2019-10-01 Medicine and Money

October, in the words of the Afrikaner poet C. Louis Leipoldt, "is die mooiste, mooiste maand" (the beautifullest, beautifullest month). This is most certainly the case in the Western Cape area, where I live.
This morning, the South African news channels are full of the findings by the Competition Commission that private medical services are "overtreating and overcharging". What took them so long? This has been going on for decades.
Almost every day, I see patients suffering from overtreatment and overcharging. It breaks my heart.
At the same time, I feel deep empathy for my colleagues, who are caught between a rock and a hard place. The overhead cost of running a practice has increased massively over the past 20 years or so. Complying with all the new rules imposed by various entities, or government, has added cost without adding value to the patient. Doctors had to bear the costs out of their own shrinking purses. To many, overtreating and overcharging seemed like the only way to keep the doors open. The other option was to emigrate, and leave the patients behind without a good GP.
Some 8 years ago, I did my sums. The results were sobering. If I went the normal GP route, charging medical aid tariffs, the cost of compliance would enslave me for life. I thus took another option, which was to consult for free, but earn income from the sale of supplements. The good news was, I was free from the system. The bad news was, I did not earn much from the sale of the supplements. Also, after me spending hours on a case, the patient would sometimes inform me that he couldn't afford the (reasonably priced) supplements. I don't begrudge my patients' that decision, but that meant time I could have spent helping someone else, was gone forever.
For this reason, I am implementing some big structural changes in Integrow Health. New systems, new procedures, better prices, better service. The aim of all this is to allow me to help more people, quicker. Over the course of the coming month, you will receive a series of important emails in this regard. I don't mean to flood your inbox, but I realise that - in this busy life - short emails get read, while long ones don't.
The first change that will affect you is that all our incoming lines will soon be centralised into a single switchboard. That will help you get the right help from the right person in the shortest possible time. As soon as this process has been finalised, you will get an email about it, later this week or early next week.
The second change relates to our courier services. Everyone wants the best courier service while paying next to nothing for it. I understand. But there has to be some trade-off. The upmarket couriers we traditionally used, have increased their prices to the point where we often get complaints about the costs. The cheaper couriers have degraded their services to the extent that we often get complaints about non-delivery or long waiting times. The challenge is that a company we do not control, becomes our public face. Poor or expensive courier service is laid at Integrow's door, not at the courier's door. We are working on ways to improve both cost and service, but bear with us in the meantime. Know that we feel your pain on a daily basis.
Every day (and I mean EVERY day), I get feedback from patients who are better / cured thanks to an approach that allows the body to heal itself. You have no idea how grateful I am to be a part of this healing process. I spend hours each day researching new and better ways to help your body do just that: heal itself. I want to keep doing this until the day I hand my body in for recycling. It will be an honour and a privilege to have your company along the way.
18 October is celebrated by many traditional churches as St Luke's Day. He was the Greek doctor who became a close friend of Paul the apostle and wrote most of the Christian New Testament. As a result, during October, Christians are asked to pray for those in the healing professions. If you are a praying person, please uplift all the healthcare staff in your circle in prayerful remembrance. They are almost all burnt out. Often, they need care more than their patients do, yet they still have to trudge on. Pray also for their families, which are constantly living in the tension between the demands of family and the demands of patients.
Money is a dutiful servant, but a cruel tyrant. It is a pity that many in my profession find themselves trapped in the death spiral of rising expenses and shrinking incomes. Do not judge my colleagues harshly. At the same time, the best and cheapest "health insurance" you can get, is to invest in your own health. About 7 out of 10 deaths worldwide occur due to lifestyle choices. By simply making a few right choices, you can avoid a shed-load of medical bills for yourself and your family. I hope to show you what these choices are in the course of the coming months. Watch this space!