Opthalmologists lament cataract controversy
The Philippine Academy of Opthalmology (PAO) said it has been trying hard to stop what it sees as unethical practices in cataract operations paid by the Philippine Health Insurance Corp. (PhilHealth).
But it blamed PhilHealth for the continued unethical practices of ophthalmologists especially in Western Visayas.
"We have been trying to get PhilHealth to impose the necessary sanctions for years but it seem there is lack of political will to do so," said Dr. Maria Dominga Padilla, PAO national president, in a text message.
Dr. Mary Katherine Rivera-Francia, PAO Western Visayas chapter president, said the practice of cataract operations being investigated by PhilHealth "has put the whole profession in a bad light."
She said they view as unethical the practice getting patients for cataract operations by recruitment agents ("seekers"). They are also questioning the use of medicines that are not necessary for all cataract operations.
She said since two years ago, they have asked the PAO to investigate their fellow doctors on this alleged unethical practices.
"It's not about they having a higher income. We felt that it would affect the practice of the entire region," said Francia.
But lawyer Jay Villegas, manager of the PhilHealth Fact-Finding and Administrative Investigation Department, said PAO should "guard their ranks and officially declare as unethical these practices."
He said if PAO declares "seekers" as unethical, this can be used as a ground for non-accreditation or revocation of doctors and hospitals who are engaged in this practice.
PhilHealth said abuses and unethical practices will soon be considered offenses that may lead to the providers' disaccreditation.
In a press statement, lawyer Atty. Valentin C. Guanio, senior vice president for legal services and PhilHealth Officer-in-Charge said it is seriously considering abuses and unethical practices of doctors as among the qualified offenses that may warrant the non-renewal of their accreditation.
"The integrity and competence of the health care professional are among the very important elements that patients consider before seeking treatment. But if these are compromised by a doctor's unethical practices, definitely, the patient's health will be at risk," he said.
Guanio said that it is currently investigating cases of rampant abuse of the medical profession being carried out by some doctors through so-called medical missions after which they file their claims for reimbursements through the accredited hospitals in their area.
"We are also working closely with specialty societies to define the parameters of what may be considered 'unethical' and already beyond the bounds of moral and ethical practice," he said.
Guanio said that penalties for such offenses will similarly be increased and other policy changes will soon be introduced to further strengthen PhilHealth's campaign against abuse of medical authority.
He also clarified earlier figures on the PhilHealth reimbursement for cataract extractions, saying that PhilHealth pays an average of P18,373.00 for cataract extraction claims.
He added that indeed, it is possible for a skilled ophthalmologist to perform more than a hundred cataract extractions in a month, but stressed that doctors performing multiple extractions in a day under unhealthy circumstances run the risk of infecting, rather than curing, the patients.