put your foot in the door
entering a business or organization at a low level, but with a chance of being more successful in the future: Networking can help you get your foot in the door when it comes to landing a job.
One of my favorite expressions in English is this. “Get your foot in the door.” Its application is not very far from the so-called “to have one foot in”, which means that a process is in motion and well directed.
For the following exhibition, opt for an adaptation of traditional use. In other words, taking advantage of the door opening, put your foot down to stop it, increasing the probability of entering, therefore, increasing the probability of success.
Para a exposição que se segue, opto por uma adaptação do uso tradicional. Ou seja, aproveitando que a porta se abriu, coloca o pé para não deixar fechar, aumentando a probabilidade de entrar, logo, aumentando a probabilidade sucesso.
Telemedicine
In the case of telemedicine in Brazil, the door has been constantly closed by the CFM. Recently (I choose this word and it immediately occurs that more than a year has passed), some progress seemed to have occurred, but CFM RESOLUTION No. 2,227/2018, Published in the DOU of February 6, 2019, was revoked . No door opened. The CFM came to the window, heard what he had to hear, decided as he understood, that is, without deviating too much from the guidance that was already being followed.
For those who divide their lives between Portugal and Brazil, phrases that point to times of crisis as times of opportunity for those who want to undertake are clichés.
But, interestingly, what has been available to read for at least 6 years, about the need for remote assistance for more remote locations (rural, according to most US publications, such as this one and this one ) or for locations which, not being on the outskirts, are difficult to access ( another interesting read ) has been ignored by the CFM and by those who have the power to change current legislation and allow access to the more careful population . Did you know that, in 2019, Portugal celebrated 20 years of telemedicine? In Europe and around the world, changing habits is booming. It’s not just about coexistence and socialization habits or work habits, the relationship with health care has already changed . In 2018, an estimate by the European Commission was that the global telemedicine market would reach 37 billion euros by 2021, with an annual growth rate of 14%. There is no doubt, the numbers will be exceeded, the virus and the fear of contagion are leading people to consider these appointments more routine and making them essential. However, it is necessary to understand that, in the same way that isolation and quarantine have already caused problems with the speed of home internet in several countries, several health institutions in the USA announced that the high volume of transfers caused systems to be overloaded and, in in some cases, unavailable.
For me, who testifies to the thirst that Brazilian entrepreneurs have to put an end to the technological lag that exists in relation to the USA, Europe or China, it is surprising to see how the CFM manages to keep Brazil behind Portugal for two decades. This could lead to a discussion of old- straight- white men who are in power, but for that to happen it would be necessary for there not to be old- straight-white -men associated with men and women, white or not, straight or not, who fight each other . daily for a more advanced Brazil. It would be enough to get CFM to open the door. But not.
It took a virus. A pandemic. It was necessary for a calamity to arise that affected everything and everyone, for the CFM, on March 19, 2020, to send a letter to the Minister of Health, Luiz Henrique Mandetta , communicating the decision to “recognize the possibility and ethicality of using telemedicine in the country, in addition to what is provided for in CFM Resolution No. 1,643/2002, which remains in force. The decision is valid on an exceptional basis and for as long as the fight against the COVID-19 epidemic lasts”.
COVID-19 is the foot in the door.
The pandemic is one such opportunity that arises from the crisis. (That’s how beautiful it seems when some people are well and say this from the height of their well-being to those who are unemployed and take a bike to make deliveries, or rent a car to “do Uber “…) But here it is something much more global. It is something that can have a significant impact. There was a response to go against the CFM, not everyone has the strength of Amil or Einstein , or the Hapvida group:
“Telemedicine has already been used in care by Hapvida ‘s own network for seven years, serving around 8 thousand patients per month. The operator has 24 rooms equipped with high-quality videoconferencing systems in sound and image, equipped with 40-inch TVs and cameras that provide 20-fold magnification of images to facilitate diagnosis. The patient’s entire history is recorded remotely in the electronic medical record.”
“A telemedicina já é utilizada nos atendimentos pela rede própria do Hapvida há sete anos, atendendo a cerca de 8 mil pacientes por mês nesta modalidade. A operadora conta com 24 salas equipadas com sistemas de videoconferência de alta qualidade em som e imagem, equipadas com TVs de 40 polegadas e câmeras que conseguem aumentar em 20 vezes as imagens para facilitar o diagnóstico. Todo o histórico do paciente é anotado no prontuário eletrônico à distância.”
Seven years! Now it is a door that is opening and doctors and institutions from all over Brazil will be able to put their foot in and prevent it from closing. Just like Uber or 99, which operated while states and the federal government talked about regulation, telemedicine is here to stay.
The Minister of Health, Luiz Henrique Mandetta , who has been exemplary, competent and sensible in the midst of government mismanagement, once again did what he should and the Ministry of Health published in the Official Gazette regulating telemedicine and allowing teleconsultation (direct doctor to the patient) during the pandemic period, allowing to specify and issue certificates electronically, following the guidelines of the ordinance.
A foot is put in the door. However, to achieve this, doctors and healthcare professionals who use available telemedicine tools must not engage in any unethical or commercial behavior that could jeopardize all the benefits offered by the use of telemedicine. Companies that develop tools need to absorb international examples to avoid errors in use, creating codes of conduct and compliance standards that help users, and that, in the case of SUS, realize that a strong network is needed to support them. millions of Brazilians who have the right to use it, to receive quality care, regardless of where they are.
