Health
Controversial doctor services: Government plans patient protection
“It is clear that an update to the outdated Patient Rights Act is needed.” photo
© Tom Weller/dpa
They are intended to help detect cancer, survive strenuous journeys or slow down certain aging processes – self-pay services from the doctor. Are there any bans due to lack of benefit?
According to the coalition’s health politicians, patients should be better protected from controversial self-pay services in the doctor’s office.
“Services that are described as harmful by medical societies have no place in doctors’ offices and should be banned,” said Federal Patient Representative Stefan Schwartze (SPD) to the Germany editorial network. More “protection against non-evidence-based treatments” is needed, demanded the health policy spokesman for the Green parliamentary group, Janosch Dahmen. These are treatments whose effectiveness has not been proven.
“It is worrying to what extent individual practices have focused on lucrative IGeL services instead of providing essential services in accordance with the state of science,” Dahmen told the German Press Agency Berlin. These so-called individual health services (IGeL) are not covered by statutory health insurance companies and must be paid for by the patients themselves. Through their massive IGeL offering, the relevant practices are discrediting the honest and important work of the overwhelming majority of medical practices, says Dahmen.
Ultrasound of the ovaries
Schwartze said, citing research, that the vast majority of IGeL offerings have no discernible benefit. “Some are even harmful because they often provide false positive results and thus lead to unnecessary further examinations and interventions.” This applies to ultrasound examinations for early cancer detection of the ovaries and uterus – one of the most sold services. “Here, young women are unnecessarily put into fear and terror.” Gynecological societies rejected them.
In fact, according to the IGeL Monitor from the health insurance medical service, there is a lack of evidence of any benefit from this ultrasound examination. Almost all practices offer this method. According to studies, no fewer women die with ultrasound than without it. “On the other hand, the examination causes women to be unnecessarily worried and can lead to unnecessary removal of the ovaries and complications during operations.” An AOK “fact box” states: “Suspicious ultrasounds are almost always false alarms, which additional blood tests rarely reveal.”
The professional association of gynecologists rejected criticism of the method. It is a comprehensive ultrasound examination of the uterus, fallopian tubes, ovaries and urinary bladder. In addition to a tactile examination, this is advantageous for overweight girls and women, for example. A possible treatment is then based, among other things, on the symptoms and course. “The general claim that an ultrasound would result in useless operations is false (…).” Schwartze’s claim that gynecological societies reject this ultrasound examination is also incorrect.
Update on patient rights
Overall, Dahmen spoke out in favor of more patient rights. “It is clear that an update to the outdated Patient Rights Act is needed,” said the Green politician. Transparency for patients must also be increased and rules for the largely digital documentation of treatments must be updated. The planned law to strengthen health care should also better finance primary care.
Federal Health Minister Karl Lauterbach (SPD) announced a reform of patient rights last year. Dahmen said: “To ensure the laws are implemented quickly, all coalition partners must now pull together.” The Patient Rights Act came into force in 2013, for example with a right to inspect patient files and support from health insurance companies if treatment errors are suspected. According to Schwartze, the traffic light coalition wants to make it easier for victims of medical errors to get justice in the future. Discussions with Federal Justice Minister Marco Buschmann (FDP) about reforming the Patient Rights Act are on the right track.
Doctors: “Don’t demonize IGeL”
The IGeL services have been criticized for years. The consumer advice centers warned: “Since the range is broad and constantly expanding, patients hardly have a chance to check and compare the medical benefits as well as the quality and price of the offers.” In practice, you should first ask for time to think about it and then obtain independent information later.
However, Germany’s statutory health insurance physicians warn: “IGeL services should not be generally demonized,” as a spokesman for the National Association of Statutory Health Insurance Physicians said. The German Foundation for Patient Protection said: “The ban on self-paying offers is well shouted, but practically impossible to implement.” Foundation board member Eugen Brysch: “Ultimately, every cosmetic service provided by the doctor would also be included.”
The committee responsible for the health insurance benefit catalog emphasizes the scientific basis of the official procedures. The Federal Joint Committee relies on scientific evidence in the further development of health insurance benefits, said committee member Monika Lelgemann. “Because new doesn’t automatically mean better or safer.”
According to a study by the AOK Scientific Institute, doctors with IGeL are increasingly targeting insured people with higher incomes – those with higher household incomes were offered an IGeL service significantly more often than those with lower incomes.
Interview Schwartze consumer center on self-pay services IGeL checklist from KBV and BÄK IGeL monitor from AOK Report Lauterbach wants to expand patient rights