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Message
How this ethical? (medical ethics related)
Posted on 8/18/26 at 7:47 pm
Posted on 8/18/26 at 7:47 pm
I got a call today from a "medical" company that partnered with my employers health insurance carrier. Their advertisements state they provide "2nd opinions at no cost to you" once a primary care doctor gives their disposition on treatment etc.
They are also 100% bought and paid for by the health insurance carrier. I don't see how a medical doctor can give a 2nd opinion on a patient thousands of miles away with the same weight as your primary care doctor, when the only reason they exist is to convince people lower cost treatment is better- sight unseen. If you go to their website in their T&C's they say...
On the company's front page they tout the creditentials, names, board certification of their "doctors", yet it seems they solely exist to push cheaper alternatives with none of the accountability as suddenly they aren't a medical provider, because they say so.
Am I wrong in thinking this is a massive conflict of interest and wildly unethical? How can a licensed doctor, whose sole objective in their profession is to benefit the health and safety of the patient... suddenly claim they don't practice medicine when pushing the company line that the patient doesn't need some service because it will cost the insurance money?
They are also 100% bought and paid for by the health insurance carrier. I don't see how a medical doctor can give a 2nd opinion on a patient thousands of miles away with the same weight as your primary care doctor, when the only reason they exist is to convince people lower cost treatment is better- sight unseen. If you go to their website in their T&C's they say...
quote:
Important Notice: Health Services & Information
_______ does not engage in the practice of medicine. It is important to note that “Service” as defined above and used throughout this document does not include any of the clinical or medical health and care services...
On the company's front page they tout the creditentials, names, board certification of their "doctors", yet it seems they solely exist to push cheaper alternatives with none of the accountability as suddenly they aren't a medical provider, because they say so.
Am I wrong in thinking this is a massive conflict of interest and wildly unethical? How can a licensed doctor, whose sole objective in their profession is to benefit the health and safety of the patient... suddenly claim they don't practice medicine when pushing the company line that the patient doesn't need some service because it will cost the insurance money?
15
Posted on 8/18/26 at 7:53 pm to NYNolaguy1
I'm not some bleeding heart lib or anything...but Jesus Christ healthcare is so fricked up in this country.
Posted on 8/18/26 at 7:54 pm to NYNolaguy1
Newsflash: Your employer and insurance carrier want to spend as little as possible on you.
Posted on 8/18/26 at 7:54 pm to NYNolaguy1
Sounds like a complete racket, I am 100% with you
Posted on 8/18/26 at 8:00 pm to NYNolaguy1
2nd opinion is arguably a medical term...how can they claim that without being MDs? You should get Gordon and get it done.
Posted on 8/18/26 at 8:03 pm to Srbtiger06
quote:
I'm not some bleeding heart lib or anything...but Jesus Christ healthcare is so fricked up in this country.
Looking into this further...
LINK
quote:
UnitedHealthcare and 2nd.MD collaborate to provide members with expert medical opinions
This service is offered to all UnitedHealthcare Commercial ASO members and to UnitedHealthcare Fully Insured members in IN, KS, KY, MD, NC, SD and TX.
Nov. 16, 2023
Since 2017, UnitedHealthcare has collaborated with 2nd.MD to provide a no-cost, member-focused expert medical opinion service to members. 2nd.MD virtually connects members who are facing a serious or expensive health care decision with a top expert in the field to review their case and provide a second opinion on their best options. UnitedHealthcare offers this service in certain health plans:
Curious how a licensed MD can legally trade his ethics to the highest bidder here....
Posted on 8/18/26 at 8:04 pm to NYNolaguy1
Unfortunately, this is the kind of shite it takes to keep medical costs down. The medical profession in this country is running completely unchecked…and it shows up annually in increased insurance rates.
Someone has to look over the profession’s shoulder and at least ensure that they are at least following the standard of care….
Someone has to look over the profession’s shoulder and at least ensure that they are at least following the standard of care….
This post was edited on 8/18/26 at 8:07 pm
Posted on 8/18/26 at 8:06 pm to NYNolaguy1
It is not ethical. Providing 2nd opinions by default establishes a physician/ patient relationship and should be subject to normal professional standards including liability for harmful advice. Providing medical advice without direct evaluation has long been a “no go” and our licensing boards should put a full stop to it. If reported to state licensing, these “physicians” would be subject to disciplinary action. But someone has to report it and follow through on it. That being said, insurance carriers do it every day in denial of care. Something has to change.
