Martin Young
Martin Young

Discovery Health wants a picture of your anus

Didn’t your mother warn you to never, ever, ever take a photograph of your private parts and give it or send it to anyone, let alone a complete stranger who asks for it? But this is exactly what happened when Donn Edwards, an old school friend of mine, submitted a claim for specialised wound care from Discovery Health. Discovery wants a picture of his butt. Donn has given me express permission to explore the ridiculousness of this situation.

I know Donn Edwards as a passionate man, relatively easily incensed by affronts to his dignity, a trait that we “friends” used to our own enjoyment in the brutal environment of an all-boys boarding school in the late 1970’s. Donn, now a programmer, has developed his own sense of worth and morality as a campaigner for personal privacy in the digital age, and has been a real pain in the anus to big corporations who transgress these boundaries.

So in an act of cosmic karma, Discovery Health unwittingly refused his request for specialised wound care when he developed a memorable condition, ranking alongside childbirth and renal colic, known as a perianal abscess. For those interested in the details, Donn tells the full story here. In a nutshell, he has been left with a festering crater in his ringpiece, which needs specialised dressings to heal. And for which Discovery will not pay until they have a detailed and explicit photograph in their sweaty palms.

Donn (@donnedwards) is not a man to take this sitting down, both literally and figuratively, and DM’ed me his concerns. I (@martinyoung) asked the Destroyer-in-Chief of Discovery Health, Dr Jonny Broomberg (@jonnybroomberg) for an opinion. Donn, with the resigned air of a man whose bum was about to go public, then outed himself with an entertaining train of tweets, now detailed in his blog, to us both. The stalemate, however, remains. Discovery stands its ground and still wants a photo of his butt.

Let’s explore the ridiculousness of this all for a bit. Lagging only momentarily behind the porn industry, doctors have been taking photographs of bottoms and other bits for as long as there has been photography, primarily to use the images as clinical records and teaching aids for textbooks. In every modern case, however, the patient must be unidentifiable and needs to give permission beforehand. To do so because the medical funder demands it is a new invasion of privacy with which many doctors, as I do, feel uncomfortable.

Tempting as it may be, a brief sojourn sitting on the office colour photocopier is no substitute for a medical photograph. Medical photography itself is an art, requiring special lenses and light sources, with many academic hospitals having their own photographers who see all the legal requirements fulfilled and make sure the image has some academic value and practical purpose. It is not an easy process, unless there is some new filter on Instagram or Snapchat that I don’t know about.

The “anatomical position” for an anus is with the body lying in the prone position, and the vast majority of photos taken to document anal pathology do this with the subject in lithotomy poles or stirrups. Now, I don’t have a set of lithotomy poles at home and I don’t believe many normal people do. The kind of friend who does probably does not represent the kind of friendship one wants to encourage. So one is left having to lie in one’s bedroom, assumedly, with less than perfect lighting and exposure. The buttocks will have to be gently retracted in this instance to reveal the focus of attention, and the guy bits will have to be elevated by hand, unless one resorts to using duct tape, and this involves three hands, with no spare hand to take the photograph. Not even your new selfie stick will do.

So, the indignity of it all not being enough, another person has to take the photograph. Who should this be? Second cousin Sidney who did your wedding photographs? Your best drinking buddy? Your mom? Your wife? Some marriages are on shaky ground already and may not survive this incident.

Make sure your images do not download instantly onto Instagram, for this may cost you old friends and gain you new ones of the wrong sort. Likewise, remove the image from your phone, lest you show it inadvertently to the girl you’re trying to impress with photos of your skydiving trip.

Assuming you do get a decent enough photograph, how do you prove the bum in the image is yours unless your face is in the picture, and this is not a stranger’s bum taken off the internet? (Yes there are images there and no, I am not inserting a link.) Or should you at least make sure your ID book is open and stuck to one buttock as proof of your identity?

A perianal abscess wound is a deep three-dimensional cavity, and a two-dimensional image may well understate the severity of the condition. Photographs nowadays, as EVERYONE except Discovery appears to know, can be photoshopped to make things look bigger, smaller, redder, pussier, or even include a maggot or two.

Assuming you overcome all of these obstacles and have a glossy, colour-contrasted HD image of your bum and identifying features to submit. Then what? Discovery wants you to email it to them. Not, as you would hope, to their resident proctologist at [email protected], who is a connoisseur of gaping anal wounds and past shocking, but instead to the general claims department!

Donn, having been annoying to many big corporations in the past and an expert on privacy, knows that his image could easily be intercepted by the FBI, Mossad and M15, or anyone else with a vested interest in him. Who at Discovery gets to look at this image? What qualifications does that person have? What security is there over their database? Could it not be your vindictive ex sister-in-law, who used to be a midwife but was fired for being too fond of the Entonox in the labour ward, and who now works as a Discovery case manager, who gets the image in her mailbox? You have absolutely no idea and no control whatsoever over your public humiliation!

