Exams without medical order

The Brazilian College of Radiology and Imaging Diagnosis receives several queries from members regarding the examination without a medical request, that is, the patient who comes to the imaging service spontaneously, wanting to undergo an examination. Article 37 of the Code of Medical Ethics is emphatic in prohibiting the prescription of treatments or other procedures without direct patient care. It can be seen that the diagnostic examination is complementary in nature to the care provided to the patient by the attending physician, corroborating the identification of the diagnosis, but without disregarding the necessary evaluation of the information collected in the physical examination and the clinical history. That is why, in most cases, it is important for the attending physician to request the examination, so that he is not subjected to unnecessary medical procedures. However, when a patient appears spontaneously at the imaging service, it is possible for the radiologist to assist him, carrying out the examinations, if deemed necessary, due to his professional autonomy. It is enough for this professional to fully assume professional responsibility for the act performed, always aiming at the best interest of the patient. In this sense, including the conclusion of the Federal Council of Medicine, in its opinion nº 18/15: “The request for complementary exams, subject to the exceptions mentioned above, can only be made by physicians. In the referred case, in which it is a question of spontaneous demand, the consultant may only perform the questioned examination, and others that constitute a medical act, if she assumes responsibility for the request, for the procedure and for guiding the patient on the necessary care”. It is interesting to note that, through this understanding, not only is the radiologist's autonomy assured to perform the examinations he deems relevant, provided that he assumes full responsibility for the act, but also the certificate that the request for complementary examinations is a medical act, Requests from other professionals should not be accepted, except in some rare exceptions (eg dentists). CBR Legal Advice