Previously on our news page, our ultrasound probe repair laboratory highlighted a book about the dangers of prenatal ultrasound. At the end of that article, we wrote that “other issues are currently being debated by health professionals” in relation to ultrasound probes. This is particularly true of the use of ultrasound in general practice. Indeed, while some are in favour of the use of ultrasound in general practice, some health professionals take a more cautious view… and others are against!
These different positions can be explained in part by the cost, but also by the waiting time for an ultrasound scan. There are also counter-examples from other countries.
The three points of view
What should we think about ultrasound in general practice? This question leads to three positions. There are the “proponents”, the “cautious” and the “reluctant”.
1 – “There is a battle to be fought”.
On the pro-ultrasound side in general practice is Dr Parmentier of the Société Scientifique de Médecine Générale (SSMG). In an article for medi-sphere.be, he says: “We must fight for recognition like in the Grand Duchy of Luxembourg, France and Germany, where there are codes for clinical ultrasound. This would reduce social security and health care costs, provided the examination is carried out correctly. It would also reduce the patient’s exposure to radiation“.
In a completely different field, physiotherapists have already spoken out in favour of using ultrasound in their practices.
Last but not least, the Centre Francophone de Formation en Echographie (CFFE) has come out in favour. According to the CFFE, an ultrasound probe is a “fantastic tool” for general practitioners. A tool that can be used in their daily consultations. So much so, in fact, that the ultrasound probe is the stethoscope of the future!
2 – Think before you act
As mentioned above, some healthcare professionals take a more measured approach. To avoid abuse! Dr Nys, of the EBECHO association, explains that a protocol must be put in place to determine “when to do it and when not to do it… My clinic is not set up to do emergency ultrasound scans instead of the hospital. That’s not the aim and it’s not our role. It complements our diagnosis”.
3- On the other side
Finally, on the other side, there are the radiologists who say they are “reluctant” to see GPs using ultrasound.
How much does it cost?
There is also the question of the cost of the consultation and how it is paid for. Dr Parmentier says: “It doesn’t necessarily have to be more expensive. Many countries have already thought about this. They have put safeguards in place. Let’s not reinvent the wheel. He also points to the cost of installation, which “can vary from 12,000 to 25,000 euros”.
The situation in Belgium and France
Dr Parmentier also highlights the excessive waiting times for ultrasound scans in Belgium. As a reminder, waiting times for ultrasound scans are also considered too long in France. This has been the case for several years.
“In some parts of the country, it takes more than a month to get an examination. The time is reduced if you pay more in private centres, which isn’t good. But you have to be aware of the limitations of POCUS (point-of-care ultrasound): If a patient comes to me and asks for a liver scan without an examination or history, I won’t do it… but the demand is there. Of course, GPs should not be allowed to carry out ultrasound ‘off the cuff’, without any clinical questioning or training. This would be completely counterproductive and risk overdiagnosis and overtreatment. The World Organisation of General Practitioners (Wonca) is very clear on this point.
Quebec: the counter-example!
Dr Nys, who favours the creation of a protocol, wants to prevent the system from going off the rails.
This position is reminiscent of what happened in Quebec in 2017. At that time, the country wanted to reduce the waiting time for an ultrasound from 5 weeks to less than 2 weeks. In order to achieve this, as of 1 January 2017, every ultrasound scan was paid for by the government. However, this decision has had the opposite effect. Waiting times have risen to 11 weeks in a very short time. The budget for these examinations also exploded, increasing by 30%. The cure was worse than the disease: our laboratory, which specialises in repairing ultrasound probes, devoted several articles to this crisis between 2017 and 2019.