This is all blatantly ridiculous, and some members might think that the financial pay-out is worth a bit of indignity. But the very worst thing about this is that Discovery, and many other medical aids, no longer believe the word, or opinion, or recommendation of the doctor looking after Donn, or you, or me. This is where we are at the moment, what this ridiculous policy means. Big Brother, the earner of fat profits from healthcare, is firmly in control of your health, not the doctors who trained so hard and work so hard to keep you well. This is the real shocker!

In my opinion, the only butt picture Discovery deserves is a group photo of all the doctors like me and likeminded consumers who oppose their tactics, showing them in unison exactly where the sun doesn’t shine.

And what’s more, not only can they have a picture of my healthy butt. They can kiss it, too.

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    • Kim Van Der Walt

      This is honestly the funniest piece of writing I’ve ever read. Yet it still doesn’t detract from the seriousness of the subject. Discovery should take a long, hard looks at their anatomically incorrect processes and then look up the definition of ‘customer service’. They definitely won’t find an infographic of their claim submission procedures.

    • http://batman-news.com DavyH

      Don’t be diagnosed with cancer as a Discovery member.

      Other than that, beautifully written.

    • Tim Bester

      Brilliant! Thank you (and Donn) for this wonderful piece…I am sure it will go viral..it epitomises how big business has morphed into the equivalent of nanny statism. Whether it is medical aids, or banks, insurance companies or assurance, they create bureaucratic processes in order to not render the service for which we have paid.

    • Andrew

      Hehehe! Oh man, just snorted my tea through my nose. And then having to email it through on the general claims email!! Do the Discovery staff get trauma counseling after opening the picture?

    • Peter JC

      This is a real ‘discovery’, and typical of Discovery. What a cheek! They make a song and dance about what a good medical aid they are, but screw their members both financially & medically – just look at their billions of rands in pure profit every year. Those billions are what they should have paid out to their members instead. What a bum rap.

    • Jacques De Villiers

      You do realise that your friend can exploit this weakness in Discovery’s system and send them unlimited indecent pictures, all of which they will have to process, until they decide to relook their policies.

      I suggest you start sending them a still image of every frame from every Leon Schuster movie ever made, one by one.

    • Toast Seagers

      I had a situation with South African Airways recently. Not quite as invasive but still… A doctor’s letter was not considered sufficient to justify a flight cancellation and they insisted on seeing hospital bills. If someone was pulling a fast one do they really think a bill would be harder to fake than a letter? F%$#ing beurocrats.

    • Elaine Cloete

      This is funny…..

      However most large medical aids have the same protocol’s…..not so funny…

      This is again the predicament of people only doing what they “have to” and not what they should and that would warrant the request for the picture ……… what they should do is check the medical records on system (everything is coded from the doctors visit to follow up care) the coding would be there for the abscess as well as a treatment plan (that would include the size and depth and status of the wound) from the wound care sister and the treating doctor would also be there on records. He has most probably also been into hospital for treatment for the condition.

      So no picture would be needed…….

      Again the medical aid is blamed instead of the PERSON…….sad but true.
      PS. You would be amazed what you can get Discovery Health to pay for if your coding is correct. ( just saying….. and that goes for most medical aids today)

    • Martin Young

      Clint – As I suggested to you on Twitter – read my other posts on Thought Leader. Some of what you say is true – the patient does get stuck with the bill. Your view is a bit simplistic.

    • Martin Young

      I’m pleased Discovery has decided to amend their policy to ‘request’ rather than ‘require’ a photograph. Perhaps those who created the policy in the first place have some explaining to do. I doubt however that it would have happened if I had not written this post.

      Funny stuff happens when accountants and actuaries make decisions impacting on healthcare. I sometimes believe their number-crunching intelligence leaves them short of the ’emotional intelligence’ that suggests outright that there is something wrong with policies like this.

      If they insist that there is nothing wrong with having one’s private body images submitted to claim cover that one has signed up for, I suggest perhaps the playing fields could be equalled by Discovery’s board posting their own naked pictures on the company website;).

    • Ciberdoog Isawsome

      “Donn, having been annoying to many big corporations in the past and an expert on privacy, knows that his image could easily be intercepted by the FBI, Mossad and M15, or anyone else with a vested interest in him” – Yeah, and thanks to the absurd Internet laws in South Africa, it can and will also be intercepted by anyone at your ISP. I can just imagine the entertainment value in the I.T department of some of the ISP’s of those photos.
      I wonder if the “Healthcare” will then cover the stress induced aftermath of your mental health, having to deal with such absurd systems.

      Healthcare – Clearly an oxymoron.

    • Ciberdoog Isawsome

      “As much as many will snigger at this a medical scheme is a non-profit organisation. They make a small percentage off administration charges. The rest of the contribution you pay goes towards covering solvency for actual medical expenses.” – So then, please explain to me, how they can afford to pay their director such a high salary, as reported by Bloomberg?

      http://www.bloomberg.com/research/stocks/people/person.asp?personId=2247892&ticker=DSY:SJ

    • Clint

      You’d need to ask him for a break down of his salary but I’d hazard a guess that being a member of the executive committee of Discovery Limited and a director of 4 other businesses has something to do with that. Discovery Health Medical Scheme is a separate entity. It hires Discovery Heath to administer the scheme.

