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More than a quarter of people who seek a second opinion on a health condition are told to change their treatment and one in 10 are told they have been misdiagnosed, according to analysis of an innovative life insurance product.
Best Doctors, a platform used by 40 million people globally and founded by Harvard medical school professors in 1989, gives users access to experts around the world and allows Australians the chance to submit medical questions to a panel of local doctors.
MLC Life has offered the service to selected customers since 2009 but plans to expand it further this year. So far 3500 people, including 10 per cent of the insurer's staff, have accessed Best Doctors, with 27 per cent being recommended a change in treatment.
"The most common reason for using the platform will range from general medical questions, to an in-depth medical review, but getting a second opinion is the main reason people use it," said MLC Life chief customer officer of retail advised life insurance Melissa Heyhoe.
According to an analysis of outcomes from the Australian users of Best Doctor, in about 9 per cent of cases a second opinion has resulted in a change in diagnosis. Customers have also saved an average of $6930 in medical costs, with recovery time being reduced by 7½ weeks on average.
The most common conditions people access Best Doctor for are orthopaedics (including shoulders and knees), cancer, neurology and gastroenterology and one in 25 per cent cases the questions relate to a family member, not the policyholder themselves.
Peter McClennan, chief executive at Best Doctors, said there are "increasing levels of unnecessary and ineffective treatment" and 10 per cent of cases in Australia are misdiagnosed.
With the resultant rising premiums also a hot-button issue for the $165 billion private healthcare sector, concerns are growing about the sustainability of paying large sums of money for unnecessary procedures.
In July, health insurer Bupa said it has shelled out almost $343 million over five years on knee arthroscopies, a procedure which a key government healthcare body, the Australian Commission on Safety and Quality in Healthcare, says is often ineffective and in many cases can be avoided via weight loss.
The ACSGH revealed in June that 47 per cent of potentially preventable hospitalisations in Australia in 2014-15 were associated with five conditions including diabetes and heart failure.
"Australians are fortunate in having world-class healthcare, including surgical care. Landmark accomplishments in surgical practice have revolutionised surgical care, saved countless lives, and significantly improved longevity and the quality of life,' said Anne Duggan, a senior medical advisor for the ACSGH.
"However, there is variation in the use of healthcare in Australia, including surgery. The goal is appropriate care – the right care for the right person, at the right time."
MLC Life is the only life insurer to offer the Best Doctors service in Australia and from October 1, 2017 will expand the service to allow 800,000 people access, including those who get their insurance via their super fund.
The vice-president of the Australian Medical Association, Tony Bartone, said a service like Best Doctors could help "as long as it is general and doesn't seek to replace good old-fashioned consultations with your treating medical practitioner".
He said insurers do have a "perverse" interest in reducing costs of claims, but supported the rise of their support health literacy and helping patients have good conversations with their doctors. However, he warned against insurers providing information that is individual to a person.
"The best information is surely the information you obtain from your treating medical practitioner who has got a history in examination and investigation or they are in front of the patient," said Mr Bartone.