Doctor's Fees...A Rant!

[KleinBoontjie]

where you there ? because this story sounds like BS to me

No, my wife took her and phoned me to do an EFT to the Hospital.

 

[Singal]

I wonder if the Doctors still take that Hippocratic Oath, or maybe they should update it to reflect the new ways.
A lady friend of mine cut herself the other day, while she was standing in medi-clinic, bleeding on the floor, they told her that she needs to pay R650 upfront before they can help her......WTF, it's no more: "Go out of your way to save a life", no it's more like: "Go the extra mile to make money"

I've heard of this happening more than once.
Is it not strange that when people complain about Isp's ,their complaints are entertained here, but when they rant about doctor's fees, pharmacists and doctor's spouses are quick to jump down their throats ?

 

[R13...]

This thread is so much fail. /sigh

At least a little common sense in this thread:

That's a special case... most doctors are attached to medical facilities where they send you off for "machining" and only worry about renting rooms and maintaining their offices. You and your medical aid are responsible for the charges incurred in those investigations and I suspect the doctor gets a kick back for referring you.

 

[AlmightyBender]

Hi, as a medical specialist(obstetrician and gynaecologist) I'd like to weigh in here and explain why we charge what we do.

Firstly, overheads - Malpractice insurance - R25000 per month!!!
- Rooms - R7000pm
- Loans(to be able to set up a practice in the first place - R600000 over 5 years) R12000pm,
- practice staff - R16000pm
- billing software - R7000pm
- auditor/financial planner - R3000pm

Those are just the big ones. My ultrasound machine is 5 years old. A new one (so you can see your baby better) is another R550000 or 11000pm. All of these have to be payed every month and then we still need to pay tax - roughly a third of my net income after expenses. Ultimately, I take home between 25% and 30% of what I write in a month, meaning I need to write R200000 to take R50000 home at the end of the month.

Then you still have to write off bad debt, pay for consumables, income protection etc.

Don't get me wrong - I love what I do and seeing the joy on a parent's face when you deliver a healthy baby really is it's own reward - but that reward doesn't pay my rent/food/petrol etc.

Out of curiosity, and if you are willing, how much do you take home a month on average?

 

[Niner]

I can assure you the doctor most definitely DOES NOT get a kick back for referring you for special investigations. The real money is made by the hospitals and they are a business. Unfortunately, everybody needs to get paid. I'm just curious - all of you complaining, how many of you "work for free"?

As far as the bleeding incident - the private hospitals will stabilize you in the case of a life-threatening event(like a car accident). If you walk in and it's minor bleeding/sprain ankle etc, they will likely show you away.

 

[Niner]

Let's just say - less than R50000. This is at 200% medical aid rates. If you only charge medical aid rates, there's no way you'll make a living. And I'm open to negotiation, especially in the case of an emergency. For elective cases, you can shop around and find the cheapest option - which happens to be me at the Mediclinic in the northern suburbs of CT where I work. If it's an emergency and you're bleeding out on the table, I'll do the surgery first and worry about the finances later.

Did a case a week ago - emergency surgery for an ectopic pregnancy. My entire bill was less than the co-payment the surgeon would have asked if it turned out to be an appendix!

 

[xumwun]

Let's just say - less than R50000. This is at 200% medical aid rates. If you only charge medical aid rates, there's no way you'll make a living. And I'm open to negotiation, especially in the case of an emergency. For elective cases, you can shop around and find the cheapest option - which happens to be me at the Mediclinic in the northern suburbs of CT where I work. If it's an emergency and you're bleeding out on the table, I'll do the surgery first and worry about the finances later.

Did a case a week ago - emergency surgery for an ectopic pregnancy. My entire bill was less than the co-payment the surgeon would have asked if it turned out to be an appendix!

This Bull @#$* really needs to stop
It seems it's really the medical aids we should be bitching about. Do what we #$&*ing pay you for, not just half or a third of it FFS.

