Council probes alleged racism by medical aid schemes

Black and Indian doctors have detailed under oath how they were bullied by medical aid schemes who queried their claims and refused to pay, leading to some taking their own lives or losing their practices and homes.

The practitioners told the first day of the Council for Medical Aid Schemes’ hearings into allegations of racial profiling against black and Indian private medical practitioners yesterday that they were targeted for perceived fraud, incorrect billing and excessive prices to block their payments.

At the heart of their submission was that medical aid schemes demanded proof of consultation, including clinical notes, while their white counterparts were simply required to “verify” a consultation before payments were made.

Dr Hlengiwe Zwane, a clinical psychologist, testified that she was blocked by a medical aid scheme and her patients referred elsewhere when she refused to be “bullied” into breaching her sacrosanct “doctor-to-patient confidentiality” to release her patients’ clinical notes as proof of consultation.

She told the Section 59 Investigation Panel, chaired by Advocate Tembeka Ngcukaitobi, that when she continued treating her patients and charging them cash, the medical aid scheme refused to reimburse the patient.

“I was told, ‘If you do not give us what we want, we are going to block you’.

“Some of my patients are high-profile people and do not want their most personal medical information to be shared with a third party.

“I need a patient’s consent to release such information to a third party and without it, I just cannot,” Zwane said.

She said the past two years have been the most difficult period for her, with bills piling up as she continued treating her patients despite lack of payment due to the relationship of trust she had built over many years with them.

This “reality”, Zwane said, has had a profound impact, not only on her patients but also on her well-being. She says she has undergone two surgeries due to health complications associated with stress.

She was excused after her testimony as she was not feeling well, with her colleagues asking that a moment of silence be observed for their colleagues who were in a similar situation and those who had committed suicide.

At least three black practitioners told the inquiry that their white counterparts had told them how they were only required to provide a diary to verify their consultation with a patient and how this led them to conclude that they were targeted because of the colour of their skin.

A North West general practitioner, Phonyoka Seeco, 60, said he was last paid in 2015 and that his practice had survived on reserves, which were about to be depleted. He claimed his outstanding bills amounted to more than R5 million.

“I feel robbed … I have had to pull my children out of school. I am only left with about R100,000 in the practice reserves. I have been crippled,” he said.

– siphom@citizen.co.za

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