Unnecessary surgeries carried out on Gesy to be monitored

The health insurance organisation (HIO) has placed surgical procedures under a close watch, as reports emerged on Monday of over 90,000 operations carried out in the space of one year within the state healthcare system (Gesy).

The stepped-up monitoring of registered interventions in the Gesy database comes as part of a general effort to prevent abuse within the system.

Figures for 2022 showed that that within one year 90,500 operations were carried out –corresponding to approximately one in ten Gesy beneficiaries – which is in itself cause for concern, according to media reports, and the high number raises the question of how many of these operations were truly medically necessary.

The question of how scalpel-happy doctors are by specialty, including gynaecology, has also been highlighted by the case of a woman who reported her experience of being pressured to undergo a hysterectomy to the patients’ association (Osak).

According to the woman’s report, her gynaecologist subjected her to repeated biopsies of doubtful indication and told her repeatedly that a hysterectomy was required.

The woman asked for referral to a different gynaecologist within Gesy, who assured her that there was no reason to undergo such a surgery.

According to the patient, the first doctor had told her that all women receiving a particular medicine must undergo biopsies every six months because the drug causes endometrial thickening.

She consented to the first biopsy when the gynaecologist told her the endometrium had thickened to 5mm. Within four months, the woman visited again, and was once again told that she needed a biopsy. Four months later, following a Pap smear the doctor once more said the endometrium had thickened, and again recommended a hysterectomy so as to “avoid having this problem all the time”.

The woman refused and a month later, when visiting a doctor of a different specialty, informed him of the matter. This doctor changed the woman’s prescription, assuring her that she would no longer have any problems with endometrial thickening.

Two months later she visited her gynaecologist again who again insisted her uterus would have to be removed, and advised her to undergo another biopsy because the endometrium had reached 8.5 mm.

The woman visited a different gynaecologist who cleared her of any problems and determined the endometrium was at 3mm.

“This is an example of a complaint that sometimes comes up – and it must be said not very often,” head of the patients’ association Charalambos Papadopoulos told daily Philenews.

“Similar complaints from the public about doctors of various specialties do from time to time come to Osak,” he said.

Speaking to the Cyprus Mail a representative for Osak said the organisation is not in a position to conduct a fine-grain analysis of the nature of the complaints it receives, but that from October 2022 until October 2023, complaints from male and female patients were 599 and 511 respectively.

Safeguarding the system from abuse and making the HIO aware of incidents to ensure proper monitoring, is up to patients themselves, Papadopoulos said.

But it would be “a big mistake” for patients to distrust all doctors and ask for second and third opinions, according to the advocate.

“I think that we all have enough common sense to judge when something doesn’t seem right.”

The patient advocate association’s line for reporting incidents and abuses is 1403.