The doctors asked them to perform several tests and radiation without need, under the pretext of reassuring their cases, pointing out that doctors are over-testing and examinations to achieve the required income rate Of them in their health institutions, and get a percentage added to their monthly salaries.
The Department of Health in Abu Dhabi has warned against the abuse of health insurance, saying that if there is an increase in the use of health care providers, they will be taken with the procedures they deem necessary, with fines or suspension of license, Health insurance, while doctors confirmed the health of these charges, and back to pressure the medical institutions, and determine a minimum financial amount must be achieved monthly to ensure the continuation of their work.
In particular, critics of private hospitals and medical centers accused some doctors of exaggerating the medical examination bill, conducting over-the-counter medical tests, dispensing high-priced drugs, and not under the umbrella of insurance, to achieve great financial returns to their institutions.
They said that they suffer from an increase in the prescriptions of medicines, pointing out that headaches, stomach or cold cases treated by private medical institutions as dangerous cases, which require multiple laboratory tests, various rays and a prescription with four or five types of Drugs, where they are directed to conduct a long series of tests and analyzes, which give the hospital thousands of dirhams, borne by the patient and health insurance.
"I went to a private multi-branch hospital in Abu Dhabi for a while because of sinus allergies. I went to the nose and ear specialist. I asked for some tests. Then I was surprised." There is an excess of nasal sinuses, which is not simple, Causing a blockage of breathing in the future, and must be a quick surgery to be removed, and asked to help him to address the insurance for approval quickly, and made me sign a paper did not understand what it is ».
He said, "I went out with him and I was not comfortable. On the second day, I saw another doctor at a different hospital. He stressed that I did not need any operations. It was nothing more than a very sensitive one, which caused irritation of the capillaries in my nose. He described me as a simple treatment. .
"After two days of my visit to the first doctor, I received a call from the hospital to inform me of the agreement to insure the operation, consult with me on the date of my appointment, and when I apologized, I received a second call from the doctor to try to convince me of the importance of the operation, , And will not entail the transfer of any financial costs ».
Ahmed Al-Shazli said that his little daughter complained of pain in her teeth. When she saw the doctor, he told him that she had a toothache at more than one age. She needed root treatment, that treatment cost 8,000 dirhams. The amount allocated for dental treatment in the insurance card is not more than 3000 dirhams. He told him that he could pay the difference in the amount of treatment from his insurance card and his wife's card, and with the review of another doctor who did not charge more than the amount on his child's insurance card.
The doctor did not give her a chance to give birth to nature. The operations involved her and performed a caesarean section without any convincing reason. A female worker in the hospital assured him that this doctor is known for this, In order to raise the bill of treatment, as they receive a proportion of the monthly amount you enter the hospital, because the difference between the cost of natural delivery and caesarean is about 15 thousand dirhams, indicating that he went to the hospital management to file a complaint with the doctor, they told him that confirmed that the fetus was in the position Embarrassed, can not wait, they resorted to Uncle
When she went to a private hospital in Abu Dhabi, the doctor in the emergency department asked for surgery and radiation, then turned her to the specialist section, wrote her a prescription with painkillers, and asked her to book at one of the clinics. Consultants in the hospital, because the detection and radiation do not clearly show the location of the imbalance, adding that it paid over 600 dirhams difference of the prescribed tolerance in its insurance card in cases of radiation and analysis, and 30% tolerated in the drug.
She said: "I got an appointment with a consultant at the same hospital. After the examination, the doctor confirmed that the feeling of extreme fatigue was an accident due to work stress. He asked me to stop the painkillers and when I asked him why I was instructed by the emergency doctor to perform tests and radiation, .
