In a recent event in the city of São Paulo, after the Revocation of Resolution CFM 2227/2018 that regulated Telemedicine, one of the topics discussed was Teleultrasonography, resulting in the following question: can the evaluation and report of Ultrasonography be done remotely?
The Standardization of Teleradiology, which is contemplated in Resolution CFM 2107/2014, makes it clear in its Art. 6: “The use of Teleradiology for interventional procedures in Radiology and Diagnostic Imaging and ultrasound examinations is prohibited”.
The ultrasound examination is performed in real time, being totally dependent on the examiner, either due to the broad knowledge of the anatomy or the formation of numerous images, depending on the angle of the transducer.
At the time of training in Ultrasound, it was common to hear from preceptors: “the ultrasound exam corresponds to a method that we must be very careful with, because we can form any image”. Where did this placement come from and why? Does lack of care due to a deficit in the financing of the Unified Health System (SUS) justify performing low-quality procedures to falsify ideal care?
Are those interested in this new modality really concerned about the health of the population, especially the underprivileged? Is it licit to defend a poor Medicine for the poorest? What are the big players behind this flag? An innocuous, radiation-free, low-cost and easy-to-perform method, but which depends on the doctor's hand for its implementation.
Unfortunately, what is sought nowadays is the withdrawal of the doctor's hands, whether from assistance or propaedeutics. Immediately a queue of candidates forms to replace the doctor's hands. Health professionals from the most diverse areas want to act as doctors, but they forget the civil and criminal responsibilities covered by these inactions.
It is up to the Brazilian College of Radiology and Imaging Diagnosis, in its role of defending good medical practice, to seek, together with the CFM, to supervise the actions that these disservices do to society. It is incomprehensible that fellow physicians, with unblemished technical training, could defend themselves in what could become indefensible.
Teleultrasonography collides with the Norms of Teleradiology and does not deserve to prosper. Stay tuned: the exercise of Ultrasonography at a distance must be prohibited and reported to the regional CRM or CBR.
Dr. Cibele Alves de Carvalho
Director of Professional Defense at CBR