The cost management role of private general practitioners in Zimbabwe

Abstract

ABSTRACT Private sector healthcare costs in Zimbabwe have become excessive and are thought to be driven significantly by the failure of general medical practitioners(GPs) to effectively play their gatekeepers’ role as caregivers and cost-containment managers. Increased healthcare costs are attributed to over-diagnosis, over-servicing, overtreatment, inappropriate treatment, and poor patient management (Keogh, 2012; Campbell, Quigley, Collins, Yeracaris & Chaora, 2000). Healthcare costs have become unaffordable to the extent that many patients make use of rural mission hospitals such as Karanda, located deep in rural Mount Darwin in search of cheaper and more effective treatment (Chibaya, 2013). The purpose of the study is to examine the role GPs are playing and could play in the management of healthcare costs in Zimbabwe. A basic interpretative qualitative research study is applied using a semi-structured interview guide and semi-structured open-ended questions. A small sample of rich cases was used. The findings of the study reveal that GPs in Zimbabwe are potentially contributing to healthcare cost increases by engaging in unethical conduct such as deliberate over-servicing, inappropriate diagnosis and treatment, fraud and referring patients to conflicted establishments. This has been exacerbated by the collapse of the gate-keeping system with the apparent collusion of Medical Aid Societies, the patients, and specialist physicians. Healthcare costs could be better managed using modern information technology, involving, inter alia the profiling of doctors and diseases and better monitoring of patients. In addition it is possible to improve the regulation of aspects of the private healthcare industry. This would include the enforcement of the patient referral system through the restoration of the GPs role as a gatekeeper.