This research aims to evaluate the impact of clinician performed ultrasound (CPU) on clinical decision making and improved access to imaging services for rural people. Using logbooks, records review, interviews and economic analyses, with oversight from a Specialist Advisory Group, the research will inform key decision-makers and educators of the safe scope of CPU use in rural settings and its costs and benefits. Achieving equitable access to complex health services when acutely ill rural patients require urgent investigation and treatment, demands innovative use of technology and re-evaluating the scope of medical generalists' practice. Health managers in provincial and rural New Zealand must make informed decisions on both workforce mix and technology. CPU by rural generalist doctors may improve the currently very limited access to acute medical imaging for rural New Zealanders. Benefits of improved access to ultrasound are likely to be greatest for patients living in socioeconomically deprived rural communities.