Unnecessary surgery First doctor gets out

Second opinion portal: The Dresden head physician Prof. dr. Hans Zwipp quits the project "Unnecessary Operations"

23/08/2011

The Remote Diagnosis Portal opened last week „Careful operations“. Instead of a premature operation, patients can get a second opinion from experts. As a result, however, it hailed clear criticism from the part of the specialist medical associations. For information from „DNN-Online“ has now the Dresden University doctor Prof. Dr. med. med. Hans Zwipp was the first medical doctor to cancel his participation in the Ärzteportal. Opposite the sheet, a spokeswoman confirmed the exit.

At first, it looked as if the portal could become a terrific success against unnecessary operations. After all, 150 patients have already turned to the project and asked for help. The aim of the offer is to prevent unnecessary and even harmful operations on the back, knees, shoulders or hips. Finally, the medical interventions have increased massively in recent years. But after the first week of commissioning it hailed clear criticism (we reported). Thus, the professional association of established surgeons called the remote diagnosis as „highly dubious“. After all, when creating a second opinion, a doctor would not only have to look at the patient with documents and x-rays, but also in person as a whole. Especially the obvious diagnosis is crucial when it comes to the question of performing a medical procedure or not.

A total of 16 medical specialists want to participate in the online platform. One of them has officially canceled his participation. The Director of Trauma and Reconstructive Surgery of the Dresden University Hospital, Prof. Dr. med. Hans Zwipp, has his cancellation officially confirmed by a spokeswoman. According to the spokeswoman is the reason for the rejection, the ongoing discussion about the seriousness of the portal. Patients have to pay fees between 200, 400 and 600 euros to get a second opinion. Further information did not want to make the chief physician of the university hospital. Zwipp was designed as an expert for foot interventions.

In order for patients to receive a specialist second opinion, they must complete a questionnaire containing 100 questions. In addition, medical reports, X-rays and laboratory findings must be sent. Thereafter, the responsible physician creates an offer with a cost note. Those who agree to the costs will receive a diagnosis after fourteen days, as well as an assessment of whether surgery makes sense.

The knee specialist and professor Prof. dr. med. Hans Pässler is one of the initiators of the portal. He defended the idea because in his opinion too many operations are being carried out in Germany. „We have twice as many knee operations as in France, Sweden and Australia“, explained the Heidelberg physician to the Dresden newspaper. The doctor suspects that financial interests are behind it. Instead of paying the head physicians fixed wages, basic salaries are paid with an additional bonus. „The better they fulfill the budgeting of their clinic, the more money they receive in the form of bonus payments“, reminded Pässler. For example, if only 80 out of the planned 100 surgeries carried out, the allocations are downgraded by the health insurance companies. The doctors at the clinics are thus supposedly forced to operate, said Pässler.

Individual associations, however, storm the idea of ​​the portal. In the opinion of the Association of Registered Surgeons and the Professional Association of Specialists in Orthopedics and Traumatology (BVOU), the diagnostics are not sufficient if the patient is not even self-assessed. It is mistaken for a second medical opinion with a medical second reading, according to the BVOU. A second opinion could not be created only by submitting the patient documents.

Although the company health insurance funds have already signaled interest, however, the positive signals of the health insurance funds are limited. The AOK points out that a second opinion already belongs to medical practice. Anyone who is unsure, could ask a second doctor for no cost to his opinion, as a spokesman for the box office pointed out. The Techniker health insurance (TK) referred to own offers. There, patients can e.g. ask for independent expertise as part of a back pain center. The TK confirmed the high number of unnecessary operations. A quota of more than 80 percent was determined at the cash-specific centers.

The fact is that in Germany the number of operations has increased. The more doctors are located in a region, the more often the scalpel is used. Alternative models that cost significantly less, but which, according to many studies, are sometimes more effective, are not budgeted. In the future, health insurance companies must ask themselves whether they are prematurely delivering patients to the surgeon. The portal could be of help, but a faint aftertaste remains: the patients remain sitting at the extra cost, although an independent second opinion would be part of daily practice. (Sb)

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Picture: Martin Büdenbender