A Cape Town neurologist has been charged with disgraceful or improper conduct after he billed patients for expensive neurological procedures said to be unnecessary and inappropriate.
Johan Reid, who works in Bellville, could be fined or barred from practising medicine if the Health Professions Council finds him guilty in a hearing expected to end on Tuesday.
Former patient Arnold Laing testified on Monday he had paid almost R2 400 for a consultation that lasted less than 30 minutes. When he queried the amount, he was told it was justified by the expensive machinery needed to conduct neurological tests.
But expert witness and neurology professor Frances Ames said tests conducted on both Laing and another former patient, John Wreyford, were unnecessary and could not have been carried out satisfactorily during the time the patients spent with Reid.
Both men testified that they could not remember the tests being performed.
Reid has been charged with:
- Failing to take a proper history of both patients.
- Failing to evaluate the patients properly.
- v Conducting unnecessary tests that were not in the best interests of the patients.
- Prejudicing the patient or medical scheme responsible for paying the accounts because of "exorbitant and/or unnecessarily high" costs.
He has pleaded not guilty on all counts.
Laing said he had been referred to Reid by an orthopedic surgeon who wanted a second opinion about the pain he was suffering in his arm.
"I went to two specialists; the one charged me R240 for about half-an-hour. The other charged me R2 400 for the same time. I really don't think this was fair," he said.
"My medical aid paid the bill, but then they informed me I had run out of funds and I had to pay R1 052 myself."
He said Reid should have warned him the consultation would be so expensive.
The other patient, Wreyford, said his medical aid had covered the cost of the bill, but he did not believe that all the tests listed on his account had been conducted. He did not receive any treatment or prescription from Reid.
Ames, who has examined Reid's files on both patients, said she was "astounded" at the number of neurological tests Reid had listed.
"In my own practice each new patient is allotted at least an hour for me to take their history, get an idea of their emotional state and do a meticulous clinical examination," she said.
"This profusion of tests is (astounding).
"The usual practice is to base tests on your clinical findings, but in these notes the clinical factors are quite meagre."
She said important details of the type and extent of pain - what made it worse, what made it better and when it tended to occur - were missing from the files.
"The patients seemed to have encountered a lot of machines and tests and very little clinical understanding."
For both patients, Ames outlined reasons why some of the neurological tests conducted were inappropriate for the symptoms displayed.
She also said the tests could not have been properly completed in 30 minutes.
"The whole procedure (listed in Wreyford's notes) could not have been adequately carried out in under three hours."
The head of neurology at Groote Schuur Hospital, Bernard Lee Pan, is to testify late on Tuesday.