Since 2013 gynaecologists' insurance rates have increased by 60%, with all gynaecologists starting the year with a R450000 insurance bill. File photo
Image by: Gallo Images/Thinkstock
Image by: Gallo Images/Thinkstock
There are only three paediatric neurologists in the country and all of them work in the public sector.
The reason: medical insurance costs make it impossible for these doctors to make a living in private practice.
In a recent South African Medical Journal article, specialists said they were worried this was an example of things to come, as new doctors avoided specialising in disciplines in which insurance costs are too high.
Since 2013 gynaecologists' insurance rates have increased by 60%, with all gynaecologists starting the year with a R450000 insurance bill.
Medical negligence lawsuits have grown in popularity, with payouts often averaging more than R15-million leading to sky-rocketing insurance costs.
Gynaecologist and head of the SA Private Practitioners Forum, Chris Archer, said new doctors were not specialising in gynaecology. Most specialists are now aged over 55.
Archer warned of a severe shortage of gynaecologists in the next few years, saying many were considering early retirement as rising insurance costs made their work unprofitable.
Insurance for neurologists has increased by 62% over the past two years.
From this month, neurologists will pay R406230 per annum for medical insurance.
This is one of the reasons newly qualified neurologists cannot make a living in private practice.
Professor Allan Taylor, of the University of Cape Town's neurology department, said as all public sector positions were filled, young neurologists were taking up jobs overseas.
He said while it was not ideal that children were operated on by neurologists specialising in adult surgery, it was not financially feasible for paediatric neurologists to work in the private sector.
Taylor said most neurologists admitted sending patients for tests such as MRIs when it was unnecessary. Although it increased costs substantially for patients, it was to protect the doctor in case of lawsuits.
Doctors also avoided high-risk surgery, leaving patients needing risky brain operations looking for help elsewhere.
Taylor, along with some of his UCT colleagues, last year sent an on-line questionnaire to South Africa's 158 neurologists asking them about the impact of malpractice lawsuits. In all, 66 responded and their answers, first published in the South African Medical Journal, revealed that:
- 58.5% would have chosen a different speciality;
- 63.3% paid between six and 20% of their gross annual revenue on insurance;
- More than 50% had been sued, with 27.3% having faced claims in the last year;
- 84% said the growing number of lawsuits was a "crisis"; and
- 89% requested scans when it was not clinically necessary.
Medical Protection Society spokesman Rajiv Pattni explained that insurance had to cover operations that could result in catastrophic injuries that would leave patients needing long-term and expensive care.
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