      In 2014 only 7.9% of contributions paid went to administration costs. And this percentage has been decreasing every year since 2005. By the way, all of Discovery Health’s financial reports and breakdown of these numbers are freely available online.

    • Uffa

      Martin you must have had fun writing this…Donn had a bum deal -I only hope the aetiology did not include a lithotomy pole. Say R Sole has a wound which he refuses to disclose in a photograph and the medical aid will not accept a report from his doctor and he treats the area himself , gets infection and even gangrene, will the medical aid now pay up for the adverse outcome created by their sphincter like action on the purse strings.

    • RSA.MommaCyndi

      Oh that was amusing!
      I have to wonder what some poor claims clerk would do with the picture? Would they even know what they are looking at? For that matter, why would someone even lie about having a hole in a delicate area – is there a secret black market where derrière dressings are in demand?

    • http://donnedwards.openaccess.co.za Donn Edwards

      The system set up by the medical aids determines the behavior of their employees: they stuck to the letter of the protocol instead of using their common sense.

      Clearly the system of unpublished secret protocols must change. Also, the medical “aids” must stop dictating to patients and doctors, but work with them. No wonder most doctors hate Discovery’s meddlesome ways.

    • http://donnedwards.openaccess.co.za Donn Edwards

      Noseweek Sept 2007:

      >>

      The Council for Medical Schemes (CMS) is not happy with Discovery Health, and has admonished the company in the past. So why has the CMS not done anything to stop Discovery running a medical scheme with a solvency ratio of less than the required 25% – in flagrant contravention of the Act?

      With a solvency ratio of around 18%, any catastrophic event will cause untold problems at DHMS. And, if trends are to be believed, medical aids will see a big (20%+) increase in claims for 2007 over 2006. This must lead to heavier increases in contributions.

      Discovery Health Medical Scheme (DHMS) is a subsidiary of Discovery Holdings Limited (DHL). DHMS pays DHL to administer the medical aid we all know as Discovery. Do the 1,8 million people on the scheme know that the admin fee paid by DHMS to DHL amounts to R2,1bn per annum? And when Gore states that the media is “hyping” the lack of reserves and proudly announces that they have R4,4bn, he neglects to say that almost half
      this is the admin fee which must still be paid to DHL.

      <<<

    • Alice Pattinson

      I do really love to read articles like this which includes Selfie Stick Pro as a subject.

    • Martin Hatchuel

      You sure you’re writing about healthcare here, and not the media?

    • Clint

      You need to mention relevancy of a cut and paste job please?

      1. In 2014 solvency was up to 25.7%. Above the required 25% so all good there. The value of the reserves is R11.7 billion.

      Discovery is often a victim of their own success. When new members join they have no reserves. The need to be built up. A medical aid with fast membership growth, which is ultimately a good thing, will battle with the solvency.

      2. In 2014 gross contributions were R44.91 billion. Risk contribution was R36.1 billion. 2.63 million lives covered. Expenses for administration were R3.58 billion. Administration expenses divided by the gross contributions gives us the figure of 7.9% of contributions going towards admin costs. Perfectly reasonable and less than many other medical aids that outsource their administration.

    • Rod MacKenzie

      Hey Donn! Long time no see! Or hear….hilarious story, get in touch, Rod…..small world too…..

    • Graham Eddy

      Hi Martin
      Really enjoy your articles. Moved my family away from Discovery last year to Momentum (more benefits at cheaper cost – no brainer for us).
      However, have to question your assertion that the accountants and actuaries are to blame for this “butt pic” proposal. I’m an accountant and see plenty wrong with this policy, as I’m sure many at Discovery do.
      Also, why have accredited Discovery practitioners if Discovery don’t trust their judgement regarding treatment?
      Cheers

    • Martin Young

      Hi Graham

      Thank you. I will limit my criticism to “Discovery’s accountants” then:) Good to know not everyone shares their views.

      Reading Donn’s post reiterates that Discovery was firmly intent on proceeding with this policy. They needed to be ridiculed to see that their own ridiculousness.

      As for ‘contracted’ doctors, please read

      http://www.thoughtleader.co.za/martinyoung/2013/08/14/why-should-you-be-concerned-if-your-doctor-is-a-designated-service-provider-5/

      Martin

    • Graham Eddy

      Thanks Martin, appreciate the response.

    • Kenny Williamson

      And I still question the need for all these cash reserves…. things were good and well when the risk was simply reinsured… the solvency requirements come from the council. Why on earth must so many schemes be sitting with liquid reserves?
      Other than that really found the bum story very funny, if not a bit sad.Unfortunately, as corporations go, common sense goes as people start watching their p’s and q’s.
      Glad you got it all sorted Donn.