Money, not medical concerns, is increasingly deciding how patients are treated claims Bermuda Medical Society President Dr. Jonathan Murray.

He said overseas experts were assessing patients they had never seen in a bid to save health insurers money.

He said: "It's coming in very gradually, we first noticed it about two years ago. Insurance companies are restricting payments more and more."

He said one dental patient was advised by a local dentist they needed six fillings but the insurance company asked for X-rays which were sent to America.

Dr. Murray said: "Someone in America said they only needed one filling based on those X-rays.

"This patient is in a quandary about what to do now.

"I am told X-rays are not a good way to decide whether fillings are needed or not."

He said insurance companies were using "so-called independent opinion" more and more.

This was happening even though the second opinion had not seen the patient but the local medic had said Dr. Murray.

He said local insurers were following clinical guidelines from American academies too strictly.

He said: "They are guidelines not rules."

Patients didn't know now if insurers were going to fund a claim or not said Dr. Murray.

He said he had operated on one of his own staff in good faith but the insurer had said instead of paying the usual $1,200 fee said they would only pay $600 of it.

"She will have to pay the difference even though she went into the operation feeling she was fully covered, as did the surgeon," said Dr. Murray.

"In many cases they refuse point blank to pay."

"American or Canadian experts will be deciding health care in Bermuda. That will be more and more the case.

"I don't know how good or qualified this second opinion is or what information they use to make the opinion because they won't allow us to contact that opinion."

He said health care was becoming increasingly packaged with insurance companies putting limits on how much treatment was needed for a particular problem.

He said visits for some medical advice had traditionally been limited such as visits to physiotherapists.

"I can understand that or everyone would go every two weeks for ever."

But he said this approach didn't allow for individual differences in more critical cases said Dr. Murray.

"We doctors understand health care, that's our main thing. This is about who runs health care."

Asked how the creeping Americanisation could be stopped Dr. Murray said: "The only way to my mind is to say to insurers you don't know enough about the subject to give an opinion."

Calls to Health Insurance Association of Bermuda president Gerald Simons were not returned.

Asked about Dr. Murray's claims Health Permanent Secretary Dr. Derrick Binns said: "I can't comment. I know some physicians feel some insurance companies are moving in that direction.

"It boils down to who has control over whose profession.

"They might not like another profession having control, I don't blame them. Any other profession would be feeling the same way.

"But I can't say if it's happening in Bermuda."