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Practitioners warned about dubious mobile radiology services

Pretoria – The Professional Board for Radiography and Clinical Technology of the Health Professions Council of South Africa (HPCSA) has warned practitioners about suspicious mobile radiology practices.

It has come to the attention of the Board that some companies have purchased x-ray equipment for mobile radiology services.  These companies are apparently struggling to obtain licenses from Radiation Control Directorate of the National Department of Health to use these machines as they are not adequately qualified and trained to operate such machines.  They make lucrative offers to practitioners in order to use their HPCSA numbers, thereby securing licenses from Radiation Control.

“With a mandate of protecting the public and guiding the professions, the Council is concerned that practitioners and the public might be exposed to suspect operators,” Mable Kekana, Chairperson of the Professional Board for Radiography and Clinical Technology said.

“Although the Board is not opposed to practitioners bringing healthcare services closer to communities through various mobile practices, the Board is concerned about the possible unethical and unprofessional relationship that might emanate between the healthcare practitioner and the companies providing the service,” she explained.

Practitioners are urged to be conversant with the type of private practice they want to engage in and to ensure that any type of practice adheres to the ethical rules and regulations* of the Council.

Practitioners are furthermore advised to desist from giving or selling their HPCSA registration numbers or private practice numbers obtained from the Board of Healthcare Funders (BHF).  Practitioners must be cognisant of the fact that they are liable for all professional acts performed or taking place in their presence or absence when their personal registration numbers are used.

The Board is also calling on practitioners who are aware of any unethical practices regarding mobile radiology practices to report these to the HPCSA for further investigation.

*EXTRACT FROM THE ETHICAL RULES AND REGULATIONS:

Professional appointments
(1) A practitioner shall accept a professional appointment or employment from employers approved by the council only in accordance with a written contract of appointment or employment which is drawn up on a basis which is in the interest of the public and the profession.
(2) A written contract of appointment or employment referred to in subrule (1) shall be made available to the council at its request.

Partnership and juristic persons
(1) A practitioner may practise in partnership or association with or employ only a practitioner who is registered under the Act and who is not prohibited under any of the annexures to these rules or any ethical rulings from entering into such partnership or association or being so employed: Provided that, in the case of employment, the practitioner so employed either provides a supportive health care service to complete or supplement the employing practitioner’s healthcare or treatment intervention or is in the same professional category as the employing practitioner.
(2) A practitioner shall practise in or as a juristic person who is exempted from registration in terms of section 54A of the Act only if such juristic person complies with the conditions of such exemption.
(3) A practitioner shall practise in a partnership, association or as a juristic person only within the scope of the profession in respect of which he or she is registered under the Act.
(4) A practitioner shall not practise in any other form of practice which has inherent requirements or conditions that violate or potentially may violate one or more of these rules or an annexure to these rules.

Technological equipment
(1) Health care practitioners shall only own and use technological equipment if it forms an integral part of their scope of the profession and practice and on condition that the health care practitioner concerned has received appropriate training in using and managing such equipment.
(2) Health care practitioners shall not over-use equipment for procedures, tests and other applications that are not indicated, scientific or based on evidence. This constitutes overservicing and is prohibited.
(3) Health care professionals shall not use technological equipment, health care products or devices for profiteering and must refrain from charging patients fees for the use of such products or devices that are not market related.

Financial interest in hospitals
A practitioner may have a direct or indirect financial interest or shares in a hospital or any other health care institution: Provided that –
(a) such interests or shares are purchased at market-related prices in arm’s length transactions;
(b) the purchase transaction or ownership of such interest or shares does not impose conditions or terms upon the practitioner that will detract from the good, ethical and safe practice of his or her profession;
(c) the returns on investment or payment of dividends is not based on patient admissions or meeting particular targets in terms of servicing patients;
(d) such practitioner does not over-service patients and to this end establishes appropriate peer review and clinical governance procedures for the treatment and servicing of his or her patients at such hospital or health care institution;
(e) such practitioner does not participate in the advertising or promotion of the hospital or health care institution, or in any other activity that amounts to such advertising or promotion;
(f) such practitioner does not engage in or advocate the preferential use of such hospital or health care institution;
(g) the purchase agreement is approved by the council based on the criteria listed in paragraphs (a) to (f) above; and
(h) such practitioner annually submit a report to the council indicating the number of patients referred by him or her or his or her associates or partners to such hospital or health care institution and the number of patients referred to other hospitals in which he or she or his or her associates or partners hold no shares.

Rentals as perverse incentives
Health care practitioners shall not:
(1) Pay rentals in lease agreements between health care practitioners and health establishments that are not market related or are at preferential rates.
(2) Enter into lease agreements with health establishments or services that wish to rent their consulting rooms at rates conditional on the health care practitioner achieving a certain turnover or targets such as admission of a specific number of patients at a private health care facility.
(3) Rent consulting rooms from health establishments or services under financial arrangements that are not openly available to other similarly qualified health care practitioners.

Commission
(1) Accepting commission
Health care practitioners shall not accept commission or any financial gain or other valuable consideration from any person or body or service in return for the purchase, sale or supply of any goods, substances or materials used by the health care professional in his or her practice.
(2) Paying commission
Health care practitioners shall not pay commission or render any financial gain or other valuable consideration to any person for recommending patients.

Charging or receiving fees
(1) For referring patients
Health care practitioners shall not charge a fee or receive any financial gain or other valuable consideration for referring patients to the other health professional or for participation in drug trials or other research trials of a similar nature.
(2) For seeing representatives
Health care practitioners shall not charge a fee or receive any financial gain or other valuable consideration for seeing medical representatives.
(3) For services not personally rendered
Health care practitioners shall not charge or receive fees for services not personally rendered by either a health care professional himself or herself or by an unregistered person in his or her employ, except for services rendered by another health care practitioner or person registered in terms of the Health Professions Act (Act No. 56 of 1974), that regulates the particular profession, with whom the health care practitioner is associated as a partner, shareholder or locum tenens.

Sharing of fees
Health care practitioners shall not share fees with any person or health care professional who has not taken a commensurate part in the service for which the fees are charged.

Contracts
(1) Health care practitioners shall not enter into a contract to work in a particular health establishment or service on the understanding that the health care professional generates a particular amount of revenue for such health establishment or service.
[Note: A health establishment or service that equips a theatre, ward or other facility for a specific health care practitioner according to his or her specifications may enter into a contractual agreement with such health care professional on condition that such health establishment or service may not stipulate any turnover targets for the health care practitioner concerned].

Last Updated on 30 April 2014 by HPCSA Corporate Affairs