Doctors give poor information about IGeL

Study reveals lack of information at IGeL

There is still a lack of transparency in individual health services (IGeL). The behavior of doctors when selling individual health services has been sharply criticized in recent months. The Federal Ministry of Consumer Protection has now published a study that analyzes the information on IGeL in more detail.

Individual health services are generally to be paid for by the patient himself at the doctor. In addition, the IGeL may only be offered upon patient request or initiative. "In order to assess services and be able to select the optimal offer, the patients need clear information - but unfortunately they often do not receive it," said Federal Consumer Protection Minister Ilse Aigner (CSU) when presenting 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 examined the information on IGeL on the Internet and in medical practices. "The IGeL offer includes more than 350 additional services, which range from the early detection of various diseases to sports or travel medical examinations to cosmetic surgery". All IGeL must be paid by the patient independently, with costs ranging from 5.36 euros for the less painful high-pressure injection of medicines or 30 euros for glaucoma screening tests (glaucoma) to several thousands of euros for cosmetic surgery. It is therefore essential to provide patients with detailed information about the possibilities of IGeL and the associated costs.

Deficits in transparency and information on the IGeL "Patients have a right to transparency - here it still suffers in some places," said the Federal Minister of Consumer Affairs. For example, there is often a lack of transparency and meaningfulness of the information provided for individual health services. The current study underlines the need for better information and clarification, especially by doctors. Although the study showed that there are adequate information options, the difficulty for patients is to identify them. For example, the “Internet portal of the medical service of the Central Association of Health Insurance Funds (MDS), which has been in existence since the beginning of the year, is particularly well-founded and rich in detail.” Here, patients will get a good overview of the advantages and disadvantages of IGeL commanded. The information in the doctor's offices, on the other hand, shows significant deficits according to the current study results and does not represent reliable consumer information. However, according to the study authors, the selection was not representative. The information provided was assessed on the basis of aspects such as information content, neutrality, comprehensibility and clarity.

Reliable information required by specialist medical staff According to the study authors, reliable and transparent patient information is a mandatory prerequisite for individual health services in order to protect patient rights. "Before taking a measure, the patient must always have the opportunity to weigh up the pros and cons of the treatment measures," emphasized Federal Consumer Minister Ilse Aigner. The education of patients must be carried out by specialist medical personnel, as is also provided for by law. The patient representative of the Federal Government, Wolfgang Zöller, also sees the need for optimization here. "Although the demand for IGeL has to come from the patient and not from the doctor and a written contract has to be signed, there is too often a lack of the necessary transparency and factual information," explains Zöller in the latest press release from the Federal Ministry of Consumer Affairs.

Patients 'rights law without improvement at IGeL Wolfgang Zöller hopes that the planned Patients' Rights Act will improve patient information at IGeL considerably: "With the introduced Patients 'Rights Act, we are also strengthening patients' rights to information." According to this, doctors have to inform their patients about the expected costs of the treatment inform, which are not included in the benefits catalog of the statutory health insurance (GKV). Information about the benefits and risks of the measures and possible alternative treatments is also required. The Federal Association of Consumer Centers, however, criticized the draft of the Patient Rights Act. This weakens patient rights in individual health services and enables doctors to sell health services, some of which are extremely controversial, more easily than before.

IGeL: A profitable business for doctors According to the Federal Association of Consumer Centers, the IGeL is a very profitable business for the medical profession, with which “at least 1.5 billion euros are implemented annually in Germany”. "Many doctors take advantage of the trust of the patients when they change from a helper to a salesperson," explained Gerd Billen, board member of the Federal Association of Consumer Centers in mid-October. Referring to a nationwide online survey from April to June 2012, in which more than 1,700 consumers were involved, the Federal Association of the Consumer Advice Center reports that IGeL patients are often not informed in the prescribed manner and are also influenced by massive advertising. The patients also "in some cases did not even get a contract or an invoice," criticized the Federal Association of the Consumer Advice Center. There is an urgent need for action here, because the "self-pay services should serve health, not fuel the self-service mentality of some doctors", according to Gerd Billen.

Medical profession under pressure The current study by the Federal Ministry of Consumer Affairs is increasing the pressure on the medical profession to remedy the information deficit in the sale of IGeL. A new revised IGeL guide for doctors and patients should remedy this. In this way, the discussion could be made more objective, the Federal Medical Association and the National Association of Statutory Health Insurance Physicians (KBV) declared. Because in individual cases IGeL are medically sensible and one cannot therefore generally deny them the right to exist, emphasized the President of the German Medical Association, Frank-Ulrich Montgomery. However, both the doctor's president and KBV boss Andreas Köhler emphasized how important it is that the doctors treat the IGeL responsibly and adhere to clear rules. (fp)

Read on: IGel services provided by doctors:
IGeL services at the doctor are often unnecessary
Health insurance companies want to restrict additional services
Doctors are selling more and more additional services
Doctors as sellers of additional services
Doctor's appointments: health insurance patients are disadvantaged
Hardly any useful additional services at the doctor
Which IGeL services really make sense

Picture: Paul Golla /

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