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HEALTHMANPRIVATEPRACTICEREVIEWApril2018

April2018Asummaryofbreakingnewsandgeneralinformationregardinghealthcareinthepublicandprivatesector,publishedinthemedia.

Contents1.FoodforThought2.ViewonSpecialNews3.ViewonGovernment4.FinancialViews5.PharmaceuticalViews6.GeneralNews6.ViewonMedicalSchemes7.SpecialNotices

FoodforThought

First'healthtax'inAfrica...butwillitwork?

SA’snewtaxonsugarydrinks(renamedtheHealthPromotionLevy),whichcameintoeffecton1April,hasbeenoneofthemosthotlydebatedtaxesinthehistoryofSA,elicitingthreatsandmassivelobbyingfrombeveragecompanies.–Health-eNews,3April

*AccordingtoProfKarenHofman,whoheadsPriceless,theWitsUniversitythinktankthatfirstsoldtheideaofthetaxtoTreasury,thetaxwillnothelpasmuchaspredictedbecausethetaxratehaseffectivelybeenhalvedfromthesuggested20%to11%,followingpressurefrom

industry.

*Coca-Colaannouncedthattherewouldbepriceincreasesonsomeofitsproductsbutthat“lowersugar(lessthan4g/100ml)andzerosugarproductsand100%juices”wouldnotbeaffected.

FreeMarketFoundation:"Taxingsugarandother'sinfulproducts'isabluntinstrumentthat,besidestreatingadultslikechildren,divertsattentionfromgovernment’sdesiretocontrolordinarypeople’slivesandtoraiserevenuebyanymeanspossible."

*ResearchbyGenesisAnalyticsshowsthatmorethanthree-quartersofSouthAfricanssupportedgovernmenttakingmeasurestoreducetheirconsumptionofsugarydrinks.However,somerespondentswerewaryoftheproceedsbeingswallowedupbythestate.

Useofartificialintelligenceinmedicineraisesethicalquestions

ResearchersattheStanfordUniversitySchoolofMedicinepublishedaperspectivepieceinTheNewEnglandJournalofMedicinewarningthatthedevelopmentofmachine-learningtoolscallsforphysiciansandscientiststocarefullyexaminetheethicalrisksofincorporatingthemintodecision-making.“Whatphysicianslearnfromthedataneedstobeheavilyweighedagainstwhattheyknowfromtheirownclinicalexperience.”Oncemachine-learning-baseddecisionsupportisintegratedintoclinicalcare,withholdinginformationfromelectronicrecordswillbecomeincreasinglydifficult,sincepatientswhosedataarenotrecordedcannotbenefitfrommachinelearninganalyses.“Societyhasbecomeverybreathlessinlookingforquickanswers,butweneedtobemorethoughtfulinimplementingmachinelearning,”accordingtothearticle.

ViewonSpecialNews

Abestpracticeguideforchoosingmedicalpracticesoftware

Choosingbillingandpracticemanagementsof twaredoesn’thavetobeanexhaustive,painstakingprocess.Whetheryou’veoutgrownyourcurrentmedicalbillingsoftwareoryouaretransitioningtoapaper-lightsystemforthefirsttime,shoppingforsoftwareisagoodopportunitytoidentifytheinefficienciesinyourpracticeandaddressthem,togetherwiththerightsolutionprovider.Understandingwhatyouneedstartswithaskingyourselfafewpertinentquestionsandensuringthatthesolutionyouchoosemeetsthecriteriaoutlinedinthisguide.

Todownloadtheguide,clickonthebuttonbelow.

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TARGETINGCEREBRALPALSY(CP)CLAIMS

Focusedonavertingtheprospectivecollapseofmaternalandchildhealthcareservices,duetotheepidemicofmedico-legalclaimsandasdescribedintheMarcheditionoftheSouthAfricanMedicalJournal*,medicalacademics,healthcarepractitioners,plaintiffanddefendantattorneys,aswellasrepresentativesfromgovernmentandConstantiaInsuranceCompanyrecentlygatheredataCPconferencetofindsolutions.Duringthetwo-dayproceedings,co-sponsoredbyConstantiaInsuranceCompanyLimitedandthePaediatricDepartmentoftheUniversityofPretoriaandheldatCSIRconferencecentreonthe8thand9thofMarch,localandinternationalexpertssetthescenebyoutliningthecomplexandmultifactorialaetiologyofthisheterogeneousdisorder.Contrarytowhatistypicallyallegedinmedicalnegligenceclaims,CPdoesnotequatetobirthasphyxiaandischaemicencephalopathy.Manycasesaredeterminedinutero,longbeforethebirthingprocess.Othersoccurafterdelivery.Indeed,intheSouthAfricancontext,thereisahigherincidenceofCPthanindevelopedcountries,causedlargelybyeventsbeforelabour,saidretiredpaediatricianProfKeithBolton.

