There was a time when the expression "Trust me. I'm a doctor" would not have had everyone falling over in laughter. Unlike politicians, who have always had a reputation for being dishonest and never waste an opportunity to confirm this reputation, doctors place great emphasis on professionalism and trust. This is as it should be if patients are to divulge their most intimate details and expect an opinion not influenced by anything but clinical considerations.
The present UK government, currently under investigation by the Metropolitan police for breaching their own regulations on electoral fraud, have always judged the professions by their own standards and imposed increasingly onerous regulation. At the same time there has been a move to replace professionals by untrained or minimally trained personnel with the mistaken belief that clinical judgment and professionalism can be replaced by strict protocols and close regulation.
Telemedicine, and in particular teleradiology, distances the doctor from the patient and the radiologist from the clinician and would seemingly demand extremely high levels of professionalism and trust or alternatively cast-iron regulation for the system to work. In the USA, physicians and radiologists offering out-of State consultation are required to be licensed to practice in that State. The UK seems less concerned with protecting standards. Before Mercuryhealthcare had their MRI contract withdrawn, their business plan involved sending the scans to Hungary for reporting. The reports were supposedly to be done by GMC registered radiologists but almost none had qualified or trained in the UK or sat any UK examinations. It is questionable whether, a few years ago, many of these people would have been recognised as doctors let alone as radiologists. At the time the GMC was so desperate to maintain its position in charge of medical regulation that they acceded to Government demands that European qualifications be recognised as of equal value and offered GMC registration to these overseas doctors.
Last week I received an invitation from a company in India offering teleradiology which I reproduce in full (emphasis mine- name deleted):
"Hello Doctor !
We provide teleradiology pre reading & reporting services from India by the name of XXXX XXXX Ltd.
XXXX XXXX Ltd.offers complete, round-the-clock, fast & 98.9% accurate teleradiology services for hospitals, clinics and physicians.
We have a panel of 30 dedicated & experienced Indian radiologists interpreting MRI, CT Scans & ultrasounds. All radiologists are MD & FRCR
some of them having more than 7 years of experience in the field. We have a setup at the city of Delhi in India. We use the most
advanced technology /RIS /PACS/ Synapse/Emed that enables a rapid transmission and interpretation of diagnostic medical images.
Since in US, You need license for each state , so we can not operate directly by the name of our esteemed radiologists .So, we cater to few
US based radiologists and teleradiology who operates by their name but outsource the work to us.So less overheads and more
quality productivity for them with 98.9% accuracy level.
Our 30 MD radiologists each can read and report 16 cases a day at 12 hrs TAT (turn around time) and yet excel in terms of quality of reports. We
usually, start with a pilot service which comprises of few 4-5 test cases and then do some back log cases with 1-2 days TAT. As we get
comfortable working with each other we go live with 12 hrs TAT cases. We suggest a test sample/pilot Project to know our quality and competency level.
To ensure customer satisfaction and quality, our Quality Measurement processes document your radiologists evaluation of each PreReads accuracy. Our
Medical Quality Improvement Board reviews aggregate statistics and individual studies in an effort to help your radiologists guarantee the highest degree of clinical quality. The Board also conducts random evaluations of completed PreReads from our personnel.
We are currently looking forward to foray into the UK and EU markets for which we already have FRCR radiologists in our pannel.We shall be highly privileged to forge any alliance /collaboration with such an eminent company like you. We look forward to a long term mutually beneficial relationship with you .Hope to hear from you real soon with more of your kind suggestions.
Thanks & Regards"
So even the strict US regulations have been bypassed. It just goes to show; where money is involved the dishonest will always outwit the regulators. As Nu Labour and Societe General have found out and UK patients will soon find out.