0nly registered practitioners will be allowed to own medical practices, in terms of a new policy announced today.
Corporate owners who were not medical professionals themselves, could not be registered with the Health Professions Council (HPCSA) of SA and therefore could not be held accountable, Boyce Mkhize, the HPCSA registrar, told reporters in Pretoria. It is difficult to insist that they comply with ethics. Often practitioners say they cannot account for the activities of their corporate bosses.
It also happened that practitioners were forced into practices inconsistent with ethical rules, he said. Corporate involvement would still be allowed though. This entailed that non-practitioners could provide services like financing, investment, administration or rental to a professional practice on an arms-length basis and be remunerated on a market-related, pre-determined fee.
The rent which a private hospital, for example, charged a doctor for the rent of rooms, could no longer be based on the number of patients seen.
Mkhize said franchise arrangements had the inherent ability to violate or contradict a number of ethical rules, for instance the franchisee having to pay a share of professional fees to the franchisor. It could result in the franchisor seeking to dictate the manner in which a practice was conducted.
At present, franchising was quite prevalent in the optometry industry, while some pathology groups had corporate ownership, he said. The HPCSA had given six months' amnesty, effective from today, for practices to extricate themselves from corporate ownership or franchise arrangements, Mkhize said. He added: Ethical transgressions that may have occurred are not part of the package of the amnesty. Those will be vigorously prosecuted.
Those presently involved in what the new policy considered to be undesirable business practices, had to submit proof that they had rectified their situation. Ad hoc inspections would be done after the six-month period.
According to Mkhize, not a large number of practices are involved in such undesirable business arrangements, but he said the impact was significant, since they could generate perverse incentives.
The new policy prohibits radiologists and pathologists from being part of group practice with other health professionals. With this measure the HPCSA wanted to prevent over servicing, like doing unnecessary tests or X-rays, the registrar said.
( Source :SAPA, 8 October 2003).