not desired? Who will perform the routine ultrasound examination, and what qualifications and certifications are needed? What are the standards in regard to examination documentation? What quality assurance measures should be in place?

The discussion in this article provides insight into these issues in an attempt to help providers determine whether owning or leasing an ultrasound system is cost-effective and likely to improve access to care and the quality of care.