While most people tend to seek treatment with just one General Practitioner, a fairly significant proportion see two or more. That’s because in South Africa’s private healthcare sector, patients can have multiple GPs and almost unrestricted access to specialist care, provided they can afford it. Our own research shows that 1 patient in 4 has already been seen by at least one other GP. This emerges from a study we did on some 4.5 million patients over 2 ½ years (Jan 2014- June 2016), while analysing the 17 million claims they made over that period.
From the patient’s perspective, what are the likely reasons for using multiple doctors? What are the pros and cons? And what are the effects on claim volumes?
* Although the data indicates that the greater the number of GPs the patient sees, the greater their claim volume; there are other factors that may also affect this relationship such as the general health of the patient.
Reasons for seeing more than one GP
•Ease of access: All other things being equal, patients will go to the GP closest to them because it’s easier. Opening hours, travel time and how long they wait will all affect this decision. It is not uncommon that people use one GP close to their place of work and another close to where they live.
• Medical aid structure: Some medical aids will allow patients to see networked GPs at no extra cost once day-to-day funds have run out. So they’ll see their preferred GP until their funds are depleted, and then switch to the networked GP.
• Practice setup: Some practices are setup with multiple GPs. So although the patient is going back to the same practice, their treating doctor changes according to availability. While there are practical advantages to seeing more than one GP, patients don’t realise how this could affect the quality of care they receive:
The disadvantages of multiple GPs
• Not seeing the full picture: Instead of one doctor having the full picture of a patient’s medical history, two or more doctors are sharing it, so to speak. So each doctor sees the patient less frequently, with less depth and exposure, and consequently has less of a handle on the patient’s health profile. So it’s harder to spot symptoms early or diagnose confidently. This could lead to delayed treatment, which might be more extensive – and expensive.
• Doctor-patient trust is eroded: A good doctor is like a good friend: seeing one allows patients to develop a deeper level of trust than seeing several. So this may affect the quality of your relationship with the patient, and hence the care they receive.”
•Higher claim volumes: If a patient’s healthcare is compromised as explained above, it suggests that they will probably claim more. Our research bears this out, and shows that patients who have 2 or more GPs also have double, or even treble, the number of claims compared to patients who have only one GP*.
It might be more convenient and practical for patients to see multiple GPs, but it comes at the expense of the doctor-patient relationship and the quality of care. A more intimate and trusting relationship – and hence more effective care – is more likely with only one GP.
Scientifica, Volume 2012 (2012), Article ID 432892, 22 pgs; http://dx.doi.org/10.6064/2012/432892