How doctors in private hospitals plan to lower medical bills

Doctors in private practice are crafting safer ways to reduce hospital charges with a keen eye not hurt their businesses.

A raft of proposals, among them hospitals sharing crucial personnel and diagnostic equipment, may be adopted by some facilities in a bid to reduce operational costs.

These proposals are meant to counter the guidelines by the Medical Practitioners and Dentists Board (MPDB) on how much a doctor can charge a patient for procedures, which the medics said they will not abide by them.

But in anticipation that the guidelines, once submitted to Parliament by the Ministry of Health can be made law, the doctors said it is wise for them to put their house in order early.

"We do not want a scenario like that of the banking industry where interest rate was capped," said Kenya Health Federation Chair Dr Amit Thakker, who convened a meeting last week to discuss how to reduce cost of healthcare.

One of the suggestions, is that hospitals should purpose to do pool purchase of medical devices and commodities, which reduce significantly the cost of medicine, through economy of scale.

Pharmaceuticals alone, according to Association of Kenya Insurers (AKI) makes up 40 per cent of the total medical bill a patient receives.

If possible, said Dr Fernandes Njoki Chair Healthcare Financing Committee, then the private sector should manufacture some consumables in the country.

“We import up to 90 per cent of drugs we use including intravenous fluids from Uganda. Even simple theatre gowns and masks made from recycled paper we still import them,” noted Njoki.

She argued that the reason why many Kenyans would rather prefer to travel to India for treatment is because it is cheaper as they manufacture almost all of the medical consumables and equipment.

Njoki discouraged private facilities from fighting to have all the expensive medical devices under their roof, which she said does not make business sense, as many of the equipment is under-utilised, sometimes as low as ten per cent.

“We have Magnetic Resonance Imaging (MRI) and Computerised Tomography (CT) scans lying idle especially at night or during the weekends. Why can’t you let other hospitals utilize them at subsidised rates?” posed Njoki.

However, Dr Joan Osoro from The Nairobi Hospital warned that while it is much cheaper to share specialists and equipment, it is at time risky to buy locally made medical consumables, which the hospital has tried and backfired.

“We once purchased 20 cc mililitre syringes but they could not fit the drugs (anaesthesia) and patients were waking up during surgeries. What happens is the commodities will pass the technical evaluation test, but when it comes to delivery, it is just something else,” she said.

Dr Osoro said as a hospital, they find it too expensive to hire specialists who have been in the field for quite a long time, that they have opted to train their own and retain.  In such a case, it will be tough to share specialists.

Osoro said one of the ways the hospital realized medical bills were high, is in occasions where one patients have up to three specialists, which The Nairobi Hospital now discourages.

“There are times when particular patients have unique agreements with the doctors and we won’t interfere in such cases,” said Osoro.

Osoro said to reduce the costs even further, hospitals should charging their billing ways.

“Rather than charging patients for every needle and syringe they use, let us charge for the total care they receive,” said Osoro.

Private hospitalshospital chargesMedical Practitioners and Dentists BoardMPDB