/arc-anglerfish-arc2-prod-infobae.s3.amazonaws.com/public/SPYBEYMYEZBNFMFYCZ62IZN3HE.jpg "Medical care in times of coronavirus")
Hippocrates, famous doctor to whom we all owe the ethical guide in our daily behavior as doctors, expresses -through what we now know as Hippocratic Oath-, the commitment to respect our teachers, to communicate what we have learned to our disciples, to act in benefit of the patient, consider colleagues as brothers, have respect for human life; in short, a series of precepts that as we see are expressed in terms of functions, “mandates” to be fulfilled, without specifying the “how”, as long as we do not depart from ethics itself.
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Our role as doctors is to contain the patient, treat their ailments and prevent the disease if possible, respecting these guidelines.
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The way it was historically done was through direct, face-to-face contact, in the presence of the doctor and the patient, in the same time and place.
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A new “how”, the telehealth, understood as all the health actions facilitated by Information and Communication Technologies (ICTs) to overcome the geographical, social and cultural barriers of the health system, has emerged more than a decade ago; and the teleconsultation, remote consultation between a professional and a patient, as a part of that.
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This, like any solution, is not intended to cover all possible scenarios, or all actors, hence it cannot and should not solve all the problems that afflict a patient.
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In the context of the current health crisis, he takes the stage, takes center stage, given the obvious need to solve problems while respecting distance.
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In concrete terms, its potential lies in treating mild symptoms, alleviating doubts, suggesting in-person assistance by a specialist, as well as preventing crowds in the hospital guards and with it future respiratory infections.
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The governments of Canada (through Telus, a national telecommunications company), Rwanda (in conjunction with the Bill and Melinda Gates Foundation), and the United Kingdom (through the NHS itself) have entered into agreements with Babylon Health, a telemedicine company, born in the UK in order to shorten patient waiting times to be seen by a specialist, issue electronic prescriptions, as well as avoid unnecessary mobilization of patients to the guards; in short, they adopted it as one more tool of the national health system to fulfill its objectives.
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In our country, on 04/01/20, the Superintendency of Health Services (SSS) issued a resolution that forces insurers and prepaid medicine entities to promote and use telecare and / or teleconsultation platforms, during the quarantine period. The Argentine Pediatric Society, likewise, was issued through “Recommendations to carry out a cideoconsultation”, within the framework of Covid-19.
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As of today, companies that provide this service are already operating: Online Doctors, Calling the Doctor, MyDDoc, among others; in fact, the technology to make this happen is ubiquitous and free (WhatsApp, Zoom, Hangouts, Skype), the only requirement of the SSS for the use of the platforms is that they are subject to subsequent audit, that is, that there be a record that said communication has been made.
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Criticisms and oppositions are presented daily in relation to this modality. Starting with the contrast, not real, of the need for a physical examination in person, without taking into account that it can be a complement, not a replacement, of the in-person meeting with the professional; until the discussion about who and how is paid / charged for this service.
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As an eclipse, today they are aligned, almost by chance, for a brief / relative period, the need to treat / prevent a disease, the technologies that make it possible and the will of political / scientific decision-makers to use them in a framework of legality.
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Perhaps it is time to stop outside the dogmas, to see the benefits over the deficiencies, to understand that no tool can be applied to all imaginable scenarios, or unimaginable as the current situation is, nor in all time periods alike.
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As you can learn from mythology, the problems were and will be similar in history, like a father’s concern for his son. Zeus afflicted by Hercules, irate, persuades him to go to the Delphic oracle to speak with timeless Hippocrates, who contains him remotely, out of linear logic. Hercules dodges his death and Zeus rewards Hippocrates who writes his Oath, in terms of functions, compatible with times of oracles, telegraphs or simple computers to help us “circumstantially and temporarily” to alleviate a global health crisis.
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