On the other hand, doctors in hospitals and private medical centers in Abu Dhabi, who preferred not to be named, that the exaggeration of some doctors in the request for tests and radiation, due to pressure on them by the medical institutions in which they work, and asking them to achieve a financial return commensurate with their salaries, The specialist doctor is required to make a monthly income to the hospital not less than three times his salary, and some hospitals require the specialist to achieve a monthly income of at least 250 thousand dirhams, while the minimum required by the consultant between 500 and 700 thousand dirhams per month.
The consultant of obstetrics and gynecology, Dr. Sameh Azazi, stressed that the profession of medicine, like any profession, has some violators, so the patient must have awareness, ask the doctor about the diagnosis of his condition and the purpose of conducting tests or radiation, Lasting on medical practices, so as not to develop irregularities to the worst, and to ensure the permanent upgrading of the ethics of the profession.
Dr. Samir Samir, a specialist in internal medicine, said that some doctors put a diagnosis on the condition that compels insurance companies to agree to perform the tests and radiation prescribed, or even to perform surgeries, so as not to assume any responsibility to refuse treatment of the patient, Within the medical institutions, the prescriptions of doctors and the extent of their conformity with the patient's health status are reviewed to ascertain the efficiency, seriousness and honesty of their doctors, but some hospitals and centers place profits above professional ethics.
The doctor and the obstetrician, Mai Mohammed, stressed that the relationship between the doctor and the patients must be based primarily on the secretariat, on the ethics of the profession, and maintenance of the section that performed, pointing out that the patient to load rays or tests is indispensable, or perform a caesarean section For a patient who can give birth naturally, things that are contrary to professional norms, and that the doctor loses the trust of his patients and is punished by the regulators of the health care sector in the country.
The Department of Health in Abu Dhabi issued a circular regarding the standard contract governing the contractual relationship between medical treatment providers, health insurance companies and claimants, confirming that if there is an increase in use by health care providers, compared to similar use by other service providers In the Emirate, which represents the average use, this is a misuse under section 9.3 of the unified contract, which requires the insurance company licensed to work in the field of health insurance to notify the Department of Health, with supporting documents thereon, and if proven For a circle Health not notified in this regard, legal action will be taken against insurance companies.
The Undersecretary of the Health Department, Mohammed Hamad Al-Hamli, stated in the circular that if the Department proves that there is an increase in use by health care providers, the Department shall implement the provisions of the law provided for in Article (17/9) Of the law, and to take such action as it deems necessary against them, with fines, suspension of license or termination of license in the health insurance scheme, and appropriate necessary procedures shall be applied.
The circular indicates that the procedures will be notified to the treatment service provider, and a report will be made on the matter. If the health department proves the validity of the notification submitted by the insurance company, the insurance provider will be warned about this. The report is submitted to the Department of Health, and if there is an increase in the rate of use, according to the report submitted by the insurance company, the Health Department suspend the license or revoke the validity of the license in the health insurance program.
Patient rights
The Department of Health in Abu Dhabi has set 13 conditions for the patient, who, if dissatisfied with any right, can complain to the management of the health facility in which he or she is being treated. These rights include receiving treatment at the highest professional standards by licensed, qualified and experienced medical practitioners The right to communicate with health-care recipients through their mother tongue, the use of interpreter services, acceptance or refusal to receive treatment for personal responsibility, access to their medical records, and update Records permanently Accurate, access to information when entering the health facility around the health care facility regulations, and other relevant policies when entering the health facility, and to obtain the best safety standards in terms of the facility's health environment and practices.
The rights, which were formulated by the Department in the "Patient Charter" and committed by the medical establishments, included the patient's privacy, his or her personal data, and the patient's health care provider's account of all costs and expenses not covered by the health insurance prior to the necessary treatment. Regardless of the status of the health insurance card he holds, and to obtain information about the complaint to the health facility, if he is not satisfied with the medical examination, treatment, occupational health, or safety level of the health facility.
• Medical institutions requiring physicians to make a monthly payment as a condition of continuing work.
• A minimum of 250 thousand dirhams must be achieved by the specialist in some private medical facilities.