My not-so-nice experience with the Medical industry in South Africa
This is a personal post that is not related to my normal writing but has been on my mind over the last 3 months. Out of respect, I am not naming and shaming Doctors, Specialists or the Medical Services businesses responsible but want to get this issue in the open.
We live in an era where medical practitioners are made by patient reviews as the online reviews are from accurate yet this non-compete and monopolistic behavior is seen daily by patients all over South Africa and the world in my opinion.
When you are a patient you believe your Doctor has your best interests at heart, well that turns Machiavellian once you decide to leave him or her. I am lucky to have a really good Medical Aid (Discovery Health) who provides me with peace of mind every month regarding getting the best treatment for chronic issues. Yet, this seems to be an invitation to certain Specialists to charge rates that are 200–300% over Medical Aid rates. Yes, I understand that these individuals have studied for years, have huge risks and responsibility but this for me feels predatory.
The background
After almost 10 years with a Specialist I decided to find myself a new Specialist as the Doctor involved missed some obvious things.
My previous Specialist withheld information but could not wait to charge me above average medical aid rates for a consult ( R2200 or $175) but being helpful to other Doctors was not a possibility. This specific Specialist made a conscious effort to undermine other doctors abilities to assist me by not providing reports or providing reports that were hastily written. As a patient we are oblivious to the bullying that General Practitioners experience from certain specialists who are obnoxious and rude to them but these same Specialist are looking after your best interests.
There is a huge misunderstanding by most patients — once you leave a Doctor or Specialist he has no obligation to provide your file to the new Doctor of your choice. This is wrong and bordering on anti-competitive behavior in my opinion — I believe here that Cryptography has a role to play as I should be able to access the service providers of my choice with my medical history without the concern of having to ask for my medical history. I agree certain information is sensitive (HIV status etc) but not being able to access your own information is just not on.
Most Specialists practice at a hospital and then refer their patients to a specific radiologist service provider or pathology service which then only sends a copy to the Specialist yet when your new Doctor contact said service operator they are unable to access that information. In my case I had to physically visit the hospital’s radiology department to get a physical copy of my MRI as “doctors not on their network are unable to access this crucial information”. Surely, as a customer that information should be accessible to any new service provider of my choice with my consent?
I was told by my new Specialist that he is unable to access certain records at work due to using a different operating system on his computer. This is 2017 where we have cloud computing where one can access data anywhere yet the medical industry seems to be in the dark ages.
Lessons based on my experience for others
Lessons learnt over the last 3 months: If I go for X-rays or MRI scans, I want a physical copy sent to me via the service provider. I keep a meticulous list of which service providers I have used in order for a new doctor to be able to access this information.
I believe that what I experienced is very noncompetitive and bordering on monopolistic behavior by certain hospitals and service providers. It makes freedom of choice and movement almost impossible and puts the customer / patient at a sizeable disadvantage in getting conditions adequately managed.
The Solution
My perfect solution is that I have a cryptographic service which I provide service providers access to and then they have write access to my data. I then provide read access to service providers of my choice to ensure that diagnosis, notes and reports can be accessed by my Specialist.
Private cloud computing should become mandatory for all medical groups who provide consumers with services which then will alleviate all of this.
There are Good Doctors that are not Tyrants
The Tyrants — your patients are leaving you in droves. As patient care becomes more personalised, I believe these tyrants will either retire or become more verbose in their actions. Remember your Medical Oath and remember that we the patients are ultimately paying you for a service.
I want to make clear that there are some amazing Doctors and Specialists that I have encountered, who treat their patients with care and genuine concern. These are the Doctors who apologize for being late, ask questions that are important and listen to their patients. These same Doctors can be seen in most cities — they have long waiting lists when you phone their practice, work long hours and are the same doctors who are treated like dirt by more respected Specialists. We the patients know who you are and thank you for being human and doing great work.