 

[AlmightyBender]

Let's just say - less than R50000. This is at 200% medical aid rates. If you only charge medical aid rates, there's no way you'll make a living. And I'm open to negotiation, especially in the case of an emergency. For elective cases, you can shop around and find the cheapest option - which happens to be me at the Mediclinic in the northern suburbs of CT where I work. If it's an emergency and you're bleeding out on the table, I'll do the surgery first and worry about the finances later.

Did a case a week ago - emergency surgery for an ectopic pregnancy. My entire bill was less than the co-payment the surgeon would have asked if it turned out to be an appendix!

Very much appreciated!

Puts the 400%-500% above medical aid rates doctors into perspective

 

[KleinBoontjie]

I'm curious about how the consultation fee works. Is it like a lawyers fee, per hour? (ie R300 per hour) or more like for the visit, no matter how long you take?

 

[Nerfherder]

Let's just say - less than R50000. This is at 200% medical aid rates. If you only charge medical aid rates, there's no way you'll make a living. And I'm open to negotiation, especially in the case of an emergency. For elective cases, you can shop around and find the cheapest option - which happens to be me at the Mediclinic in the northern suburbs of CT where I work. If it's an emergency and you're bleeding out on the table, I'll do the surgery first and worry about the finances later.

Did a case a week ago - emergency surgery for an ectopic pregnancy. My entire bill was less than the co-payment the surgeon would have asked if it turned out to be an appendix!

Just as a comparison, a non specialist doctor in public health takes home about R43 000.

So its not much at all.

The true cost of healthcare is the big business behind it... the private hospitals, the labs the research and drug companies.

So much abuse gets hurled at the Doctors but they are the ones that do all the dirty work and the ones that had to study for 6 years, then do 2 years internship, then a year community service, then specialize.

So... i'm sorry. What the doctor bills you is what it costs.

 

[Nerfherder]

Let's just say - less than R50000. This is at 200% medical aid rates. If you only charge medical aid rates, there's no way you'll make a living. And I'm open to negotiation, especially in the case of an emergency. For elective cases, you can shop around and find the cheapest option - which happens to be me at the Mediclinic in the northern suburbs of CT where I work. If it's an emergency and you're bleeding out on the table, I'll do the surgery first and worry about the finances later.

Did a case a week ago - emergency surgery for an ectopic pregnancy. My entire bill was less than the co-payment the surgeon would have asked if it turned out to be an appendix!

Just as a comparison, a non specialist doctor in public health takes home about R43 000.

So its not much at all.

The true cost of healthcare is the big business behind it... the private hospitals, the labs the research and drug companies. (and the medical aid !)

So much abuse gets hurled at the Doctors but they are the ones that do all the dirty work and the ones that had to study for 6 years, then do 2 years internship, then a year community service, then specialize.

So... i'm sorry. What the doctor bills you is what it costs.

 

[Niner]

Just as a comparison, a non specialist doctor in public health takes home about R43 000.

So its not much at all.

The true cost of healthcare is the big business behind it... the private hospitals, the labs the research and drug companies. (and the medical aid !)

So much abuse gets hurled at the Doctors but they are the ones that do all the dirty work and the ones that had to study for 6 years, then do 2 years internship, then a year community service, then specialize.

So... i'm sorry. What the doctor bills you is what it costs.

Depends on your level of experience, but yes, that sounds about right. Also, bear in mind that in the public sector you have several junior doctors working with you, doing the 'grunt' work like filling out forms and arranging things, seeing phe atients at midnight etc. In private, you're pretty much by yourself, so you have to get up and manage each little(sometimes trivial) complaint by yourself. A lot of doctors charge what they do so that you don't get called at 03:00 with stomach cramps that have been there all day and could in theory wait until morning.

Also, have you guys heard of GAP cover? It covers the difference between what your medical aid pays and your doctor charges. A lot cheaper than medical aid as well!

 

[w1z4rd]

The true cost of healthcare is the big business behind it... the private hospitals, the labs the research and drug companies. (and the medical aid !)

Had to highlight that and hope it sinks in with people.

 

[saksakgp]

Nah doctors make way more than R50 000 pm. I know a friend of a friend of a friend who is a GP and has a private practice in Tembisa. She charges R300 per consultation and on average she sees 20 people per day. Her overheads are not that much.

