By Miriam Norman, Outgoing Chair, Professionals in Cardiac Sciences Australia (PiCSA)
Since completing my final term as Chair—having reached the maximum consecutive terms as a PiCSA Director—I have been reflecting on how far we have come, and the important work that still lies ahead. Across these last months, many conversations have continued to return to the same core themes: professional identity, accreditation, registration, public protection, and how Australia’s emerging regulatory models compare with the UK’s more mature Healthcare Science framework. These issues will shape our next decade.
Our Professional Identity
We now have clearer entry pathways, stronger national engagement, and a growing sense of collective identity. The outdated perception of cardiac physiologists as “technicians” has largely given way to recognition of a highly trained, tertiary-qualified healthcare science workforce.
We are Cardiac Physiologists: healthcare scientists who help diagnose and treat heart disease. Whether our expertise lies in echocardiography, cardiac devices, electrophysiology, the cath lab, or ECG/non-invasive cardiology, we are essential workers in hospitals and cardiac clinics throughout Australia.
Accreditation vs Registration: Understanding the Difference
Accreditation answers the question: “Are you qualified to perform this skill?”
It confirms that a practitioner holds the relevant credential and maintains CPD.
Registration answers the question: “Are you legally allowed to practise?”
Registration bodies:
- set qualification and recency-of-practice standards
- require professional indemnity insurance
- publish codes of conduct
- investigate complaints
- suspend or revoke the right to practise
Australia’s Regulatory Gap
Example: ASAR accreditation enables sonographers to perform Medicare-claimable scans. However, ASAR cannot investigate complaints, enforce conduct standards, regulate day-to-day practice, or prevent unsafe practitioners from practising (except through CPD non-compliance).
At present, Australia has no mechanism—accreditation or otherwise—to prevent a clinically unsafe cardiac physiologist from practising in any modality. This remains one of our most significant long-term risks, and one of our greatest opportunities for reform.
Because of Medicare rules, almost every cardiac physiologist working in echocardiography is accredited. However, fewer than 10% of those working in the other cardiac physiology modalities are registered. This means that there is no guaranteed minimum qualification for the person programming your pacemaker. Such a gap in public safety is unacceptable and requires urgent attention from government.
Looking Ahead
The pathway toward a fully regulated profession is neither quick nor simple, but it is essential. PiCSA will continue to advocate for a future in which all advanced cardiac physiology modalities are appropriately accredited, registered, and recognised, safeguarding both our workforce and the public we serve.
It has been an honour to serve as Chair during this period of substantial growth and momentum. As I step down, I offer my sincere congratulations and best wishes to Sam Burgoyne, our incoming Chair. Sam brings deep expertise, steady leadership, and a genuine commitment to strengthening our profession. PiCSA is in excellent hands.
Although I am concluding my term, I look forward to continuing to support PiCSA’s mission as an advisor, and through my roles on the councils of the Cardiac Society of Australia and New Zealand (CSANZ). I remain available to our members and stakeholders, and can now be reached via my dedicated volunteer email: miriamcardiac@gmail.com.
