How far should doctors duties extend before we pay extra money?
One of South Africa’s most popular low budget airlines, Kulula.com, is characterised by the service that it offers it’s patrons, including a pay-as-you-go service to purchase beverages and snacks on flights. The airline also offers the added benefit of paying extra to pre-reserve a seat on the flight. While this has proved popular in the airline industry, one has to ask if added services would be applicable and beneficial in the medical scheme industry.
This is the current situation facing the US medical industry. A report by Concierge Medicine Today indicates that there are about 12 000 doctors in the US who now run concierge medical practices. These companies are charging patients between $1 200 and $2 500 for providing enhanced care and the number of doctors that are adopting this approach is increasing.
The report adds that some of these doctors accept medical scheme payments and some are expecting patients to pay the fee upfront and then claim the money back from their medical scheme.
Fees for outside consultations?
How many times have you been faced with a medical situation where you could have easily just sent an e-mail to your doctor or picked up the phone and asked for medical advice? Often, these small issues open up the door for doctors’ visits, particularly when children are involved.
Doctors in the US are offering patients a concierge service for a small fee, usually $50, a patient is able to receive medical advice over the phone or by e-mail.
It seems as if South Africa is not the only country in the world that wants to create gravy trains in every industry. One has to ask if providing advice to patients over the phone or by e-mail for free was not part of the service that doctors used to offer patients? While this has not become a major issue in the US yet, there are a growing number of reports that have voiced their concerns about this service.
Enhanced care slippery slope
Often, after receiving care from a specialist, you receive a courtesy call from the office asking you to rate the level of service that you received.
According to reports from the US, these calls are being followed up by an offer where for a nominal fee per month, a patient can receive a concierge enhanced care service. Patients would be able to receive next day appointments with the specialist and they would be able to receive the specialist’s cell phone number.
This care is being sold on the premise that it is for patients who are looking for the specialist to act in an enhanced capacity and it is only available to a limited number of patients. The doctor selling the care, will then go on to describe how a certain amount of hours are set aside each day to accommodate these patients.
This opens a whole new can of worms within the industry. Do we assume that specialists are only offering the best advice to patients who belong to the enhanced care programme? What about patients with genuine medical issues who do not belong to this programme? Will they have to take a back seat while patients who do belong to this programme enjoy the best that the doctor has to offer?
For ethical reasons, I doubt that this is the case. However, these are the types of questions that will be asked by patients.
The local effect
While these are challenges which are currently affecting the US medical industry, we cannot be complacent and assume that there is no chance that they could make a local appearance.
This would have a devastating effect on the South African market as there is already an impasse in an industry that has no medical tariffs which almost gives medical practitioners free licence to charge the public what they like.
It seems as if the majority of the anger in the US market is being directed towards medical schemes. Consumers pick a medical scheme based on the mind-set that certain doctors will accept them and that if you go to a medical practitioner and abide by the rules, you should not have to pay extra just to get into the door.
There are also significant accusations in the US that medical schemes are actually aware of these practices, but are not making any moves to block them because any fee that a client has to pay out of their own pocket will discourage them from seeking medical advice. Therefore, claims are decreased.
Editor’s Thoughts:
This is a frightening thought, and one that would have a significant impact if it became a reality in South Africa. Gap cover was created because of the fact that there are no tariffs in the industry, so if these trends had to be adopted by South African medical practitioners, is the industry prepared for yet another demarcation debate? Please comment below, interact with us on Twitter at @fanews_online or email me your thoughts [email protected].
