You’re Not Behind, The System Is.

Dec 9 / Dr Robert Jones

I talk to a lot of clinicians who whisper some version of this:

 

“I’ve been practicing for years. I intellectually embrace the value of ultrasound. I’ve watched videos. But truthfully… I still don’t feel confident with POCUS. Did I miss the boat?”

 

Here’s the real answer: You didn’t miss anything.

 

Across hospital medicine, EM, ICU, primary care, and outpatient medicine, published surveys show a striking pattern: most clinicians who want to use POCUS still feel under-trained, under-supported, and short on practice time. 

 

The various professional societies are still formalizing POCUS standards, curricula, and aspects of medical records documentation. 

 

If you feel behind — you’re normal.

 

We’re building this plane while flying it.


Barriers to POCUS Use at the Bedside … a scan of the literature.

 

When you look across multiple specialties, the story is consistent.

A 2020 multi-site survey of practicing internists found that the top barriers to using POCUS were lack of training (79%) and lack of handheld devices (78%).

 

According to the authors, time wasn’t the real obstacle—the training pattern was. Learners who committed to brief, consistent practice outperformed those who relied on occasional deep dives. That’s good news: you don’t need a different job, just a different rhythm. A little structure turns ‘I don’t have time’ into ‘I’m making measurable progress.


Comfort in POCUS as a skill

 

A 2023 family-medicine study found that although 95% of physicians believe POCUS is important, only 5% described themselves as “extremely comfortable” using it (Ludden et al., 2023). 

This  data is reassuring: comfort in real clinical scanning isn’t innate, it’s trained. 

 

Start with low-acuity patients, use a simple on-shift image checklist, and grab fast feedback when you can. Those three moves build the muscle memory that makes POCUS feel natural instead of ‘one more thing’.

Critical care physicians are not immune. 

 

Allen’s 2023 study added another layer we think matters a lot: confidence isn’t built by scanning more—it’s built by scanning more predictably. 

 

Learners improved when POCUS became part of their routineworkflow instead of something they did only when the stars aligned. 

 

The study showed that even brief, structured exposures—paired with fast, specific feedback—changed how comfortable people felt at the bedside.

 

It’s not the heroic cases that build confidence. 

 

It’s the ordinary ones you choose to scan on purpose.


This Isn’t About You.  It’s About the System.

 

Here’s the truth: POCUS isn’t hard – but learning in a system that struggles to support you is. 


Understanding this landscape helps explain what you may be feeling: 

– Frustration that watching short online videos hasn’t translated into confidence. 

– Guilt that you’re “not scanning enough.” 

– Doubt that you’ll ever be truly competent.  After all, you’re not getting any younger…

There is some good news...


Those moments when you felt uncertain weren’t signs of weakness — they were signs of learning. 

 

Every clinician who has mastered POCUS has passed through the same threshold of self-doubt.

 

Confidence isn’t born from perfect conditions. It’s built through persistence — the willingness to take the next step, even when you’re not sure it’s “good enough” yet.

 

If that’s you, you’re right on track.


Stay encouraged that your practice is paying off.


This Week’s Action Step

 

Take two minutes today and identify a single clinical scenario where you wish you had more POCUS confidence. This becomes your “anchor case” for the month.

 

Why this works: anchoring new skills to real clinical problems accelerates learning and makes the practice meaningful.

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Tune in next week to learn…

 

The real barriers — and how to overcome them.

 

You’re not behind. The system just didn’t hand you the keys. By the end of December, you’ll have a map — and maybe even a flight plan.

 

If you want structured support without a big upfront decision, the monthly membership is the easiest place to start. Same course access, lower stakes, and progress at the rhythm that fits your life.

 

Talk soon,

Bob


Dr. Robert Jones, DO, FACEP — a nationally-recognized educator and front-line emergency physician — has dedicated his career to advancing POCUS from “novel tool” to standard practice. From launching ultrasound fellowships to authoring curricula and training thousands of clinicians worldwide, he blends over 30 years of high-volume trauma experience with proven teaching skill to shape the next generation of point-of-care innovators.
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