Teachers welcome new referral system

THATO CHWAANE
Staff Writer | Friday February 1, 2008 00:00

BTU secretary general Keorapetse Kgasa said that members have accepted the system and it has had a positive impact since it encourages them to have one family doctor.

AFA requires a member of a medical aid to register a family doctor - a General Practitioner (GP), who is responsible for any referrals to medical specialists. GPs are to serve as gatekeepers or the first contact points for members and their registered dependants. Kgasa said that when members consult many doctors, their medical history is not kept in one place. 

By launching this referral system, AFA hopes that a family doctor will help improve the quality of care and help avoid excessive duplicative costs of patients who see several medics simultaneously. AFA says that in the past two years, there has been an increase in claims costs relative to the contributions received and the reserves they hold.

Where a member consults a medical specialist who does not treat the eye or is not a gynaecologist, without a referral from a general practitioner, reimbursement will be paid at a rate of a GP.

The president of Botswana Public Employees Union (BOPEU), Andrew Motsamai, said his members are aware of the system, however it was still too early to say how they have reacted to it.

He said that they would need to travel to various regions to inform members about the system. He said they will only receive feedback after the educational campaign. Motsamai said individual members had been sent letters about the new system but some had still not received them. The scheme sends a form to the member, who identifies a primary doctor of his or her choice. A registration form completed with the doctor is then submitted to the fund.In a letter to the members, AFA says that reimbursement at the rate of a GP is intended to mitigate the adversity of self-referrals to medical specialists for conditions that could be more cost effectively managed at a GP level. 'You may wish to note that self-referral to the medical specialists is one of the factors that contribute avoidable expenditure to increased claims cost,' the letter says.