A&E UPSIDE DOWN - DOCTORS COMPLAIN ABOUT DANGEROUS PROCEDURES - DIAGNOSIS CANNOT BE MADE WITH A DELAY - Filenews 17/4
The doctors in the Accident and Emergency Departments of state hospitals are upside down after the decision of the State Health Services Organization to proceed with the purchase of services from a private body abroad for the opinion of X-rays performed on patients who are looked after in the A&E for service.
The discomfort of the doctors does not concern the process of telediagnosis itself, during non-working days and hours, but the way in which it is attempted to be applied in an A&E environment, as, on the one hand, as they reported to "F", they are asked to fill in a very "demanding", as they characterize it, document before the electronic registration of the exams and on the other hand their immediate service is not ensured, As private radiologists who are abroad are given the time limit of 7 days to deliver the opinions.
In fact, from the very first days, tensions began to arise between doctors, with the Pancyprian Guild of Government Doctors, making a relevant reference in a letter sent yesterday, in protest, to OKYPY: "PASYKI states with absolute clarity that it will not allow the creation or exacerbation of differences between doctors of different specialties, which are already recorded as a direct consequence of such wrong administrative choices. The shifting of responsibilities, the ambiguity of roles and the lack of a clear operating framework cannot lead to intra-medical controversies. Doctors are not and cannot act as recipients of administrative failures."
"The seven-day procedure," he told "F", "was applied until today for the purposes of registering claims for compensation in the context of the GHS and the opinions were given for a small fee by the radiologists of the hospitals. This was a not so safe process from the beginning, because the doctors of the A&E were asked to "read" the x-rays in order to manage emergencies, however, there was always the immediacy and easy access to doctors of the specific specialty in cases where there was a need. Now, we are going to make official, possibly, a wrong practice."
The Pancyprian Guild of Government Doctors has sent, so far, two letters to OKYPY, requesting a dialogue to determine safe procedures, criteria and conditions for the implementation of telediagnosis in the A&E.
"This decision, in addition to the serious legal issues that have already been documented, raises key and essential issues of practical application, which directly affect the safety of patients, the quality of the services provided and the very core of the medical practice," PASYKI states in its latest letter and adds: "At the operational level, the doctors of the A&E are called upon to be included in a process that is de facto time-consuming and incompatible with nature and the requirements of emergency medicine. A&E operates under pressure, with a need for immediate, documented and often decisive decisions for the patient's outcome."
"The most worrying," says PASYKI, "is not the operational dysfunction, but the very philosophy that seems to govern this regulation. While the primary goal of any such measure should be the immediate and reliable opinion of the X-rays, for the benefit of the clinical management of the patient, it appears that in practice the priority is shifting. The provision for the possibility of submitting opinions within a period of up to seven (7) days, in order to ensure administrative and financial processing vis-à-vis the GHS, demonstrates that timely medical evaluation is not the central axis of the regulation."
This approach "is not only problematic but also dangerous", while "a fragmented and unclear framework of medical responsibility is created, in which one doctor requests the examination, another gives an opinion (possibly outside the system and at a later time) and another bears the direct responsibility for making critical clinical decisions".
The doctors, in their letter, also raise financial issues, wondering if "it has been documented that the choice to purchase tele-diagnostic services from a private body abroad actually leads to a reduction in the costs of the Organization".
Medical practice "cannot be subordinated either to time frames that serve economic mechanisms, or to choices that are not documented in terms of cost and benefit".
Therefore, PASYKI concludes in its letter, the union, "has no choice but to reject this action, as undocumented, unsafe and unacceptable from a medical and institutional point of view and to proceed to inform its members about the consequences and risks arising from its implementation. The Organization is called upon to immediately review the existing framework, ensuring immediate and substantial radiological support of the A&E Departments, clear and unambiguous delimitation of medical responsibility, prevention of intra-medical conflicts and full financial transparency and documentation of its choices."