Theaudiencelearntthatthenatureofthedisorderposesasignificantchallengeintheresolutionofmedicolegaldisputesrelatingtoallegedbirthasphyxia,asthelegalprofessionmaynotfullyappreciatetheinterplayofthevariousdeterminants.Manydelegatesagreedthatplaintiffattorneysshouldhavepotentialcasesassessedbyappropriatelyqualified,unbiasedandexperiencedmedicalpractitionersbeforedecidingwhetheranactionfordamagesisappropriate.

*ToreadthearticleintheSouthAfricanMedicalJournalhttp://www.samj.org.za/index.php/samj/article/view/12229/841

Left:VolkervonWiddern,ChiefExecutiveOf f icer:ConstantiaInsuranceCompanyLimited

Right:Prof IzelleSmuts,PaediatricNeurologist:Facultyof HealthSciences,UniversityofPretoria

Toreadamorecomprehensivesummaryoftheconference,clickonthebuttonbelow

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GENE-BASEDPERSONALISEDMEDICINE

Practitionersareinvitedtojoin3X4aswewelcomeworldrenownedinternationalspeakerfromLosAngeles–DrMylesSpar.Specialisinginintegrativemen’shealth,DrSparistheCo-ChairoftheAmericanBoardofIntegrativeMedicineandconsultanttotheNBA.

DrSparwillsharehisuniqueinsightsintomen’shealthattheCapeTownandJohannesburgevents.

Weareproudtolaunchthenew3X4Genetictest,acutting-edgepractitioner-basedtoolattheforefrontofnutrigenetictestingworldwide.

Thef irst10practitionerstoregister(andattend)willreceiveaFREE3X4GenetictestvaluedatR4999.

Practitionerswillalsohavetheopportunitytolearnaboutthebenefitsandcriteriaofbecomingamemberof3X4Network-atranslationalnutrigenomicscommunityofexpertpractitioners-who,througheducation,mentoringandongoingsupport,areabletocontinuetheirlearningandoffertheirpatientsthefullest,highestvalueofcare,interpretationandintegrationofnutrigeneticresults.

CPDpointswillbeaccredited.Limitedspace,[email protected]

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ViewonGovernment

Foreign-traineddoctorstowritelocalmedicalboardexams

Self-testingHIVkitsandmachine-dispensedmedicines

Gautenghealthdepartmentgetsbiggestcutofprovincialbudget

HealthProfessionsCouncilofSA’s(HPCSA)hasdoneanabout-turnandwillnowallowforeign-trainedmedicstowritetheirmedicalboardexams.

TheHPCSAreverseditsdecisionafterinsistingthatgraduatesdointernshipsinthecountrywheretheystudiedbeforewritingtheirmedicalboardexamsinSA.

Thedoctors-manyofwhomstudiedinRomania‚MauritiusorChina-arguedthattheregulation‚firstdraftedin2009butonlyimplementednow‚wouldposea“hugechallenge”forthembecauseofresidencyissues.

StudentsandlabourersareflockingtoanewHIVself-testingstandoutsideasupermarketinHillbrow.Asmallteamofyoungandstylishly-dressed“peereducators”convincemenagedbetween18and30totakethetests,which-inabreakthroughforSA-areself-administered.

FromMay,theschemewillbeextendedtoseveralofJoburg’staxiranks.

TheprojectwasstartedinMalawi,ZambiaandZimbabwein2015andexpandedlastyeartoincludeSA.

Gauteng’sDoHreceivedthelion’sshareoftheprovince’sbudgetthisyear,increasingitsbudgetfromR37.6-bntoR40.2-bnforthe2018/2019financialyear.Yetcriticshavewarnedthatthismaynotbeenoughtomeettheprovince’shealthneeds.ByDecember2017,thedepartmenthadR5-bnworthofaccruals.

