Private Medical Practitioners Hit Back At Medical Aid Societies {Full Text}

By Marisa Johannes

Medical aid societies and Private Medical Practice: The naked truth!

There have been sentiments to the fact that private practitioners now demand cash upfront from holders of medical aid cards especially those from Premier Service Medical Aid Society (PSMAS).

For all this time, we have been watching while our necks are chocked by the same medical aid societies that should also be serving the interests of their clients.

The impression shown by utterances by some executive members of these medical aid societies is that of a greedy, inconsiderate, inhumane medical practitioner who is there to profiteer.

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It is unfortunate that the dispute between service providers and medical aid societies has been left to blossom over a long time with no solution in sight.

If truth be told, there are some Medical Aid Societies (MAS) that want to be seen as doing prodigious things for patients yet they are at the fore-front of financially neglecting the very service providers that play a very indispensable role in the management of patients.

Private practitioners have been forced into abject poverty, all the blame concerning patient care has been heaped on them while we witness medical executives driving the latest Prados with unlimited fuel supplies every month.

Since January 2020 when there was talk about Coronavirus, some medical aid societies have not paid a single cent to a lot of service providers.

PSMAS is one of them and I wonder if it is fashionable not to pay the service providers. Despite PSMAS putting a tariff of 75RTGs as consultation, the money has not even come to our pockets as practitioners.

The 75 RTGS pegged now translates to 80 cents if we are to consider the ever-spiralling black market rate. There are other medical aid societies where we have to first beg them in order for them to release our money.

Personally, I have struggled with my claim forms from medical aid societies Cellmed, Harare City Council, Bonvie and Steward Health to mention but a few. I am not sure if they are paying my other colleagues.

This is unfortunate considering the harsh economic environment that is prevalent where the doctor also needs to survive.

This behaviour should stop if there is going to be good working relationships with the medical aid societies. We have been strangulated for a long time as practitioners, our voices have been muzzled to the edge while patients suffer.

The Medical Aid Societies have been the chief architects on gazetting tariffs for the private sector. I wonder why tariffs are imposed by non-medical people who sometimes do not understand how we work as clinicians.

In 2015, Zimbabwe Medical Association(ZIMA) came up with tariffs of $35 as consultation but Medical Aid Societies clandestinely rejected and went on to pay $20.

If it is true that they are facing financial challenges, then I wonder where they get the money for executive perks including the latest vehicle models on the market.

That money should be used for the betterment of patients and not for self-aggrandisement. Many of them have now moved to open their clinics yet they cannot pay service providers.

The people should know that the actual service providers are at a disadvantage as they have to fork out money for clinic or surgery rentals, money for Personal Protective Equipment (PPE), money for salaries, drugs, sanitization, waste disposal, council levies plus operating licences.

Honestly, if one is getting 75 RTGS for consultation, how will he get to work considering that petrol is selling for US 1.28 per litre?

Now that private practitioners are coming under one roof, we ought to remain united and speak with one voice in a bid to avert further strangulation that threatens our viability as practitioners, especially during this difficult Covid-19 era.

Private practitioners are the first port of call for patients and Covid-19 will surely strike us if we are continuously exposed to it.

It is a pity that some of these medical aid societies refused to open their offices for submission of claim forms since February 2020 citing COVID-19 spread.

If offices cannot be opened in order to pay medical practitioners yet they are the front-liners, then we are doomed as a nation. Where will we get money for PPE, drugs, equipment and so forth? Why are these issues allowed to prosper at the detriment of both the patients and service providers?

We believe in engagement but if that does not work, we do not hesitate to promote Medical Aid Societies that are not hostile to us as practitioners.

We will not hesitate to reject all Medical Aid Societies that are arrogantly giving us headaches. Patients should appreciate the value of their monthly contributions and due diligence should be done when joining some of these Medical Aid Societies.

Up to now, some MAS have not sent us their tariffs and one has to drive several times in order to get just a few figures.

This is grossly unfair and practitioners have been brutalised left, right and centre. Many Medical Aid Societies will wake up from slumber and realise that our eyes can now see what they could not see.

Dr Johannes Marisa is the interim president of the Medical and Dental Private Practitioners Association of Zimbabwe (MDPPZA).