Equity of Care?

Misdiagnosis and inappropriate treatment are common concerns for individuals suffering from a serious medical condition. In Ireland more than 1.5 million people can access a second opinion service at no additional cost to themselves. Best Doctors helps people facing serious illness to get the most appropriate care. It’s unique database has harnessed the knowledge of over 50,000 doctors identified by their peers as the best in their specialities. Access is available through three insurance companies in Ireland – VHI Healthcare, Hibernian Life & Pensions and Combined Insurance (IRL) – who pay an annual fee for the service.


The service operates as follows. An insured person who is diagnosed with a serious illness, has the option of having their case reviewed by Best Doctors. On the patient’s request, the health insurance company arranges for Best Doctors to contact the patient. A Nurse Advocate is then assigned, who contacts the patient or their doctor for a copy of all the patient’s medical records. Using their database, Best Doctors identify the most appropriate specialist from around the world to assist in reviewing the patient’s case. The selected specialist(s) comprehensively reviews the test results, diagnosis and prognosis and a report is sent to the patient and their doctor. Doctor patient confidentiality is maintained at all times throughout the process. Patients wishing to have Best Doctors review their medical file continue to have medical care with their own consultant who now has the back-up of other world renowned specialists.

This all sounds very reassuring until you realise that almost 50% of the Irish population hold no insurance cover added to which, not all health insurance companies pay into the scheme. Surely every patient facing serious illness, should have access to the best and most appropriate care available? Do all patients not deserve access to the skill, experience and insight of these highly trained doctors? Nope, sorry! Unless you’re a member of an insurance company which is participating in the scheme, access is denied. It seems care is given based on a person’s ability to pay for health insurance instead of their medical need. There is a fundamental struggle going on over the soul and shape of Irish healthcare.

11 Responses to Equity of Care?

  1. Annb says:

    How true this is! I’ve just written a post about our year long battle for a second opinion. It is truly like swimming the Atlantic in treacle! I now feel completely ground down by it. To survive as a patient in Ireland you have to be built like an optimistic, scientific, forensic detective with very deep pockets and the best of insurance. Anyone else can just forget it.

  2. Steph says:

    Ann – By coincidence, I was over at your place when you sent this.

    You forgot one vital component for survival – humour. You wouldn’t last five minutes without a sense of humour. I agree with you too about all the rest!

  3. Annb says:

    Hi Steph, Just sending you some good vibes from the West. I know yesterday must have been tough. Hope you’re not feeling too rough today.
    Hugs from Boy wonder and gang!

  4. I’ve recently made contact with an old college friend in the States and have been hearing a little about US healthcare – now there’s something to really make your hair stand on end. My friend has leukaemia and a 20% chance of being alive in 5 years. The only way they could get any kind of medical aid/insurance was for her husband to stop working – which means, of course, that they’re now broke. She had to come out to SA for a bone marrow transplant because they just couldn’t afford it in the US. It’s just been one long series of nightmares for this poor woman.

  5. Steph says:

    Thanks for comments and well wishes. Not a well Steph today. Back as soon as I can.

  6. Lilinator says:

    Hi Steph, hope you are feeling better soon. Very useful post. I came in on end of a discussion of ‘Best Doctors’ on Marian Finnucane show last weekend. You have now filled in the gaps, thank you

  7. Baino says:

    Sorry to hear it Steph. . .take it easy on yourself. And yes, health care is really only for those who can afford it. Very sad. Big hugs out to you darling. You’ve been through a lot. Take care.

  8. JBBC says:

    This is such an excellent post Steph and one I also feel very strongly about. Sending you my good wishes too for your recovery.

  9. Steph says:

    Lily – Hello and welcome!

    I was so incensed by that interview that I felt compelled to research ‘Better Doctors’ further. Radio interviews are often my stimulus to blog.

    Baino – Thanks Missus! I’m doing my best.

    JBBC – You’re too kind. But your comment did my heart good.

  10. acountrydoctorwrites says:

    Interesting post, interesting concept.
    Of course, this only helps patients who have been diagnosed with a serious illness. The most frightened and dissatisfied patients are often the ones without a diagnosis.

  11. Steph says:

    Country Doctor – Nice to hear from you.

    You make an excellent point. People who have been diagnosed with serious illness, are most likely to be already receiving care as part of a treatment programme. Those without a diagnosis could benefit hugely from having access to the best doctors in the world. It would appear that Best Doctors concentrates it’s services on best ‘treatment’ rather than diagnosis.

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