Second opinion portal: Doctors warn against remote diagnosis

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Specialists criticize second opinion via online remote diagnosis and suspect financial interests

Too many operations are carried out in Germany. This position is represented by twelve experienced and renowned surgeons and founded the "Advice portal against unnecessary operations". The portal is not without controversy: A part of the medical profession criticizes the project as "highly dubious" and profit-oriented. Without a personal introduction, a comprehensive diagnosis cannot be made, the criticism.

Caution operations: Online portal for medical second opinion The second opinion portal should help all patients to make a final decision. "Does a medical intervention make sense or not?" Twelve physicians from various specialties have teamed up to offer patients help in making decisions about unnecessary operations using a medical portal. Because, in their opinion, surgeries on the back, hips or knees are performed too hastily in Germany. "In many cases, suffering is even made worse." One of the founders of the “Caution operations” patient portal is Prof. Dr. med. Hans Pässler from Heidelberg. Pässler complains to the "dpa": "Germany is not only a leader in the automotive industry, but also in operations". According to the university lecturer and knee expert, countless interventions are performed not for the benefit of the patient but for the doctor. To back up his arguments, Pässler compares Germany with other European countries. In relation to the total number of inhabitants, for example, twice as many operations are carried out in Germany as in Sweden. The obvious reason: In Sweden, doctors get a fixed salary. The numbers in Germany have been skyrocketing for years, especially for outpatient interventions. A resident surgeon works with surgery centers that rent operating theaters. To make up for the rent, the doctor had to do many operations.

For more than half of those interested who have previously used the second opinion portal, an operation would have been unnecessary from the medical point of view. In order for a remote diagnosis to take place at all, the patients must scan medical reports, laboratory findings and X-rays and send them online. In addition, patients have to fill out a detailed questionnaire. At the moment, 12 experienced and longer working specialists are involved. A total of 16 specialists will be involved in the future. But there is no credit for nothing. Regardless of whether someone is privately or legally insured, a second medical opinion costs between 200, 400 and 600 euros, depending on the scope of the diagnostic tasks. The rush seems to be big. According to the portal "", 150 patients have already registered in the first weeks after opening.

Sharp criticism from specialists and associations The new portal is not approved by many colleagues. The professional association of resident surgeons classifies a remote diagnosis as “highly unreliable”, which the patient does not see. The professional association of German surgeons thinks that "diagnostic results alone are not enough to make an informed decision for the benefit of the patient". Rather, doctors need to look at the patient and his or her social environment as a whole. The latter point in particular is of great importance when it comes to a major medical intervention. "Because we operate on people and not X-rays," said Professor Dr. Hans-Peter Bruch, President of the association. The association chairman expresses harsh criticism of the fee-based model. Because a "well-founded free second opinion is already practiced in German surgery". Patients would not have to spend extra money to get a second opinion. Because the statutory health insurance companies allow you to obtain a second report from a second doctor. The association offers help to all patients if they are unsure.

The professional association of specialists in orthopedics and trauma surgery also believes that the portal is not a suitable address for receiving an in-depth second opinion. So the vice president of the association, Dr. Andreas Gassen: "Sometimes there are terrible pictures - and the patient is still playing golf". It could be that the doctors are concerned with the profit. Because he himself as an orthopedic surgeon with private insured persons can only charge 21 euros for a consultation including an examination. The flat rate is even lower among statutory health insurers. The second opinion portal defends itself against such arguments. The calculated fee is justified because the responsible medical doctor deals with a case for at least two hours. Thanks to the detailed questionnaires, the doctor can learn more by "remote diagnosis" than in a "two-minute conversation" in the practice, says Pässler.

Health insurance companies express interest in assuming costs Some health insurance companies have already expressed interest. The private Debeka, for example, most likely wants to cover the costs during a set test period and then continue to decide, as a spokesman for the fund announced. The Association of German Company Health Insurance Funds (BKK) is examining cooperation at the statutory health insurance funds. Other health insurance companies, however, refer to their own second opinion offers. For example, the Techniker Krankenkasse in a back center offers a second report. After initial results, it was also found here that almost 85 percent of the operations are superfluous.

Little money for alternative treatments Instead of medical interventions, a variety of conservative therapies such as physiotherapy and physiotherapy or alternative concepts such as osteopathy or chiropractic are available. The former lack sufficient budgets and the latter only the private health insurers cover the costs. But even the second opinion portal could not make an adequate offer if the diagnosis means that an intervention is superfluous. The patients are at the beginning again. (sb)

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