She makes a real killing in June/July when she does circumcisions - she charges R1 700. Mothers bring in their kids and per day she chops about four kids. She also works occasional nightshifts at a gov hospital, I think they pay her R30 000.

Last year September she went on a three week holiday to Europe with her husband who is also a doctor. She found a recently qualified doctor to look after her practice while she was away. She paid him R40 000 for those three weeks.

I've spent a full Saturday at her practice and I can confirm that she doesn't do much work besides talk to housewives who decide to use the husband medical aid for silly reasons. Shes more of a therapist than a doctor.

I think that if a white doctor were to open a private practice in the township he/she would make lots of money.

Edit. And she drive two cars, each of which cost more than my house

 

[Niner]

Ah, that old money cow! If you want to talk about robbing people of their savings, those 'township-practices' are where it's at. They do make a lot of money, and quite a few of them only declare about 50-80%, as it's cash only. I've also worked in a few before I went to specialise. The one guy used to charge R85 a pop and include meds- average time per consult was 5 mins...

Please don't lump us all under the same umbrella.

 

[binkybozo]

I am going to say it again. I have no issue paying a bit over the scheme rates, I read my claim statements, I know scheme rates are horrible. I know it takes a lot to become a doctor, especially a specialist. It is when doctors start charging 3 to 5 times or more over the scheme limit that I will question if it is a ethical practice.

I would not question it if I did not know of any specialist doctors that struggled to make it in just charging a bit over a scheme rate. My wife's OBGYN at PTA East, charged us during my wife's pregnancy only R100 over the scheme rate per visit and he did everything at every visit, scans, did measurements for Downs the whole nine yards and he was always driving a very nice Land Rover, had a holiday home in Mozambique and when he was not on holiday in Mozambique he and his family would be in Mauritius (sp). He did not take a holiday once a year, he would take a holiday every school holiday for two weeks and most of December. He has a staff of three and has 4 patient rooms in his office with scans in two of them. I would say he is doing pretty well to be 46 years old and only charging a R100 over the scheme rate per visit. He also only charged us R1500 over the rate for delivery but I think that rate has to do with PTA East.

The same with my son's pedi at PTA East, he only charges R150 over scheme rate and he seems to be doing pretty well.

If you would just see a specialist just one or two times in a month it would be different but a lot of times that is not the case. If something serious is going on you can expect a lot of visits and it adds up quickly. Perhaps some of you have that kind of cash laying about but a lot of us don't.

I am seeing a private neurologist at the state hospital because I can't afford to shell out that kind of over the top money. He also charges over the scheme rate (R100). At the state hospital I got a doctor that does not take notes, did no kind of physical exam, asked three me questions, then looked at the note my GP sent and sent me for a MRI and MRA. I was in his room for maybe all of 5 mins. Oh and this was after he skipped his first appointment with me (and others) and his staff "forgot" to call and cancel his appointments for that Thursday and Friday. Would you guys that keep shouting "go to the state hospital" be happy with that service?

 

[RiaX]

No, my wife took her and phoned me to do an EFT to the Hospital.

Exactly. You cut yourself or you injure yourself they arent going to treat you for free. I think its kind of idiotic that one expects this. Before you all go "oh the private sector does nothing" its not their job to treat you for free, if you are in a life threatening situiation then they will stabilize you and transfer you to an appropriate facility that can handle your case and they do this free of charge. You forget that many people use the services of netcare's 911 ambulance service that will help you in the case of an emergency. Who do you think pays for this ? its the hospital group themselves that are paying for it.

You think electricity water and equipment is free ? you get cut and require stitches and you expect the doctor/hospital group to pay for you ? thats just idioticc. I dont expect the banks to pay my interest or the costs of giving new cards when I lose mine. KFC doesnt give me food because im hungry - so why must health care be any different.

