PubMed2003
The tasks of the medical director in private German health insurance companies is largely unknown to the public and to physicians, and there is a lack of scientific literature about this subject, though medical directors have a long tradition in the German insurance system. The result of a representative sample of 826 enquiries to the medical director showed that most of the questions are about the medical necessity of medicines, duration of in-patient hospital treatment, alternative medicine, extensive laboratory diagnostics, physical therapy, the German fee system (GOA) and in recent time also about the demarcation of cosmetic surgery from medically necessary surgery, and about anti-aging therapy and artificial fertilisation. Risk management and consulting about case and disease management is also increasingly important.