Need to know
- A chain of medical clinics in NSW, Qld and Vic will only bulk-bill patients who sign up to their app and rewards program
- Patients of the Our Medical clinics are outraged at being forced to choose between signing up or being out of pocket
- Our Medical's online privacy policies are broad, vague and allow the sharing of data with ‘third parties’
When Gold Coast retiree Ken received an email from his regular bulk-billing doctors' clinic in June saying that they had started a rewards program, he wasn't particularly interested.
But after reading the email promoting the program, one line left him outraged.
"Non-members will be charged a private fee to see a GP," the email said.
Our Medical operates around 33 medical, dental and radiology clinics across the east coast of Australia. The medical chain is raising the ire of some patients who say they're being forced to hand over their personal data through an app and rewards program, or pay extra fees for appointments if they refuse.
"I don't see why I should have to join anything," Ken tells CHOICE. "I wouldn't join if they paid me, just out of principle. Something seems very unethical about it."
Extra fees
Ken isn't the only one raising complaints about Our Medical.
When another CHOICE supporter based in western Sydney (who asked not to be named) went to the company's Penrith clinic, she was told she had to sign up to the Our Medical app and rewards program in order to make a booking to see a doctor.
She questioned why she couldn't simply just see the doctor without signing up. She was told there'd be a $90 out-of-pocket fee if she chose not to sign up to the app.
The customer says she felt like patients were being used as a "marketing tool" and that the practice was "unethical".
She was told there would be a $90 out-of-pocket fee if she chose not to sign up to the app
Privately owned by Cornerstone Health, Our Medical's privacy policy – available on its website – says personal and health information collected on individual patients can be used "to conduct business processing functions including providing personal information to our related bodies corporate, contractors, service providers or other third parties".
It also says that data can be used for the marketing and research purposes of Cornerstone, its contractors or service providers.
The policy also says that if the member permits device location settings on the device they are using the rewards program on, then their location will also be tracked.
'Ethically outrageous'
Melbourne University Professor of Law and co-director of the Centre for AI and Digital Ethics, Jeannie Paterson, says while the practice of charging patients more money for refusing to sign up to an app and share their data was likely not illegal, it was "ethically outrageous".
She says the policy's statement that it will share data with third parties is "ridiculously unclear and undefined", and that using patients data for research and marketing were not what one would expect when signing up for a medical service.
The assumptions that we had about how medical professionals handle information simply don't apply
Professor Jeannie Paterson, Melbourne University
"It's so difficult for consumers to manage their personal information and their sensitive information because they're used to dealing with doctors where the parameters and the ethics are well understood and well regulated," Paterson says.
"Now we're in that grey zone of dealing with digital platforms or digital health intermediaries where the assumptions that we had about how medical professionals handle information simply don't apply," she adds.
Cornerstone Health responds
A spokesperson for Cornerstone Health says the Our Medical app has been progressively rolled out at clinics over the last nine months.
"There is no obligation on privately owned medical centres or practitioners to provide general practice medical services on a bulk-billing basis," they say.
"However, general practice medical services are available on a bulk billing basis at Our Medical to patients who have joined the Rewards Program. General practice medical services are available on a private billing basis to all other patients.
"Cornerstone Health handles all personal information in accordance with relevant privacy and health records legislation," they add.
What kind of society do we want?
Hannah Smith, from the University of Western Australia Tech and Policy Lab, says Cornerstone's practice of seeking patient consent to share data is questionable when it is taking place in the same online form as general medical consent.
"While the health sector in Australia is somewhat of a business, it doesn't feel that it fits with the spirit of the law to collapse both the medical and business side into one when asking for consent," she says.
She is concerned about senior citizens and others who might not have the digital literacy to access a smartphone.
Smith also questions whether access to healthcare should be based on your willingness to hand over data.
"It goes to what kind of society we want to be living in and whether we think it is fair that access to affordable health services are premised upon this," she adds.
Serious questions raised by health consumers
Consumers Health Forum of Australia CEO Dr Elizabeth Deveny says the national peak body for health consumers were concerned about the implications of primary care becoming increasingly corporatised in Australia.
"Where profit is put before patients, you have to question whether people are getting optimal care," she says.
"For people on low incomes or pensions, many of whom would be eligible for bulk-billing at most GP clinics, this approach raises serious questions about equity and accessibility of services."
Reforms to the Privacy Act needed
CHOICE senior campaigns and policy adviser Rafi Alam says patients need more assurance that their sensitive information isn't being exploited for commercial purposes or shared with unknown third parties.
"Many Australians are already struggling to make ends meet, and being slugged with extra fees to access a vital service only makes things tougher. Consumers shouldn't be forced to choose between their privacy or getting help when they're sick," he says.
Alam says the federal Attorney-General should fast-track proposed reforms to the Privacy Act to better protect consumers and restore the balance between businesses and their customers.
Consumers shouldn't be forced to choose between their privacy or getting help when they're sick
CHOICE senior campaigns and policy adviser Rafi Alam
"Too many businesses are finding ways to collect data in unfair or underhanded ways. Consumers shouldn't be pressured to sign up to apps or reward programs just to access a service, especially when it's something as essential as a GP appointment.
"Introducing a 'fair and reasonable use' test in the Privacy Act would ensure businesses only collect and use data for the express purpose of providing the service and not use it in ways that unfairly exploit the customer," says Alam.
Do you know more about this story? Contact CHOICE investigative journalist Jarni Blakkarly at [email protected].
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