MedicalsuppliescompaniesthatareowedmillionsbythedepartmentarefumingoveraproposalthatsuppliersowedmorethanR10-m,enterapaymentplanenablingthedepartmenttosettlethedebtoverfouryears.

FinancialViews

Clicksopens500thpharmacy

NetcaretodisposeofitsUKinterests

PfizerseeksanotherViagra

HealthandbeautyretailerClicksrecentlyopenedits500thpharmacyatParkStationincentralJohannesburg.

Clickscurrentlyhasa22.2%shareoftheSAretailpharmacymarket.Inthe2017financialyearitopened73pharmacies,including37aspartofanoutsourcingagreementwiththeNetcareGrouptomanagethepharmaciesinitsMedicrossmedicalanddentalcentres.

HospitalgroupNetcareplanstoexittheUK,joiningalonglineofSAcompaniesthathavehadtheirfingersburntbyambitiousoffshoreventuresthatfailedtodeliveronexpectations.

NetcaresaidithaddecidedtodisposeofitscontrollingstakeintheUK’sbiggestprivatehospitalgroup,GHG,duetodifficulttradingconditionsanditsinabilitytonegotiatearentreductiondespitefiveyearsoftalks.

20yearssinceViagrawasintroduced,andPfizerisstillsearchingforanotherdrugwithasmuchearningpowerastherevolutionaryblueerectionpill.

Pfizerforecastsitwillspend$7.4to$7.9-bnthisyearonR&D,comparedwith$7.7-bnlastyear.

InJanuaryPfizerendeditsresearchprogrammesintotreatmentsforAlzheimer’sandParkinson’s,cutting300jobs.

PharmaceuticalViews

UJdiscoverssilver-based,anti-cancerdrugthatischeaperandlesstoxicTheUniversityofJohannesburg(UJ)revealedthat“anewfamilyofverypromisingsilver-basedanti-cancerdrugs"knownasUJ3‚hasbeensuccessfullytestedinratsandonhumancancercellsinthelaboratory.TheresearchwaspublishedinBioMetals.UJstatedthatUJ3isshowntobeaseffectiveagainsthumanoesophagealcancercellsasawidelyusedchemotherapydruginusetoday.AntibioticguidelinesmustbeenforcedasworldbattlesresistantbacteriaAnewstudy,headedbyJuliaGassonoftheWesternCapedepartmentofhealth,hasfoundthatclinicsintheprovinceareignoringguidelinesonprescribingantibioticsmorethanhalfofthetime‚andalmostoneinfivepeople,whoweregiventhemedicationateightCapeTownclinics,didnotneedit.Othersweregivenincorrectdosesorthewrongtypeofantibiotic‚orweretoldtotakethedrugsforthewronglengthoftime.Inafewcases‚peoplewhoneededantibioticsdidnotgetthem.

NewvaccinecouldstopTBfrombecomingactiveAteamofresearchers,headedbyProfMarkHatherilloftheSATuberculosisVaccineInitiativetestedvaryingdosesofanewvaccineon54peoplenearCapeTown.InaspecialeditionofTheLancet‚Hatherillsaidthatglobally‚approximately10%ofpeopleinfectedwiththeTBbugdevelopTBovertheirlifetime.RatherthanjusttargetingtheTBbacteriumitself‚thenewvaccineaimstoprovokeantibodiesandT-cellresponsesfromthehostthatmayprovideimmunity.

