plan to "ban'' family doctors from making direct overseas referrals.

Dr. Brown was responding, at a press conference, to recent news that patients going abroad without seeking a second opinion from local specialists will have to pay up to 20 percent in insurance premiums.

From April 1 -- according to the Health Insurance Association of Bermuda plan -- family doctors must get the approval of a local specialist before their patients can be covered 100 percent abroad.

By introducing the plan, the HIAB said it hoped to prevent Bermuda's insurance costs from "going through the roof''.

Insurance companies have said residents are leading Bermuda into a US-style health crisis, with costs zooming out of reach of ordinary people.

Therefore, the HIAB said it wanted to bring in a system of second opinions from local specialists to cut "unnecessary'' trips abroad.

But yesterday Dr. Brown said while insurance companies' concerns were legitimate, the HIAB action was hasty and showed "a callous disregard for the opinion of those who actually deliver medical services'' in Bermuda.

He said doctors at the Bermuda Medical Society's last meeting "seemed quite prepared to work with the insurance companies to reduce the flow of Bermudians going abroad unnecessarily for medical care''.

And he said doctors were prepared for further discussion on the matter.

But, Dr. Brown said: "The HIAB had failed to capitalise on the cooperative mood of the family physicians. As frontline participants in health care, we are especially sensitive to the need to reduce costs.'' He said a "more constructive approach'' would have been to create a "rotating panel of doctors'' who would be selected from the Medical Society, headed by Dr. John Stubbs.

"These doctors would serve to evaluate an overseas referral in the event a particular insurance company's medical advisor did not agree with the opinion of the patient's family doctor,'' Dr. Brown explained.

"In this way, the patient's advocate, his family doctor, would remain central to the process, and the burden of clearing the referral would not rest with a single specialist who may be less informed about a particular area of medicine or surgery than the family physician himself.'' Dr. Brown also called on the insurance community to join doctors' fight to bring overseas specialists to Bermuda.

HIAB president Ms Judy Panchaud said she agreed with Dr. Brown "wholeheartedly'' on the latter suggestion.

She also said an informal working committee with representatives from insurance companies, the Medical Society, the hospital, and PALS was formed at the end of last year to look into such issues.

But, Ms Panchaud denied that insurance companies were trying to interfere with the work of the local medical profession. And she said the HIAB's plan received verbal approval from the Medical Society's executive after detailed discussion took place between the two bodies.