Clinical ultrasound in general practice: barriers to dissemination and drivers of training

Clinical ultrasound is gradually establishing itself as an extension of the physical examination. It enables general practitioners to better orientate their diagnosis, gain in autonomy and reduce unnecessary recourse to radiology. In France, however, its adoption remains slow, unlike in other European countries. What are the obstacles to its spread? And how can training become a lever for sustainable adoption?

Multiple obstacles to the integration of clinical ultrasound

A vague regulatory and financial framework

In France, clinical ultrasound is neither clearly defined nor recognized in the nomenclature. It is not systematically recognized as a GP skill, which limits its integration into daily practice.

Economic and organizational obstacles

Even if the devices have become more affordable, their cost remains an obstacle for many practices. Moreover, the time required to integrate ultrasound into a standard consultation is not always compatible with general practitioners’ work schedules.

Lack of initial and continuing training

The main obstacle is the lack of structured training. The majority of GPs were not trained in ultrasound during their studies, and continuing training opportunities are often ad hoc, non-certifying or ill-suited to the context of general practice. As the poster presented at the Congrès de la Médecine Générale France 2025 points out:

“The absence of mandatory university training in clinical ultrasound is perceived as a major obstacle by the practitioners surveyed” (Feraudet et al., 2025).

More widespread use in other parts of Europe

Several European countries have taken important steps towards the democratization of clinical ultrasound:

• Switzerland: Over 50% of general practitioners use ultrasound on a daily basis, thanks to a recognized training program and a well-established culture of use (Kuhn et al., 2020).

• Germany: Training is integrated into the medical curriculum, with ultrasound procedures financially rewarded.

• Denmark: Clinical ultrasound is taught as part of a training course and used by almost a third of general practitioners.

• Spain: Regional efforts have resulted in better-equipped health centers, with growing interest in on-site training.

These models show that a coherent policy, combining training, regulatory framework and material support, enables wider and faster adoption.

Ultrasound training for primary care

Clinical ultrasound is not intended to replace full radiological examinations. Its value is based on simple and frequent indications in general medicine: looking for urinary retention, confirming a suspicious image of cholecystitis, spotting a pleural effusion, etc.

Hybrid, practical and targeted training

To be useful and safe, this practice must be learned within a structured framework, including :

• supervised practical workshops to learn the right gestures ;

• contextualized clinical cases to develop reasoning skills ;

• and complementary digital tools, adapted to the pace and constraints of doctors in the field.

A number of studies have shown that GPs have a strong need for training that is accessible, practical and integrated into their practice.
Recent initiatives in this direction include practical teaching tools designed by and for general practitioners:

“The creation of standardized practice sheets, validated by expert consensus, aims to harmonize targeted clinical ultrasound practices in general practice” (Aubertin et al., 2025).

diSplay U/S: an innovative learning simulator

Among the tools available, the diSplay U/S simulator offers a realistic solution for learning clinical ultrasound without the need for special equipment. This online simulator offers:

• interactive healthy and pathological clinical cases based on real-life situations ;

• progressive training in image reading and analysis;

• hands-on learning and total accessibility, from any connected computer.

It enables doctors to practice on their own, reinforcing their visual reference points and gaining confidence, even before they have access to a real ultrasound scanner. It’s an invaluable complement to face-to-face training, promoting a smooth, gradual build-up of skills.

Conclusion

Clinical ultrasound is a valuable tool for enhancing the autonomy and relevance of care in general practice. In France, its development is slowed down by a lack of structured training, official recognition and organizational obstacles. However, experience in other countries shows that a proactive strategy – focusing on training, equipment and recognition – can bring about changes in practice.

A study carried out in France in 2023 confirms the concrete impact of targeted clinical ultrasound:

“Ultrasound modified management in 88% of cases, by influencing diagnostic orientation, imaging prescription or therapeutic initiation” (Feraudet et al., 2025).

Innovative tools such as diSplay U/S open up new prospects for enabling physicians to train autonomously and securely. Clinical ultrasound is not a technological luxury: it can become a mainstay of modern consultations, provided that access to it is facilitated.

References

• • Société Nationale d’Echographie en Médecine Générale (SNECHO-MG) – Aubertin, L., Aujoulat, P., Bouquet, S., Buron, S., Chabardes, A., Chauvin, B., Cibois-Honnorat, I., Dambor, A., De Bandt, D., Hagiu, D.-P., Leboucher, O., & Skendi, M. (2025). Harmonisation de l’échographie clinique ciblée en médecine générale : Développement de fiches pratiques standardisées [Poster]. Congrès de la Médecine Générale France 2025.
    https://posters.congresmg.fr/2025/pdf/57.pdf

  • Feraudet, I., Liard, R., Ibanez, G., Juillet, C., Andersen, C., Bach, M., & Skendi, M. (2025). L’utilisation de l’échographie clinique ciblée par les médecins généralistes en 2023 et son rôle dans la prise en charge des patients [Poster]. Congrès de la Médecine Générale France 2025. https://posters.congresmg.fr/2025/pdf/39.pdf

• • • Kuhn, A., & Dejours, C. (2020). Use of point-of-care ultrasound by general practitioners in Switzerland: a cross-sectional survey. BMC Family Practice, 21(1).

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    • Robert, A. (2023). L’échographie clinique ciblée : une extension de l’examen physique. Revue du Praticien.

    • Bornemann, P. et al. (2019). Assessment of primary care physicians’ use of ultrasonography as a decision-making tool. Annals of Family Medicine.