The UAE healthcare system is under strain.
Our rapidly growing population has gone from 4.9 million in 2006 to about 9.3 million as of January 2016. Now add to that the increase in unhealthy lifestyles and the booming tourist numbers and it’s no wonder that it’s creaking a little. But there’s something more – something that is impacting the system which has been spotted by those in the medical and medical insurance industries.
Excessive visits to the doctor’s office.
Now, clearly no one is suggesting putting off a doctor visit if you’re unwell, but it seems that here in the UAE we are far too quick to burden our physicians with the most minor of ailments. And this is having a major impact on the wider healthcare system. Someone has to pick up the costs and this could have a negative impact on your business.
So first let’s determine the source of this issue and then get into practical actions you can take to alleviate the strain on your business.
Are UAE residents really visiting the doctor too often?
While expat resident figures are hard to come by, on average, