Doctors are selling more and more additional services

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Doctors are selling more and more additional services. The medical profession was able to generate revenues of around 1.5 billion euros a year.

Many are familiar with the phenomenon: As a patient, doctors are increasingly asking whether certain additional services for preventive medical care or treatment should be carried out. The special feature: The services offered must be paid out of one's own pocket, since many services are not covered by the health insurance companies. This also applies to many treatments from naturopathy, for example. Patients are often dependent on the statements of doctors, who in many cases like to sell additional services to generate additional income. In fact, however, therapies are also sold that are very well covered by the health insurance companies.

According to a study, medical professionals are increasingly selling additional benefits such as ultrasound examinations, homeopathy or laboratory tests that are not covered by statutory health insurance. These treatments brought in additional treatments of around 1.5 billion euros per year for the resident doctors, according to the study by the AOK Scientific Institute (WidO) presented on Wednesday. This means that the proceeds from treatments and diagnostic procedures not recognized by the health insurance fund have increased by 50 percent since 2005.

Every fourth legally insured person (28.3 percent) has been sold a health service that was not paid for by the health insurance companies. The patients had to pay the costs out of their own pocket. Around six years ago (2004), the share of additional benefits for insured patients was 16 percent. In 2001 only 9 percent. The best-selling medical services were so-called individual health services (IgeL) such as ultrasound and glaucoma check-ups at the ophthalmologist. Additional drugs followed in second place, remedies in third place e.g. from naturopathy and then aids and preventive offers such as Blood tests and laboratory services.

It is not health but income that determines the stress. Around 2,500 patients took part in the survey conducted by the AOK's cash institute. It was striking in the study results that the individual additional benefits depended less on the patient's state of health or age, but rather on the level of education and the income of the insured. According to this, people in particular took advantage of the additional benefits from resident doctors who earn more than 4,000 euros net per month. Here the rate for claiming the benefits was twice as high as for those who have to make do with less than 1000 euros net earnings per month. In this income group, only about every sixth person (16.9 percent) took advantage of such health care benefits without taking over health insurance. One third of patients who had a correspondingly high income had already taken advantage of a chargeable additional health service. Here 38.8 percent of the participants stated that they had already had such experiences in a doctor's office.

There were differences in the provision of non-compulsory benefits, especially among the individual specialists. The most expensive preventive care services were offered by the ophthalmologist and gynecologist. Here, the additional services were sold up to seven times more than, for example, general practitioners. In the other ranks are urologists, who made patient offers in about five times as often, as well as general practitioners and dermatologists with an approximate fourfold offer.

Health insurance companies advise patients to exercise caution The health insurance companies advise caution. For some services, it is questionable whether an additional benefit is guaranteed at all. On the other hand, according to the general local health insurance company AOK, health services are often sold, which are actually considered to be standards and can be billed regularly by doctors as a fee. This applies above all to the necessary ultrasound examinations and skin cancer screening. A request from the responsible health insurance company can provide certainty in advance. Again and again it happens that due to the ignorance of the patient, doctors invent additional sources of income, although certain preventive and therapeutic measures can be billed as a cash benefit. (sb)

Also read:
AOK boss: problem with medical oversupply
Dispute between AOK and family doctors escalates

Picture: Paul Golla /

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