Johan van Zyl by liwenting

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									Medical Advisors Group



                     Dr Johann Van Zyl
              Head: Private Practice Unit
               Objectives
•   Stimulate constructive debate
•   Pose fundamental questions
•   Raise controversies
•   Highlight concerns
•   What went wrong?
•   Highlight potential synergies
•   Way forward
                    Questions
• When is evidence evidence?
• Can there be interpretation bias?
• What does appropriate mean?
• What is the difference between funding and
  clinical recommendations?
• What is being funded?
    – Healthcare?
    – Diseases?
    – Benefits?
          Questions (Cont)
• What should the priority be?
  – Patient care?
  – Financial status of the scheme?
• Should there be funding priorities?
• What are we talking about?
  – Managed healthcare?
  – Managed benefits?
  – Managed disease care?
• Who should be the manager?
            Controversies
•   Benefits vs Clinical needs
•   Benefits vs Patient needs
•   Funding vs Clinical recommendations
•   Funding of Diseases vs Health
•   Evidence vs Evidence
                 Concerns
•   Professional independence
•   Clinical autonomy
•   Clinical judgement
•   Doctor/patient relationships
•   Communication between doctor and patient
•   Recognition of expertise
•   Generalisation
•   Ethical rules
•   “Dual loyalties”
         What went wrong?
•   Poor communication
•   Lack of mutual understanding
•   Benefit designs
•   “Savings” approach
         What went wrong?
•   Poor communication
•   Lack of mutual understanding
•   Benefit designs
•   “Savings” approach

                     Adversity
              Synergies
• We are all professionals!
• We should all be patient focussed
• We are all concerned about the cost of
  healthcare
• There is a will to work together
• We are all SAMA members!
            Way forward
• Create a platform for open and
  constructive debate
• Establish a list of core issues
• Replace the actuarial approach with a
  clinical approach, or at least a balanced
  approach
• Engage rather than accuse!
            Conclusion
• Relationships have been badly
  managed
• Various perceptions have developed
• We need to unite as a profession in
  order to address these
• SAMA is committed to such a process
      For the sake of our patients!
Thank you!

								
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