Posted on 8/18/26 at 8:07 pm to Srbtiger06
w
100% agree. I work in dc planning/case management at a hospital.
quote:
healthcare is so fricked up in this country
100% agree. I work in dc planning/case management at a hospital.
Posted on 8/18/26 at 8:08 pm to Spankum
quote:
Unfortunately, this is the kind of shite it takes to keep medical costs down. The medical profession in this country is running completely unchecked…and it shows up annually in increased insurance rates.
The medical profession or the health insurance industry?
Posted on 8/18/26 at 8:11 pm to NYNolaguy1
I do work for some health plans and a network will sometimes try to help the participant with a peer to peer review after an initial denial, but I'm not sure how rigged that setup is.
Another interesting thing is how it's coming out that some networks are just using AI on most initial claims.
Another interesting thing is how it's coming out that some networks are just using AI on most initial claims.
This post was edited on 8/18/26 at 8:13 pm
Posted on 8/18/26 at 8:11 pm to OldHickory
quote:
Newsflash: Your employer and insurance carrier want to spend as little as possible on you.
They rather you die and pay out your company life insurance, if you even have that, because that would be cheaper than paying the hospital. Doctor's are generally good, it's the greedy medical corporations like Ochsner and the insurance companies like United Healthcare that are the worse.
Posted on 8/18/26 at 8:12 pm to NYNolaguy1
No different than your health insurance seeing you fill an expensive medication, lets just say Ozempic for all the fat baws in Louisiana. Then reimbursing your local pharmacy below what they paid to order your medication. Your local pharmacy telling you sorry we can't fill this, then you either have to get it via mail order (that your insurer owns) or CVS (that your insurer also probably owns)
Posted on 8/18/26 at 8:14 pm to boosiebadazz
quote:
The medical profession or the health insurance industry?
It is a parasitic relationship. At this point it nigh impossible to separate the two. One has to ask which is the parasite and which is the host.
This post was edited on 8/18/26 at 8:15 pm
Posted on 8/18/26 at 8:15 pm to WaydownSouth
quote:
No different than your health insurance seeing you fill an expensive medication, lets just say Ozempic for all the fat baws in Louisiana. Then reimbursing your local pharmacy below what they paid to order your medication. Your local pharmacy telling you sorry we can't fill this, then you either have to get it via mail order (that your insurer owns) or CVS (that your insurer also probably owns)
This is exactly what happened with my diabetes supplies. Local pharmacy that picks up the phone on the first ring said my insurance was shorting them. Had to get certain things moved over to CVS where calling isn't even an option. It goes straight to voicemail and if I'm lucky they'll listen to my message in a few hours.
Posted on 8/18/26 at 8:15 pm to NYNolaguy1
quote:
Curious how a licensed MD can legally trade his ethics to the highest bidder here.
A lot of Dr's are sociopaths.
Posted on 8/18/26 at 8:16 pm to boosiebadazz
quote:
The medical profession or the health insurance industry?
Good point,,,,I believe it is both,
Posted on 8/18/26 at 8:18 pm to Uroblast
quote:
is not ethical. Providing 2nd opinions by default establishes a physician/ patient relationship and should be subject to normal professional standards including liability for harmful advice. Providing medical advice without direct evaluation has long been a “no go” and our licensing boards should put a full stop to it. If reported to state licensing, these “physicians” would be subject to disciplinary action. But someone has to report it and follow through on it. That being said, insurance carriers do it every day in denial of care. Something has to change.
It's a twisted day in medicine when a doctor tells a (not) patient to skip some treatment or surgery (deep down knowing it will save their life) because the insurance company doesn't want to pay up...
If it's gotten to this point, why do we have insurance?
Posted on 8/18/26 at 8:20 pm to Srbtiger06
quote:
I'm not some bleeding heart lib or anything...but Jesus Christ healthcare is so fricked up in this country.
And yet it’s still the best healthcare in the whole world. Certainly expensive, but there is a reason people come from around the world to get healthcare here.
I think your frustration would be better directed at the insurance providers and litigators who drive so much of the cost.
Posted on 8/18/26 at 8:27 pm to NYNolaguy1
Employers are in it to make money, so are your politicians.
Don't ever forget that.
Don't ever forget that.
This post was edited on 8/18/26 at 8:28 pm
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