The Council of Medical Colleges of Catalonia (CCMC), chaired by Josep Vilaplana, president of the Gerona corporation, has reminded professionals in the autonomous community, in the midst of the Covid-19 pandemic and because of the increase in telematic attention in hospital and primary care, that “the virtual visit must comply with the principles of good clinical practice and with the provisions of the Code of Ethics, without forgetting that non-face-to-face consultations are not a substitute or equivalent to a face-to-face medical visit”.
They recommend, according to the Ethics Commission, that “the use of virtual consultation should not interfere with the basic principles of the doctor-patient relationship, which are mutual respect, independence of clinical judgment, patient autonomy and professional secret. ” And that “non-face-to-face consultation, made by telematic means, will be possible and fully acceptable with known patients who have an open and active medical history, about any circumstance that has occurred in the course of the care process or due to treatment modification or new prescriptions.”
The CCMC explains that the current situation, “due to eventual reassignments of tasks within the teams and possible incorporation of reinforcement professionals, may generate other different situations, such as the case of a patient who is followed up by telephone by part of a doctor who is not his usual one, but who has access to his medical history “, and that this case” would be comparable to that of a temporary replacement of the physician and, therefore, acceptable “.
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On the contrary, in the current circumstances, “consultations made with patients not known or historically asking for diagnoses, as well as pharmacological or other therapeutic prescriptions made in the course of a virtual consultation without prior physical visit, would not be ethically acceptable and, furthermore, the doctor would expose himself to a risk of civil and criminal liability. ” In these cases, “the role of the doctor must be strictly guiding and refer the patient to his or her referring doctor, to an emergency department or in person to the appropriate specialist.”
Exceptionally
Given the current circumstances of health emergency and lack of resources and the need to give the maximum possible protection to the health of the population, they admit that, “exceptionally, the doctor (with the limits of prudence that he believes should be adopted), attending to symptoms referred by the patient, can guide the diagnosis and give advice on treatment and conduct (either possible isolation of the patient or referral to the hospital), which it deems appropriate and also according to the guidelines of the health authorities. “
– The doctor must ensure the confidentiality of the content of the communication.
– The act carried out by telematic means must be recorded in the medical record, mentioning this circumstance. A copy of the documentation generated during the same will be kept.
– If it is necessary to prescribe medications, while the prescription of electronic public health has been developed for years and continues in force at the present time, in the case of private prescription, it is necessary for doctors to consult their College to to tell them, technically, how to do it.
