Private Health Services – your Shield against Overtherapy

Independent medical expert advice protects you from medical errors. Medicine does not always act in your best interest

Patients in Switzerland and many other countries are increasingly asking themselves questions like these after a medical consultation: Is the recommended therapy proposal optimally suited to my situation? Do I have to take on this difficult treatment path at all costs? Is there no other way? The answer is: Yes, it is possible. These uncertainties need not be.

In our article we describe suitable steps for a need-based and individual treatment. In addition, we outline the advantages that result for those affected. We also look at the background which is responsible for the increasing overtreatment.

Definition of overtreatment

In Switzerland, the discussion on excessive therapeutic measures is widely discussed by the medical profession, politicians and the general public. There are essentially two key points. One concerns the high, constantly rising treatment costs. The other relates to whether and to what extent individual clinical pictures justify all diagnostic and therapeutic options, even if the patient does not benefit additionally from them.

In 2016, the Swiss Academy for Quality in Medicine SAQM wrote a basic paper on this subject, which describes the interrelationships in a way that is also understandable to interested laypersons. This institution uses the term “overuse” as a catchy slogan, which it defines as follows: “Supply with a … medical diagnosis or treatment that has no benefit for the patient or whose risks exceed the potential benefit”. It also points out that alternative terms such as overtreatment and overdiagnosis are also common.

The medical development dynamics of the last 50 years

Until about 1970, the actions of the medical profession were shaped by the ethical rules of the Greek doctor Hippocrates, the forefather of modern medicine. The following three principles of conduct can be traced back to him: First, the doctor should be careful not to harm the patient. Secondly, he should identify the cause of the illness and thirdly, only then should he initiate the healing process.

Although these rules continue to apply in terms of content and morality, medical technology, new surgical methods, modern drugs and the patients’ entitlement behavior have had a strong influence on medical action. At least the balance between these three points is not always maintained and shifts according to the person affected and the clinical picture. The consequences for today’s health care system can be seen, among other things, in an oversupply of therapeutic options, which in individual cases can also lead to medical errors.

The Swiss Federal Office of Public Health FOPH has been closely monitoring these developments for years with corresponding control concepts such as “Health 2020”. However, the success of the measures introduced is not yet sufficiently tangible.

Important influencing factors for overtreatment and incorrect treatment

The aforementioned SAQM basic paper deals in detail with the causes of medical overuse and points out these facts in particular:

Patients’ expectations increase with every general information on new diagnoses and therapies. Regarding their own complaints, patients also want to participate in these innovations and hope that their therapist will always provide them with the latest information. A distanced, professionally justified medical opinion often finds little understanding. The result is often superfluous prescriptions or diagnoses without additional knowledge, for example repeated heart catheter examinations.

Medical expertise is by no means evenly distributed among all therapists, which leads to a certain information asymmetry within the individual specialist groups. One of the consequences is that there are different professional opinions on how to deal with a disease and the best way to treat it.

Economic constraints on self-employed doctors also play a significant role. An own practice with modern diagnostics is only viable if the equipment is used to its full capacity, which is why regular use of the equipment is a fixed plan.

Medical staff working in hospitals or specialized centers are in many cases also subject to financial constraints and the profit motive of the institution concerned. Unfortunately, this also leads to the fact that patient concerns are somewhat neglected.

Even the status of a privately insured person does not protect patients from overtherapy and medical errors. This is because this group of patients prefers to receive the expensive diagnoses and treatments that are considered particularly innovative.

Private health service for a medicine in your best interest

To protect yourself from overuse or incorrect treatment, it is recommended in Switzerland as well as in other countries to obtain a second opinion. However, it is often the case that the second examiner arrives at a different assessment of the disease and a different therapy recommendation. The uncertainty of the affected person remains, and a third opinion also does not provide the desired certainty of decision.

These facts are understandable, as many physicians are subject to a certain subjectivity and are involved in the professional and economic constraints already described. For patients, however, only independently produced assessments and prognoses of the treatment outcome are relevant. This is especially true before surgical interventions and long-term treatment concepts.

And it is precisely this advice that Swiss Insurance Partners (SIP) offers as a private health service. SIP calls this service Privileged Healthcare and uses a selected group of independent medical experts.

They take care of all aspects of your illness. The most important thing is that these specialists are not involved in your treatment and cannot draw any financial benefit from it. This guarantees their independence. At the same time, the exclusive network of these experts includes worldwide access to independent, leading specialists in all medical fields, if required. For particularly difficult cases of illness, a Medical Advisory Board is also available as a team of consultants.

Privileged health care using examples

Severe back pain

In recent years, more and more people have been willing to undergo surgery in such cases, as these procedures are financially attractive. However, each individual treatment of the spine also brings with it risks such as undesirable stiffening, which the patient did not expect.

On the other hand, not every spinal disease requires surgery. Even conservative treatments can restore freedom from pain and mobility to the patient. Supplemented by targeted prevention, this approach can ultimately mean more quality of life for those affected than surgery.

When deciding on the more suitable treatment option for the individual, patients with this type of disease are better cared for with independent expert advice and can look forward to their future with greater peace of mind.

Therapy options for prostate cancer

The prostate tumor is the most common form of cancer in men but has good treatment chances if diagnosed early enough. On the other hand, this is precisely where the patient has a problem. The patient has several options for decision, the consequences of which are difficult to assess without professional expertise. In addition, this form of cancer directly influences sexuality and thus the partnership. Therefore, any decision should be jointly supported by those affected. The selection of treatment options outlined below illustrates the pressure to decide in this form of cancer.

Since a prostate tumor tends to grow slowly, waiting several years under medical supervision is an acceptable option. This does not change your previous sex life. However, the thought of cancer remains a constant companion.

A non-operative method is the localized, repeated radiation of the prostate. However, it takes several months before the success of the treatment is diagnostically confirmed. Unfortunately, after several years, consequential damage to surrounding tissue such as blood vessels, bladder or intestinal structures cannot be completely ruled out.

If an operation is under discussion, three main variants are common. The classic version with a lower abdominal incision, a keyhole surgery or the use of a surgical robot but operated by a physician. All three surgical methods are very demanding. It is therefore extremely important to choose the treatment center and the surgeon carefully. Nevertheless, in individual cases, permanent disorders such as limited erectile function or unintentional loss of urine may occur.

This tumor example makes it particularly clear that independent expert advice is almost mandatory in order to make a therapeutic decision that also corresponds to personal ideas.

Benefit aspects of private health services

Medicine has changed significantly in the last 20 years. For example, the abundance of diagnostic innovations, treatment methods and new active ingredients has pushed patient well-being into the second tier of medical thinking and action. Economic constraints, the uneven level of knowledge within the medical profession and the financial constraints of the health care system have encouraged this development. These are all major reasons why medicine today does not always act in the best interests of patients.

The above-mentioned examples of illnesses such as severe back pain or prostate tumors also illustrate how important independent expert advice can be in addition to good private insurance against medical costs.

Added to this is the high priority that specialists in a private health service place on prevention, which ensures the success of treatment as permanently as possible.

Overall, the benefits of privileged health care clearly outweigh the additional costs because you protect and safeguard your most valuable asset: your health.