Patient mediator

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Patient mediators are individuals or companies who, for a fee, refer patients from abroad to domestic clinics and / or take on services in connection with the acquisition and care of international patients. After the Internet and personal contacts, patient mediators are the third most important sales and communication channel in medical tourism . Two thirds of all clinics active in the "International Patients" business area work with intermediaries.

market

The patient mediation market is very heterogeneous and ranges from individuals with foreign contacts to professional agencies with several employees and several branches abroad. In addition to these specialized companies, translation services or import-export companies for medical technology often refer patients to the hospitals. The market is considered to be very intransparent, as almost no information on structure, size, market participants or brokerage volume is available. According to an estimate by the Bonn-Rhein-Sieg University of Applied Sciences, there are several hundred patient mediators active in Germany, most of whom treat fewer than 100 patients per year. The small number of referrals can be compensated for by the fact that the brokers demand substantial money from both sides, clinics and patients. The clinics pay amounts that make up 15 percent of the treatment costs. Patients are required to pay an amount equal to the fee, sometimes taking advantage of an emergency; in some cases higher.

Services

Patient mediators can work for patients from abroad as well as for clinics, foreign insurance companies or companies. Your range of services includes a .:

  • Marketing abroad,
  • Translations of doctor's letters and findings from the patient's home country,
  • Selection of suitable treatment options in Germany,
  • Obtaining cost estimates
  • Appointments,
  • Handling of travel formalities such as booking flights, hotel accommodation or applying for a medical visa,
  • Care of patients and their companions on site,
  • medical interpreting and translations,
  • Cost management and invoicing.

Very few agents offer their services to this extent. In most cases, the activities are limited to the selection of a clinic, inquiries about costs and appointments and accompanying the patients to the clinic. In addition, even these services are provided in very different quality. In a study by the Bonn-Rhein-Sieg University of Applied Sciences, a random sample of 50 intermediaries who specialize in the Russian market were sent an inquiry from a patient from Russia (including medical documentation and imaging) by email. The replies from the placement agencies were appraised by 26 criteria in the main areas of structure / structure of the letter, content, response time, contact details and price information. Only five agencies achieved more than half of the possible rating points.

Billing and payment for services

The services of the patient mediator should be recorded in writing in a service contract between the agency and the patient or between the agency and the clinic and given prices. For the remuneration of services such as interpreting or patient care, standard market prices are to be used. In some cases, the performance remuneration is still processed through commissions. The agent receives a percentage of the final amount of the hospital bill (excluding additional fees, optional services, additional costs such as transport, medication, etc.). The amount of the commission varies depending on the number of people placed and the total turnover, mostly between 5 and 20 percent.

The district court of Kiel considers remuneration for the pure mediation service through lump-sum commission payments by the clinics to be immoral due to the medical professional code and competition law. Financial interests can significantly disrupt the relationship of trust between doctor and patient.In addition, the participation of members of the health professions in the referral of patients for remuneration is punishable under Section 299a of the Criminal Code or for doctors under Section 31 MBO-Ä or Section 73 (7) SGB V forbidden. Different regulations apply to hospitals depending on the federal states. In NRW, for example, the prohibition of allocation is regulated in Section 31a of the KHGG NRW.

criticism

Mutual financial dependencies in the collaboration between clinics and doctors on the one hand and patient mediators on the other hand can, in extreme cases, lead to considerable disadvantages for patients. In the organ donation scandal in Göttingen in 2012, a mediation agency is said to be involved in addition to doctors.

In the Stuttgart clinic scandal surrounding the former Green Party politician Andreas Braun with regard to bribe payments for the treatment of foreign patients, patient mediators have, according to the Stuttgart public prosecutor, generated higher income through fraud and thus damaged the cost bearers and the clinic. Several suspects were arrested in mid-July 2019.

Media reception

In 2013, Die Zeit reported on the phenomenon under the title “Die Krankenschlepper”. Research was carried out in cooperation with the radio station of the BR and ARD Report Munich. Also on this topic in 2013 wrote Der Spiegel - under the title "The Russian Patient", a month later Die Welt am Sonntag - under the title "The Libyan Patient", and in 2018 Die Welt ("Veiled Business").

swell

  1. ^ J. Juszczak: Results of the 5th market study "International patients in German clinics". Sankt Augustin 2011, p. 21.
  2. ↑ A. Kremel: Patient imports from abroad: An empirical analysis of the patient mediator market segment. unpublished Thesis. Sankt Augustin 2007.
  3. ↑ Time. No. 16, April 11, 2013, p. 22.
  4. ↑ J. Juszczak, V. Gornus: Acquisition of foreign patients: the Internet presences of German patient mediators in an international comparison. In: A. Gadatsch, D. Schreiber (Ed.): Economic action in teaching, research and practice. Saarbrücken 2007, pp. 63-75.
  5. ^ C. Christ, S. Zutt: Cooperation with patient mediators - from the perspective of Asklepios Kliniken GmbH. In: GE Braun (Hrsg.): Winning foreign patients for German hospitals. Neuwied u. a. 2004, p. 278f.
  6. ^ J. Juszczak: Entry into the CIS patient market. Seminar documents, Sankt Augustin 2012.
  7. ^ LG Kiel Az. 8 O 28/11
  8. ↑ OLG Hamm, NJW 1985, p. 679 ff.
  9. ↑ ARD magazine fact. August 14, 2012.
  10. ^ Rüdiger Soldt: Dubious business with the sheikhs . Frankfurter Allgemeine Zeitung. March 8, 2017. Retrieved September 29, 2019.
  11. ↑ Mathias Bury: clinic scandal arrested two patients mediator . stuttgarter-nachrichten.de. July 12, 2019. Retrieved September 29, 2019.
  12. ↑ Christiane Hawranek , Marco Maurer : Die Krankenschlepper. Die Zeit No. 16 of April 11, 2013, p. 22
  13. ↑ Udo Ludwig , Matthias Schepp, Antje Windmann: The Russian patient. Der Spiegel No. 46 of November 11, 2013, pp. 50-56
  14. ^ Lars-Marten Nagel, Marc Neller : The Libyan patient. Welt am Sonntag from December 16, 2013, pp. 34–36
  15. ↑ Timo Stukenberg: Veiled shops. Die Welt from July 8, 2018, p. 36.