Insurer information demands colour GP attitudes
General practitioners may deliberately “under-identify” patients at risk if they believe an insurer is likely to request their medical records, according to the Royal Australian College of General Practitioners (RACGP).
In a submission to the Parliamentary Joint Committee inquiry into the life insurance industry, the RACGP appeared to confirm the views of some life/risk advisers when it pointed to the impact that insurance claims had on the doctor/patient relationship.
The RACGP submission said that “understanding that medical records can be requested by an insurer may lead GPs to under-document or under-identify patients at risk in efforts to ensure the patient’s access to insurance is not affected”.
It said GPs have advised the RACGP that “they feel they are placed in a difficult situation where they need to ensure adequate documentation of their consultation with patients while also considering the broader impact this may have on their patient”.
“This in turn may have medico legal ramifications for GPs,” the submission said.
“Similarly, patient knowledge of the issues they may face after disclosing symptoms or seeking treatment, particularly for mental health issues, is likely to discourage disclosure and help-seeking, which adversely affects patient wellbeing,” the RACGP submission said.
It said there were distinctions between mental health issues, their management and prognosis that members of the RACGP had suggested were not appropriately reflected in the insurer’s assessments.
“Therefore, the RACGP supports the recommendation from Beyondblue that individualised approaches to risk assessment are needed,” it said.
“More broadly, our members reported that they were unsure of whether insurers differentiate between patients whose conditions are well managed and those where risk factors are poorly controlled. Greater information on how assessments take this information into account would assist GPs to provide advice to their patients and would reward patients who seek to address and manage risk factors.”
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