GeneralNews

Newsflashes

NewbloodtestpredictsonsetofTBStellenboschUniversity’sImmunologyResearchGroup,aspartofaninternationalconsortium,developedasimplebloodtestthatcanpredictthedevelopmentoftuberculosis(TB)uptotwoyearsbeforeitsonsetinpeopleathighriskofdevelopingthedisease.Theteam’sresearchwaspublishedintheAmericanJournalofRespiratoryandCriticalCareMedicine.KidneystoneneedleopafirstforSASA’sfirst-everproceduretoremovekidneystonesusinganeedlewassuccessfullyperformedbyateamofurologistsattheInkosiAlbertLuthuliCentralHospitalinKwaZulu-Natal.Knownasmini-percutaneousnephrolithotomysurgery,theprocedureinvolvesaneedle-punctureoftheskintoaccessthestonesandremoveit.Cancer,chronicillnessesontheincreaseAccordingtothelatestdatafromDiscoveryHealthScheme,memberswithatleastonechroniccondition-suchasdiabetesorhighbloodpressure-morethandoubledbetween2008and2017.Hypothyroidismsawthebiggestincreaseinenrolledmembersin2017,increasing11%to55331members.Dataalsoreflected“theglobaltrendinincreasingcancerprevalence”Thethreemostcommoncancerswerebreastcancer,prostatecancerandcolorectalcancer.ListerosisDeathTollAttheendofMarchtheNationalInstituteofCommunicableDiseases(NICD)announcedthatthedeathtollinthelisteriosisoutbreakhasclimbedto189–upsixdeathsfromitslastupdate.Therewere982confirmedcasesofthedeadlydisease‚withoutcomesknownin687ofthese.Currentlythemortalityrateis28%.WHOat70:workingforbetterhealthforeveryoneOn7April,WorldHealthDay,theWorldHealthOrganization(WHO)markedits70thanniversary.Overthepast7decades,WHOhasspearheadedeffortstoridtheworldofkillerdiseaseslikesmallpoxandtofightagainstdeadlyhabitsliketobaccouse.

Thetaglineforthisyear ’sWorldHealthDay:“UniversalHealthCoverage:everyone,everywhere”.

*NeithertheDepartmentofHealthnorHealthMinister,AaronMotsoaledi,releasedanystatementregardingWorldHealthDay

AccordingtothelatestWHOreportclimatechangewillresultin250000additionaldeathsperyearbetween2030and2050.Theseincudemalnutrition,malaria,diarrhoeaandheatstroke.Globallytemperaturesareexpectedtorise,onaverageby2°C,InSAitisanticipatedthatby2100temperatureswouldhaverisenby4°C,causingadetrimentaleffectonenvironmentalandsocialhealth.

ViewonMedicalSchemesAframeworkforbenefitoptionclassificationandstandardisation

TheCouncilforMedicalSchemes(CMS)isdevelopingaframeworkforbenefitoptionclassificationandstandardisationaswellasareviewofefficiencydiscountedoptionsandmedicalschemesthatarenotcompliantwiththeAct.-BusinessReport,29March

Itwillenablebetterrisk-poolingandcross-subsidisationand,oncebenefitoptionshavebeenproperlyclassifiedandstandardised,consumerswillbeempoweredtomakeinformedchoiceswhenpurchasingmedicalschemescover.

Fewerbenefitoptionswillalsoenablememberstocompareentitlements,limitationsandpenaltiesagainstpremiumschargedperoption.

SincetheActstipulatesthatcommunityratingshouldonlyexistwithinthebenefitoptionsintheschemes,adegreeofriskratingforessentialbenefitswillcontinuewithincertainmedicalschemesbecausedifferentoptiondesignsdeliberatelyattractdifferentriskgroups.

ForasummaryofSpecialistPaymentArrangementNetworks(Feb2018),seeattacheddocument.

Circulars:CouncilforMedicalSchemes

ThefollowingCircularswerepublishedbytheCMSinApril2018.Visit www.medicalschemes.co.zaformoreinfo.

16of2018Measuringqualitiy,outcomesandvaluepropositionofmanagedcareinterventionsinrespectofGlaucomaandHaemophiliaDiseases

17of2018FinalguidelinesforpreparationofbrokeragreementsincompliancewiththeMedicalSchemesActandRegulation28pubishedintermsoftheAct.

18of2018Measuringthequality,outcomesandvaluepropositionofmanagedcareinterventionsinrespectofSystemicLupusErythematous(SLE)Disease

SpecialNoticesPracticeOpportunitiesintheEasternCapeLifeHealthcareisofferingopportunitiesfordoctorswhowanttojointheirteamofspecialistcolleaguesintheEasternCape

Vacanciesforphysicians:LifeStGeorge’sHospital,PortElizabeth;MercantileHospital,PortElizabeth;LifeEastLondonPrivateHospital,EastLondon;andLifeStDominic’sHospital,EastLondon

FormoreinformationonpracticeopportunitiesinthePortElizabethandEastLondonregion,pleasesendyourcontactdetailstoveronica.holliday@lifehealthcare.co.za

ToadvertiseinPrivatePracticeReviewcontactMarethaConradie:[email protected]

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