Irish Medical Organisation

IMO publishes paper on Commercialism in Healthcare

Saturday 2nd April 2016. Seven out of ten doctors surveyed by the IMO believe that insurance companies are increasingly dictating the delivery of medical care and the same number expressed concern that private health insurance companies do not always promote evidence-based care.

The survey result was published by the IMO as part of a broader Policy Paper on commercialism in medicine - Preserving Medical Professionalism in an Increasingly Commercial Healthcare Environment. The paper was published at the organisation’s AGM in Sligo today.

The paper said that IMO doctors found that private health insurance reimbursement favours admission to hospital above day treatment, outpatient care or care in the community. The paper also said that many doctors were critical of the willingness of private health insurance companies to reimburse more expensive MRIs over less expensive diagnostic procedures whether the tests are clinically indicated or not.

Dr. John Duddy, President of the IMO, said that there was a need for constant vigilance to prevent the over commercialisation of medicine in Ireland. He said; “In Ireland’s two tier health system, there is an inevitable overlap between public and private medicine so we need to be constantly vigilant to the dangers of over commercialising the profession and compromising the provision of objective, patient focussed advice and care.”

The paper makes a number of recommendations designed to preserve medical professionalism in an increasingly commercial healthcare environment as follows:

Reducing Commercial Influence on Medical Professionalism

In order to reduce reliance on the private sector the public healthcare system must be appropriately resourced to meet current and future healthcare demand;

Greater use of pharmacoeconomic assessment and health technology assessment should be made by the public sector;

Appropriate non-directional educational material on new pharmaceutical therapies should be provided;

The rollout of activity-based funding must 

ensure that diagnostic related payments are adequately costed,

allow for complex patients with multiple co-morbidities,  

Encourage appropriate care in the appropriate setting

Private healthcare facilities should be subject to the same standards and oversight as public hospitals

Licences for private healthcare facilities should be awarded on the basis of provision of evidence based healthcare services,

Advertising standards for healthcare facilities should be developed and strictly enforced;

Employment contracts in the public or private sector should support and promote the role of the doctor and should not include incentives to meet profit targets at the expense of patient safety and quality of care;

Recognising and Declaring Conflict of Interest

Medical ethics, including conflict of interest and the potential impact of private and public medicine on medical professionalism, should be promoted in undergraduate, post-graduate and CPD educational programmes;

While recognising the role of industry in the research and development of new therapies, medical council guidelines on industry sponsorship of educational events should be strictly adhered to;

There should be routine registration of conflicts of interest in advocacy, education and academia;

Medical journals should ensure conflict of interest statements are published for all submitted articles;

When referring patients, doctors should openly declare any financial interest they have in private healthcare facilities;

Clinical guidelines for care should be developed and applied where possible across public and private patients. Guidelines should be flexible to support innovation and improvements to patient outcomes and quality of care;

When carrying out clinical audit doctors should pay careful attention to potential disparities between public and private patient care.

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