You go to a hospital for minor things, complain that you have to pay (mind you you ended up in a private medical facility for an injury). A hospital deals with emergency cases first and they will sort out their patients accordingly so if you go to the out patient department and complain about waiting first consider that the reason you are there does not warrant immediate medical attention and secondly you require the attention of highly skilled and trained professionals you will never find a hospital with a doctor to patient ratio of 1:5 ... they are busy in theatre, in the wards and with other patients that require attention then and there or people that came in before you.

Most of you people ranting and raving have no idea how hard it is to work as a doctor. You have to be spot on and there is no room for error and you must do it everyday non stop for about 100 - 300 patients a day depending on where you work. Not only that but you must be available to do calls and specialists move between multiple hospitals. To deal with so many people in a day is no simple task and each patient (even for the flu) is a complex case that requires a lot of knowledge.

When you recieve flu medication the doctors must decide:

1) is my diagnosis correct
2) what is the optimal medication that i can give to this patient. Are they allergic to it, will it interfere with their current therapies, how will it affect them in life with respect to side-effects
3) What dose must i give these medications at. Is the infection severe to warrant a maxium dose of 70mg/kg/day or is it mild to use 30mg/kg/da or should i use an intermediate dose?
4) how will the dose affect the liver or kidneys and hence affect co-morbidities
5) How long must I give the patient the medication and when should I check the patient to see if they coping well 5 days 2 weeks a month?
6) Should I give it orally, IV ?

these questions run through doctors mind everytime they see a patient. Its the sheer experience these people have that allows it to seem fairly simple. What do you expect a lecture when you see the doctor? if you feel robbed the doctor took 5 minutes then there is something wrong with you. Be glad its something not severe that requires advanced diagnostics and be glad your doctor is experienced enough to just pick it up.

Not to mention that doctors have to study till the day they die. They have to do a thing called continuous professional development, where they go for specialised lectures and conferences hosted by drug companies and questionaires in the medical journals, in order to keep up with the times and provide you the patient the best possible care that is safe to use.

If it was so easy to do these things there wouldnt be any doctors, just a chemical supply store where one could buy and make their own medicines at home.

As for the pharmaceutical costs, im in the middle of developing nanomedicines to be used in TB. The cost for the reagents when designing drugs are not cheap (as they have to be of the highest purity). The in vitro testing is not cheap. Mice are not cheap. Im currently working on a project worth over a couple billion rand and you expect these companies not to make their money back? because you dont want to pay R400 for a month supply ? you welcome to not buy the drugs, see how long you last.

 

[RiaX]

Nah doctors make way more than R50 000 pm. I know a friend of a friend of a friend who is a GP and has a private practice in Tembisa. She charges R300 per consultation and on average she sees 20 people per day. Her overheads are not that much.

She makes a real killing in June/July when she does circumcisions - she charges R1 700. Mothers bring in their kids and per day she chops about four kids. She also works occasional nightshifts at a gov hospital, I think they pay her R30 000.

Last year September she went on a three week holiday to Europe with her husband who is also a doctor. She found a recently qualified doctor to look after her practice while she was away. She paid him R40 000 for those three weeks.

I've spent a full Saturday at her practice and I can confirm that she doesn't do much work besides talk to housewives who decide to use the husband medical aid for silly reasons. Shes more of a therapist than a doctor.

I think that if a white doctor were to open a private practice in the township he/she would make lots of money.

Edit. And she drive two cars, each of which cost more than my house

Dont confuse GPs with specialists. GPs dont require lots of expensive equipment, they depend on volume of patients. As I said earlier a specialist requires more money than the GP. Some GPs earn way more than surgeons and specialists because the cost to practice is much lower. All a GP needs is a BP machine, a blood sugar machine, a steths and some general first aid stuff.

Its not like the GP has an MRI in his rooms. His equipment doesnt cost R15 million and doesnt have a running cost.

This isnt a hard concept to understand.

 

[saksakgp]

Dont confuse GPs with specialists. GPs dont require lots of expensive equipment, they depend on volume of patients. As I said earlier a specialist requires more money than the GP. Some GPs earn way more than surgeons and specialists because the cost to practice is much lower. All a GP needs is a BP machine, a blood sugar machine, a steths and some general first aid stuff.

