November 10, 2017 - Thiago Braga

PE Radiology Society reports important achievement for the class

Álvaro Campos, Mário Lins, Fátima Aragão, Jerusa Ávila (representing Lucilo Ávila), Leon Berenstain, Boris Berenstein, Lina Soares, Beatriz Maranhão and Marcos Miranda

The Brazilian College of Radiology has encouraged and supported the various movements of its state associations with regard to professional defense, and encouraged those who have had victories in their movements to share them with their colleagues, in order to base negotiation strategies. Below is an account of the important achievement of the Society of Radiology of Pernambuco (SRPE), with the work of its Director of Professional Defense, Dr. Álvaro Campos, and the president of the Fees Commission of the State of Pernambuco, Dr. Mário Lins, with the support of the president of SRPE, Dr. Maria of Fatima Viana Vasco Aragon:

Dear colleagues,

We came here to bring a report on a topic that is of great interest to radiologists.

As many of you may already know, in recent years we have had actions in favor of defending the fair remuneration of physicians, filed by the various Medical Fee Commissions, which have as their main axis the strength of the Physicians Union, doing this work sectorally together with the various categories through their Societies.

The Pernambuco Medical Fee Commission has a very close partnership with the Pernambuco Radiology Society, which has brought promising results in the various negotiations with Health Plan operators since 2013.

All this work and achievements were only possible due to the understanding of colleagues that only together would they have the strength to demand fair remuneration for their work, with periodic readjustments, as provided for in Law 13,003/2014, which deals with contractual rules between providers and operators .

In the midst of all this context, we report yet another victory of the Pernambuco Medical Fees Commission / SRPE, which, eventually, may serve as a subsidy to the work of other commissions.

A little over a year ago, a large health plan operator disqualified one of the most traditional services in the area of Imaging in Recife.

With this news, the radiologists approached the PE Medical Fees Commission, which questioned the operator about the reason for disqualification, since this would mean closing several jobs.

The operator claimed that this Imaging service was performing more “matched” ultrasound and mammography exams than what the statistics showed in the other clinics throughout Brazil.

CEHM then requested a meeting to clarify the facts and asked that there be no disqualification until that issue was completely clarified. It was argued that such a company was a pioneer and specialized in the breast area, and that it was only natural that there would be guidance from mastologists when ordering exams. And yet, that radiologists only perform tests that are requested of them, not prescribing these requests.

The operator then imposed a reduction in the number of plans that could be attended to by this team while the negotiations continued.

This reduction caused a drop of 85% in the care of patients from this operator by this team.

A meeting was therefore scheduled with the plan's management, in São Paulo (SP), where CEHM-PE representatives were received by the medical technical director. This put forward several arguments that, according to its view, would justify the disqualification of the service. In the understanding of CEHM-PE, such justifications would not fit, since radiologists do not request exams, they only perform them.

After this meeting, it was agreed that a kind of audit would be carried out in the service in question and that, after six months, we would sit down again and, given the analyses, we would seek a consensus.

This case was even the subject of discussion in several forums of radiologists at state and national levels, which led to a common feeling that there was an inadequate attitude by the operator, generating serious dissatisfaction among physicians, reflected in notes supporting the actions of the CEHM-PE, and solidarity in service.

The CBR was consulted and issued an opinion regarding breast imaging, which can be seen below.

After several conversations and meetings, CEHM-PE understood that, as nothing was presented that discredited the conduct of the medical group in question, it would be mandatory as a class representation and like CEHM-PE to claim that the plans previously attended under the responsibility of this medical group to return to the original constitution of the portfolio, so that doctors could have back the jobs now lost.

As the expected response from the operator did not occur, it was understood that it was up to CEHM-PE to urge a full return to the situation prior to disqualification, since the agreed deadlines were fulfilled, without any measure or new pronouncement on the part of the operator and without any finding of the reported irregularity.

Almost a year has passed. The operator did not follow up as agreed, nor did it bring up any new facts on the subject. Negotiations were reaching an impasse.

CEHM_PE once again sought dialogue with the operator, informing the great dissatisfaction of doctors from all Imaging services in Recife with the treatment they were being given, in the face of an act that they understand to be totally unreasonable and completely fleeing the high level mutual respect of providers and insurance institutions. It understood that it should also inform the decision taken in the category assembly to position itself and express its repudiation of the aforementioned act, making the population aware, by all available means, facts about the impasse that occurred, with the consequent indication of stoppage.

We understand that the arguments presented were understood as valid, with the previous accreditation circumstances having been fully reestablished, reflecting the spirit of understanding that, finally, prevailed, restoring the dialogues to the level we always wanted to maintain.

From here we want to get the message that the search for dialogue must be permanent and that the union of the category must always be sought for the greater appreciation of it.

Let's move on,

 

Mário Fernando Lins / Maria de Fátima Aragão / Álvaro Campos

Pres. of CEHM-PE / Pres. of SRPE / Dir. Def. Prof. of the SRPE