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Radiologists have been making diagnoses based on images transmitted over electrical wires in digital format since the introduction of ultrasound and CT in the early 1970s.

Just because something has been done doesn't make it right. There are physicians who have been prescribing over the internet without ever meeting their patient. Is this right and true to the pledge of beneficience? The Radiologists that I am involved with, use these kinds of services in conjunction with actually seeing the film and would never use it as a replacement. There is a huge difference between the two. When used in conjunction, it can be life saving, offering speed of diagnosis in certain situations. It is sort of like a pathologist who relies on a freeze fracture in middle of surgery, but later goes on to examine a specimen more comprehensively. It should not be relied upon as a replacement, and I would not use a radiologist that has adopted this approach.

I can only describe this sort of attitude as quaint and wholly uninformed.

Just call me quaint than. It is also quaint to abide by the virtues professed in the oath we take at the start of our medical careers. I feel I am bound by the principles of beneficience and 'to do no harm.' Remember those? It is sometimes hard to remember when technology permits us to become lazy. In this case there is a fine line between what is most beneficial to the patient and what is cost effective. My primary consideration is always about the patient, even if my practice has to take a bath. At the same time, a cost saving procedure that doesn't allow a comprehensive review of a given patient's needs is intolerable, and compromises the level of care. In this case, the fine line is between something that is a valuable adjunct versus a perilous substitute.

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