Medical reports “at the speed of an express train”: IV doctor collected 568,650 francs in his part-time job

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If someone applies for disability pension, the Canton IV offices must explain whether the claim for support is justified. To do this, they prepare medical reports. Reports covering various medical disciplines are randomly assigned. Monodisciplinary reports (i.e., reports affecting only one area) can be distributed directly to relevant experts.

In 2022, Canton IV offices commissioned more than 4,300 single-disciplinary reports. 386 doctors participated: 294 submitted less than 10 reports. 70 doctors prepared between 10 and 50 reports. 22 doctors came with 50 or more reports.

The most popular individual critic was Christian Fricke from the canton of Lucerne. The specialist in psychiatry and psychotherapy received 150 orders for monodisciplinary reports from the offices of Canton IV in 2022 and received 568,650 francs for them. He had already received a lot of money from IV for studies in 2020 (342,425 francs) and 2021 (439,827 francs).

For comparison: According to a study by the Federal Statistical Office, self-employed psychiatrists in 2019 earned an average annual income of 126,633 francs.

150 reports per year is an incredible workload for a single doctor. This number is even more surprising because Fricke only works part-time as an IV evaluator. As Blick’s research shows, 70 percent of full-time jobs are German in Suva. He advises the claims processing department in accident insurance on psychiatric issues.

The Federal Social Insurance Office (BSV) defended Fricke

This leaves him with 70 to 80 working days per year to work as an IV evaluator. During this time, Fricke produced an average of approximately two medical reports per day in 2022, which brought 7,600 francs into the GmbH’s coffers every day. Can serious reports determining the fate of humanity be produced in such a short time?

Fricke has no doubt about this: “The ability to produce meaningful reports within a limited time frame is based on my many years of experience and structured approach to work,” he says when asked by Blick. The number of annual reports will comply with the ethical and medical standards of all involved.

Fricke also notes that he calls on “assistants” to prepare reports: “This is a common practice measure to delegate certain administrative or supporting tasks.” This included, for example, collecting additional patient data or organizing documents. The psychiatrist emphasizes: “The content and medical responsibility of the reports are always in my hands.”

The Federal Social Security Office (BSV), which is responsible for IV assessments, provides support for Fricke: “A technically competent back office can certainly contribute to the rapid processing of assessments,” says a spokesperson. The official also notes that Fricke may work longer than the 70 to 80 days listed in his “freelance” schedule, meaning there will be more time to prepare individual reports.

In addition, BSV states that insured people can determine for themselves whether they have actually been examined by the relevant specialist during the examination interviews. “This can also be confirmed using relevant audio recordings of the interviews,” the spokesman said. In addition, the appraiser guarantees with his signature that the report has been prepared correctly.

But a signature is like that. In 2022, the Cantonal Court of Lucerne criticized the “missing handwritten signature” in the Fricke report. Instead, Fricke’s signature was “clearly copied.”

It is the patients who suffer

Newly elected SVP National Assembly Member Rémy Wyssmann (56, SO) is generally critical of “high-speed IV reports” where one can earn “more than a Member of the Federal Assembly.” The patient rights lawyer pointed out to the state government during a parliamentary question that Fricke’s report had been ruled “inadequate” by the courts and wanted to know: “Will the Federal Council launch an investigation?”

Blick has numerous court decisions criticizing Fricke’s work. The cantonal court of Basel-Landschaft, for example, ruled that his psychiatric evaluation was “incomplete, even contradictory.” In another case, the judges stated that “there are serious doubts about Fricke’s report, so that it cannot be relied upon.”

The Federal Council still sees no need for any action. In his response to National Assembly Member Wyssmann on 18 December, he confirmed that two of the eleven Fricke reports considered by the courts in 2022 were deemed to be “of no evidentiary value”. However, there is “no reason” for an investigation.

What you need to know is that there are other doctors on the BSV list whose reports have been deemed unusable by the courts. According to some critics, his recognition rate is significantly worse than for Fricke.

Alex Fischer, head of the social policy department of the disabled people’s organization Procap, still evaluates Fricke’s work very negatively: “Anyone who produces so many reports cannot deal deeply with individual patients.” Fischer also criticizes Fricke’s statement that a higher than average number of people are healthy.

PMEDA expert body is no longer allowed to prepare IV reports

The figures in the BSV report support this statement: across all reports, total incapacity for work in the previous job was identified in 46 percent of cases. In Fricke, on the other hand, this happened in only 27 percent of cases.

The open expert does not want to go into this distinction, but remains unclear: “Experience in preparing reports can be considered a prerequisite for quality assurance,” he writes. The extent to which there are “statistically significant abnormalities” in their assessments compared to the full range of psychiatry monodisciplinary reports can best be answered by the BSV or the Federal Commission for Quality Assurance in Medical Evaluations (EKQMB).

In 2023, the EKQMB made a negative recommendation to ensure that Henning Mast’s controversial PMEDA expert group is no longer allowed to prepare IV reports. It is highly likely that the commission will take a closer look at the Fricke case in the new year.

Source :Blick