Australian Doctor Australian Doctor 29th September 2017

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THE PRETENDERS
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29 SEPTEMBER 2017
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Inquiry urged to rein in insurers
Medical record requests are like ‘fishing with dynamite’
ANTONY SCHOLEFIELD
INSURANCE companies should
be banned from accessing patients’
full medical records when assessing
claims, GPs and other specialists
have told a parliamentary inquiry.
They raised their concerns that
insurers are accessing complete
medical records to fish for infor-
mation to justify denying patient
payouts with the Committee on
Corporations and Financial Ser-
vices.
The committee, which is inves-
tigating the ethics of the industry,
also heard there were no rules
regarding how long companies
could keep medical records.
One insurer admitted to the
inquiry it had no details of how
many patient records it possessed.
RACGP vice-president Dr Edwin
Kruys told MPs that half of the
requests he received were for com-
plete medical records rather than
reports on specific conditions.
“They ask for the whole lot and
that is what is so concerning. We
really think that should stop.
“The remedy we suggest is that
insurance companies should only
be allowed to request specific
reports that are relevant to the
insurance issue at hand.
“All the other information con-
tained in medical records, includ-
ing, for example, that miscarriage
that occurred 10 years ago, is
totally irrelevant to the insurance
claim at hand.”
Associate Professor Stephen
Bradshaw, a vascular surgeon and
practitioner-member of the Medi-
cal Board of Australia, said he had
never received a request for a spe-
cific report.
“They just want the lot, always.”
Labor Senator Deborah O’Neill
described insurers’ demands for
complete records as like “fishing
with dynamite rather than a fishing
rod”.
“There’s something a little
unethical about it, it would seem,”
she added.
Comminsure managing director
Helen Troup told the inquiry the
company did not know how many
complete patient records it had on
its files.
‘There’s something a
little unethical about
it, it would seem.’
— Deborah O’Neill
Labor Senator
“We don’t actually record that
level [of information], in terms
of data and when we receive the
information. There is not a code on
our system that enables us to [do
that].”
She also argued there were rea-
sons to request a complete medical
record. “Having a full and com-
plete file of what was sent to us is
also an important verification that
we aren’t selectively cutting and
pasting things out,” she said
However, Ms Troup said the
industry would be open to a policy
of destroying medical records that
they held when they were no longer
needed.
The inquiry is due to report on 7
December.
Comment
Rachel Worsley
LAST week, Victoria put before its
Parliament a bill to legalise voluntary
assisted dying.
It is the culmination of two years
of debate and is seen by euthanasia
campaigners as a landmark moment.
If passed, doctors will play a
significant role in the system, but
amid the arguments about the rights
and wrongs of what is happening,
exactly what that role would be is not
widely known, but it should be.
The scheme will be restricted to
only those patients who are 18 and
older, and who are terminally ill and
are expected to die within 12 months
with a condition that causes suffering
that cannot be relieved in any other
tolerable way.
And patients, who must have the
mental capacity, make two self-
initiated requests to die and must be
assessed by two separate doctors.
Professor Brian Owler (pictured),
who led the ministerial advisory panel
that devised this model, estimates
these restrictions will mean around
150 people a year will access the
scheme.
If the patient’s final request is
approved, a pharmacist will dispense
the lethal medication to the patient,
who is expected to store it in a
locked box until it is time to self-
administer.
However, many assume that
doctors will be administering lethal
injections to the patients.
But this may not be the case. First,
there may be no lethal injection. The
expectation is that the medication will
be ingested orally, possibly coming
in powder form — say morphine or
diazepam — which can be mixed
with orange juice and drunk.
Second, there is no requirement
that a doctor is present at the death.
They will only be involved if the
patient requests a doctor’s help and
has lost the physical capacity to self-
administer or digest the substance.
Orange juice cocktail? The means of death under Victoria’s euthanasia plan
cont’d page 8
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