Its not like the GP has an MRI in his rooms. His equipment doesnt cost R15 million and doesnt have a running cost.

This isnt a hard concept to understand.

Right, so specialists are the good samaritans who chose to engage in work that has less net earnings then their GP counterparts. Specialist charge a thousand rand just to have a chat and if anything more than a chat is required such as utilising their expensive equipment then they charge even more. And in most cases this equipment is owned and maintained by hospitals.

Specialist charge for use of their equipment(R5 000 – R10 000, or is it now R20 000?, for a MRI scan), so how do you justify R1 000 consultation fee when equipment overheads are catered for in a separate fee?

 

[RiaX]

Right, so specialists are the good samaritans who chose to engage in work that has less net earnings then their GP counterparts. Specialist charge a thousand rand just to have a chat and if anything more than a chat is required such as utilising their expensive equipment then they charge even more. And in most cases this equipment is owned and maintained by hospitals.

Specialist charge for use of their equipment(R5 000 – R10 000, or is it now R20 000?, for a MRI scan), so how do you justify R1 000 consultation fee when equipment overheads are catered for in a separate fee?

lol wow, i can see you not a businessman. Lets go with radiology since I have extensive knowledge of that field.

When the machine is not in use is it not an expense to the practice ? of course it is, it never goes off. It takes electricity, coolant (in the case of MRIs as i said earlier the coolant alone is R200 000 per month per unit, as it runs on liquid helium which is used to cool the magnet). Next is the actual insurance on the machine itself - a monthly premium.

Now lets look at consumables. There is a cost of paper, film (for xrays), CDs (advanced radiology), gloves, syringes, needles, blades ect ect ... again not free

Ok now support staff. A secretary to make appointments and deal with medical aid for you. Internet costs. Telephone and fax cost. In case of radiology or surgeons the support staff are more expensive and require medical aid and to be paid an appropriate salary in the case of surgical technicians and radiographers.

Next is Insurance on the actual practice, and health professional charges, council fees, rent, in case of surgeons they are billed by the hospital per second to utilize its theatres.

Why should the doctor pay out of his pocket for this ? he doesnt know you? you are being absolutely retarded saying that these people must not turn a profit at the end of the day and even worse if you saying they must turn a minimum profit. Who the hell are you to say this person cant charge what they want for professional service?

Its no different in ANY OTHER FIELD.

My field pharmacy, same its expensive to run and own a pharmacy. Franchise pharmacies are even worse as you required to pay for a franchise license on top of that.

Engineering try an call out an engineer and see how much it will cost you.

Law. Calling out a labour advocate will set you back R10 000

IT. I dont like paying R1000 for windows. AS you say the doctor just has a chat with you, well windows is just a disc why cant it be R20 ? or how about the price of apple stuff?

Electronics. You want a smart TV you gotta pay up.

Communication. LTE isnt cheap? internet in SA isnt cheap.

so tell me why should the doctor drive a tazz? or take the bus so you can have pocket money?

WOULD SOMEONE HERE EXPLAIN why they think the doctor should be poor ? why they shouldnt manage their practices with business sense to make a positive turn over and their books balance in the green (oh lets not mention the cost of accountants - after all, all he uses is a pen and calculator why cant his fee be R6.95?) . Why should the doctor, a highly skilled professional be in your eyes earning minimum wage. Please provide a valid reason why they cannot drive porsches/ferraris ect but the engineer/banker/accountant/businessman ect can have one ? also why is the doctor not allowed to charge for his time ? an electrician does it, a plumber does it ... provide a proper reason and not a selfish miser reason - all you established in this thread is that you are cheap and selfish people, doesnt matter who or what happens as long as you save your $$$ isnt

oh and btw the GPs have more money generally because they pay less tax, you think the doctors declare the cash patients ? that cash patient fee goes straight into the wallet. Big practices where most specialists (like radiology which are worth billions) dont have that luxury as SARS is very watchful over them. Also with the high cost people are less likely to pay cash.

P.S communism is east of here, so if you dont like the cost of professional labour and are jealous of skilled individuals driving porsches you know what to do