Doctors inform badly about IGeL

Study reveals information deficiencies at IGeL

08.11.2012

Individual health services (IGeL) continue to lack transparency. The behavior of physicians in the sale of individual health services has been criticized several times in recent months. Now, the Federal Ministry of Consumer Protection has published a study that more precisely analyzes the information offered by the IGeL.

Individual health services are generally to be paid by the patients themselves to the doctor. In addition, the IGeL may only be offered on request or initiative of the patient. „In order to assess performance and to be able to select the optimal offer, patients are dependent on clear information - but unfortunately they often do not receive it“, said the Federal Consumer Protection Minister Ilse Aigner (CSU) at the presentation of the current study results in Berlin.

More than 350 individual health services available
On behalf of the Federal Ministry of Food, Agriculture and Consumer Protection, experts from the Institute for Health and Social Research (IGES) and the Institute for Medical Law at the University of Cologne have examined the information offered by the IGeL on the Internet and in medical practices. "IGeL's offer includes more than 350 additional services, ranging from the early detection of various diseases to sports or travel medical examinations and cosmetic surgery." All IGeLs have to be paid for independently by the patients, with costs ranging from 5.36 euros for the less painful high-pressure injection of pharmaceuticals or 30 euros for the glaucoma screening tests (glaucoma) and several thousand euros for beauty surgery. A detailed information of the patients about the possibilities of the IGeL and the associated costs is therefore essential.

Deficits in transparency and information on the IGeL
„Patients have a right to transparency - here it is still sick in some places“, explained the Federal Consumer Minister. For instance, individual health services often lack the transparency and informative value of the information offered. The current study underlines the need for better information and education, especially by the doctors. Although the research has shown that there are adequate opportunities for information, the difficulty for patients is identifying them. For example, it is particularly sound and detailed „the Internet portal www.igel-monitor.de of the medical service of the umbrella organization Bund der Krankenkassen (MDS), which has been in existence since the beginning of the year.“ Here, the patients are offered a good overview of the advantages and disadvantages of the IGeL. The information in the doctors' offices, however, according to the current study results, according to clear deficits and do not represent reliable consumer information. However, the selection was not representative, according to the study authors. The information offered was evaluated on the basis of aspects such as information content, neutrality, comprehensibility and clarity.

Reliable information required by expert medical staff
According to the authors of the study, reliable and transparent patient information is an indispensable prerequisite for individual health care in order to protect patient rights. „Before a measure, the patient must always have the opportunity to weigh the pros and cons of the treatment measures“, emphasized the Federal Consumer Minister Ilse Aigner. The education of patients must be done by competent medical staff, as required by law. Here, too, sees the patient representative of the Federal Government, Wolfgang Zöller, need for improvement. „Although the demand for the IGeL must come from the patient and not from the doctor and a written contract must be made, there is often a lack of transparency and factual information“, explains Zöller in the current press release of the Federal Ministry of Consumer Affairs.

Patient rights law without improvement at the IGeL
Wolfgang Zöller expects the patient rights law to significantly improve patient information at the IGeL: „With the introduced patient rights law, we also strengthen the rights of patients to information.“ Accordingly, physicians must inform their patients about the expected cost of treatments that are not included in the catalog of benefits of statutory health insurance (SHI). There is also an obligation to inform about the benefits and risks of the measures, as well as about possible treatment alternatives. However, the Federation of Consumer Advocates criticized the design of the Patient Rights Act. This weakens the patients' rights in individual health services and makes it even easier for doctors to sell the sometimes highly controversial health services.

IGeL: A worthwhile business for doctors
According to the information provided by the Federation of Consumer Advocates, the IGeL are a thoroughly rewarding business for the medical profession „in Germany at least 1.5 billion euros annually“ be implemented. „Many doctors take advantage of patients' trust when they turn from helper to salesman“, explained in mid-October Gerd Billen, chairman of the Federal Association of Consumer Affairs. Citing a nationwide online survey from April to June 2012, in which more than 1,700 consumers were involved, reported the Federal Association of Consumer Services that patients at the IGeL often not enlightened in the prescribed manner and also influenced by massive advertising. Also, the patients received „in some cases not even a contract or an invoice“, complained the Federal Association of Consumer. Here there is an urgent need for action, because the „Self-payer benefits are meant to serve the health, not to fuel the prostate mentality of some physicians“, so the conclusion of Gerd Billen.

Medical profession under pressure
The current study by the Federal Ministry of Consumer Affairs has put pressure on the medical profession to remedy the information deficit in the sale of the IGeL. A new revised IGeL guidebook for doctors and patients is intended to remedy this situation. In this way, the discussion can be re-objectified, said the German Medical Association and the Kassenärztliche Bundesvereinigung (KBV). Because in individual cases, IGeL medically quite useful and therefore you can not deny that in principle the right to exist, stressed the President of the Federal Medical Association, Frank-Ulrich Montgomery. However, both the president of the medical office and the head of KBV Andreas Köhler underlined the importance of doctors responsibly handling the IGeL and adhering to clear rules. (Fp)

Read on the topic: IGel services of doctors:
IGeL services often unnecessary at the doctor
Health insurance companies want to restrict additional benefits
Doctors are selling more and more benefits
Doctors as sellers of additional services
Doctor appointments: Cash patients are disadvantaged
Barely useful additional services at the doctor
Which IGeL services really make sense

Picture: Paul Golla