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Glaucoma Early Detection - A Nepp? Serious allegations against self-pay services by ophthalmologists

Glaucoma Early Detection - A Nepp? Serious allegations against self-pay services by ophthalmologists


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Medical service accuses ophthalmologists of sometimes dubious marketing

Almost every second insured person in Germany receives individual health services (IGeL) when they visit the practice. Patients in ophthalmological practices are particularly often confronted with the so-called "self-pay services". Partly dubious marketing is carried out there.

IGeL (individual health services) is to be understood as all services that do not belong to the defined service catalog of the statutory health insurance companies, which a health insurance fund does not have to pay. Patients are particularly often confronted with this in ophthalmological practices. The IGeL monitor, initiated and commissioned by the medical service of the Federation of Health Insurance Funds (MDS), takes a critical look at how to deal with the so-called "self-payer benefits" and, as a new evaluation, provides early detection of glaucoma using optical coherence tomography (OCT). in front.

IGeL generates around one billion euros annually

The market for individual health services is booming. According to a message from the Medical Service of Health Insurance (MDK), medical practices generate around one billion euros a year. IGel are well known and widely used. The insured person's need for information is also increasing. Every day, almost 2,000 visitors inform themselves on the IGeL-Monitor internet portal. The need for information at IGeL is particularly great in the ophthalmology practice.

According to the information, of the 51 ratings in the IGeL monitor, the two previous ratings for glaucoma early detection are accessed the most - they account for around 15 percent of the page views. Almost 40 percent address IGeL ophthalmologists when insureds are sent to the IGeL monitor. According to the announcement, the experiences that are described prove that aggressive practice marketing can be used. In many cases, insured persons report that they are already being asked by the practice staff to buy IGeL or that the doctor's appointment is made dependent on it.

“Ophthalmologists often fail to adhere to the recognized rules for selling IGeL. Instead, extremely dubious marketing is carried out and even vulnerable patient groups such as the elderly, patients with little money and insured persons in rural regions with little practice offer feel under pressure, ”says Dr. Peter Pick, Managing Director of the MDS. "Therefore, we appeal to the medical profession to adhere to the recognized rules and to return to serious dealing with IGeL."

Optical coherence tomography "tends to be negative"

In its new assessment, the IGeL-Monitor examined another IGeL on the subject of eyes. The experts researched whether optical coherence tomography (OCT) as an early detection examination can prevent people from going blind due to glaucoma. The experts were unable to find any meaningful studies on this. In addition, they could not find any studies that showed that early therapy was useful. However, indirect damage due to overdiagnosis can also be expected with OCT for early glaucoma detection. For this reason, the experts, when weighing up the damage and benefit potential, came to the conclusion that this early detection check-up should be rated “tend to be negative”.

In advance, insured persons had contacted the IGeL monitor and asked about the OCT for early glaucoma detection. That is why the IGeL monitor first researched whether the OCT was used at all.

“An initial inquiry among ophthalmologists about the importance of OCT for early detection showed that the use was viewed with skepticism. Even in the guidelines, this examination is not recommended for early detection. However, our research at 100 ophthalmologic practices shows that 25 percent of the practices offer OCT for precisely this purpose, ”explained Dr. Michaela Eikermann, Head of Evidence-Based Medicine at the MDS.

Tips for patients

The consumer advice center has some tips for early glaucoma detection patients on its website:

  • If your ophthalmologist offers you early glaucoma detection, ask specifically about the individual benefit.
  • Clarify with your doctor and your health insurance provider whether you suspect glaucoma or a certain risk factor. Because then the examination is a benefit of the statutory health insurance.
  • If you decide against early glaucoma detection, you do not have to confirm your waiver to the ophthalmologist in writing and you do not have to fear any disadvantages in the event of a later diagnosis. (ad)

Author and source information

This text corresponds to the requirements of the medical literature, medical guidelines and current studies and has been checked by medical doctors.



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