Breach of ethical standards

My complaint deals with a breach of ethical standards, viz ‘over-servicing’ the patient and charging excessive fees by the billing department of, Dr. N. Wellington & Associates [T/A Kenilworth Medicross].

Background to my visitation to Kenilworth Medicross on 8 July 2021 for a general check-up: I am on the Discovery Key Care program because I reside overseas. With this program, you choose a particular health care physician – which then becomes your primary doctor. I was on holiday in Cape Town in July 2021 and decided to switch from my usual doctor to Dr. Gary Schwartz - hence my visitation to Kenilworth Medicross in order to activate the switch over.

I explained this to Dr. Schwartz, the treating physician, and pointed out that all I needed was a general check-up so that he would be on record with Discovery as my primary doctor.

I also mentioned to Dr. Schwartz, that three weeks before arriving in Cape Town, I had done a blood test and that my glucose and cholesterol levels were fine. He indicated to me that he wanted to do another blood test for glucose and cholesterol. I was particularly concerned that this test was going to be for my account and expressed this to Dr. Schwartz. I had no intention to incur any expenses as this was a simple switch over to another health physician.

Doctor Schwartz assured me that this would be covered by my medical aid and intimated that the blood test was only a finger ***** and that the result would be available in 5 minutes.

I emphatically state that I had no intention of paying for any blood test and made this clear to Dr. Schwartz- as I only wanted a general check-up so that my switch over could be activated.

My complaint is that, over and above the standard consultation fee that Discovery paid to Dr. N. Wellington & Associates, I have been charged for additional tests, to the amount of R406.90, which I was not informed of. This included, ‘unscheduled emergency consultation’ which I have no idea about as well as ‘completion of chronic medication forms’ which I did not need.

When I contacted Discovery Client Centre, they informed me that Discovery had adequately covered the general check-up that I had requested and which was paid over to Kenilworth Medicross. The excess amount of R406.90 for blood tests, I am contesting, which was for bogus tests and claims, which I did not request nor have any knowledge about. These blood tests were not sent to a lab for analyses – it is the same hand-held machine I have at home, which gives a positive or negative result. So this begs the question of how the billing department arrived at the astronomical amount of R406.90.

I understand that Dr. N. Wellington and Associates tried to pass this amount onto Discovery Medical Aid, but they refused the payment and this is why the bill was sent to me. I reached out to Dr. N. Wellington, as the principal member of Kenilworth Medicross, via email on numerous occasions and explained the situation to him. Dr. Wellington has to date not responded to my query.

I would like to make people aware of this **** that is going on with the billing departments of some doctors and it should not be left unchallenged.