Ultrasound as the new stethoscope
This is an idea that’s been gathering pace for a while. It’s a few years since I was in general practice but, even then, I was starting to find that having ultrasound in the consult room was immensely useful for a lot of cases as a triage tool and extension of the physical examination. The World Health Organization now recommends them as a primary diagnostic tool in low resource environments.
https://onlinelibrary.wiley.com/doi/full/10.1111/medu.13714
Anyway, the technology is now here to make this a reality. For a few thousand pounds each vet can have a personal pocket ultrasound. In general practice that might average something like 20p per consult assuming a five year lifespan and 20 consults per day. Right now that will present a challenge to managers who are going to be faced with pricing decisions. Personally I feel that these reservations will rapidly be swept away by the wave of progress: it’s just so much better to be able to say instantly and with confidence whether a patient has a full bladder, a joint effusion, pulmonary oedema or a hernia. Standard of care for a cardiac patient in ICU might involve a 30 second sonographic examination of the lungs every couple of hours…. this is a modus operandi which has always been difficult to price up using conventional pricing menus for sonography in many practices. The war against the ‘quick scan’ may have been lost!
Happily, this won’t replace the need for specialised sonographers to perform systematic examinations and diagnosis any more than the stethoscope replaces cardiologists. If anything our experience is that it will increase demand for follow-up investigations of abnormalities identified by GP vets.
This is a good current review of the options on the market in the UK:
https://criticalcarenorthampton.com/2019/04/15/the-final-battle-portable-ultrasound-devices/
I’m feeling that one of these for each vet at <£5000 is a better investment for a practice than a £20,000 machine with a load of features which will scarcely be used.
