Podiatry practices see circulation questions constantly. Wound care, diabetic foot management, pre-operative planning and rest pain complaints all raise the question of what the arterial supply to the foot actually looks like. In most practices that question gets answered somewhere else — the patient is referred out to a vascular lab or hospital imaging department, and the practice waits. Bringing the imaging into the office changes the pace of the practice more than it changes the clinical work.
This guide covers what it actually takes: the room, the schedule, the staff roles, the referral pathway, and the decision between having a technologist visit on a recurring basis versus contracting for regular in-office coverage.
What changes when the imaging happens in your office
The most visible change is the collapse of the referral loop. A patient with a non-healing ulcer who currently needs an outside appointment, a separate trip, and a report that comes back days later can instead be imaged on a day when the technologist is in your building. The practice keeps the patient inside its own workflow. Follow-up is scheduled while the patient is still in the chair.
The second change is quieter but matters more over time: patients who would have quietly not gone. Referral leakage in podiatry is real, particularly among older patients, patients who do not drive, and patients for whom an extra appointment across town is a genuine obstacle. When the study happens where the patient already is, that attrition largely disappears.
The physical requirements are smaller than most practices assume
Practices often assume adding vascular imaging means buying an ultrasound system and finding space for a vascular lab. With a mobile model, neither is true. We bring the system. What the practice supplies is a room.
Practices with tight footprints sometimes designate a room only on imaging days and use it normally the rest of the week. That works. What does not work is trying to run imaging out of whichever room happens to be free — arterial studies in particular involve cuffs, multiple limb positions and a technologist who needs to stay put for the length of the protocol.
Which studies podiatry practices order
The workhorse pairing is arterial index testing and arterial duplex. Index testing gives a non-invasive measure of pressures at the ankle and toe; duplex imaging looks directly at the arteries. Our companion articles explain what ABI and TBI testing each measure and where they differ.
- Ankle-brachial and toe-brachial index testing — non-invasive pressure measurement, frequently ordered for patients under active wound care.
- Lower extremity arterial duplex ultrasound — direct imaging of the arterial segments supplying the leg and foot.
- Venous duplex for DVT evaluation — ordered when a patient presents with new unilateral swelling, including post-operatively.
- Venous reflux mapping — relevant to practices whose patients present with venous stasis changes at the ankle.
A practice does not have to start with all of it. Most begin with index testing and arterial duplex, then add venous work once the imaging day is an established part of the week.
Staff roles on an imaging day
- Front deskBlocks the imaging slots when scheduling, and knows which appointment types belong in them. This is the single highest-leverage piece — a poorly built schedule is what makes imaging days feel chaotic.
- Medical assistantRooms the patient, confirms the order, and helps with positioning or shoe and sock removal. The technologist does not need an assistant present for the study itself.
- TechnologistPerforms the complete protocol, documents measurements on the worksheet, and cleans equipment between patients.
- PhysicianInterprets the study, or routes it to the physician who will. Nothing our technologist produces is a substitute for that read.
Building the schedule
The practical unit is a half-day block, not an appointment. Practices that try to schedule individual studies scattered through a normal clinic day end up with a technologist waiting between patients and a room that is neither available for clinic nor fully used for imaging. A four-hour block filled with imaging appointments is easier for everyone and makes the economics work.
Starting cadence
Most podiatry offices begin with one half-day every other week, then move to weekly once the schedule fills reliably. Practices with several locations sometimes rotate — one office one week, another the next. If your locations are clustered, say in Orland Park, Tinley Park and Oak Lawn, that rotation is straightforward. Offices further apart, such as a Joliet or Aurora site paired with a Northwest Indiana location in Munster or Schererville, generally want separate days rather than a split one.
The referral pathway to sort out first
Adding imaging changes what happens after the study, and this is where practices under-plan. A study that raises a question your practice does not treat needs a destination. Before the first imaging day, decide which vascular or interventional practice you refer to, how the images and worksheet get to them, and who in your office owns that handoff. Practices that sort this out in advance look organised to their referral partners; practices that do not end up chasing studies.
Similarly, decide how imaging findings re-enter your own recall system. A patient imaged today who needs a follow-up study in six months should leave with that appointment already made.
Recurring visits versus contracted coverage
There are two ways to have a technologist in your building. The first is recurring mobile visits, where we schedule a technologist to your office on a set cadence. The second is a staffing contract, where a credentialed technologist covers your practice on defined terms of three, six or nine months — described in our guide to how RVT staffing contracts work.
The dividing line is volume and predictability. If your imaging need fills a half-day every week or two, recurring visits are simpler and you carry no ongoing commitment. If you are filling multiple days a week, or if you are building a broader vein or vascular service line rather than adding a test, a contract term gives you a consistent person who learns your practice, your worksheets and your physicians' preferences.
Who performs the studies
Every study is performed by a credentialed, RVT-certified technologist, and our vascular technologists trained through the Rush University vascular ultrasound program. Podiatry offices are one of the facility types we regularly serve; the full list is on our facilities we serve page, and the complete scope of mobile imaging and staffing services sits alongside it.
A reasonable first step
Count how many vascular studies your practice referred out in the last three months and how many of those patients you can confirm actually went. If the second number is meaningfully smaller than the first, that gap is the argument for bringing imaging in — and it is an argument about access and continuity, not about equipment. From there the conversation is short: which studies, what day, and which room.
Practices thinking beyond diagnostics toward treating venous disease directly should also read what a practice needs in place to start a vein program.
This article is general information for healthcare professionals about imaging logistics and does not constitute clinical guidance. Studies are interpreted by the physician responsible for the patient's care.
Talk through your facility's coverage
Tell us the exams you order, how often, and where your locations are. We will tell you plainly whether on-site imaging or RVT staffing is the better fit.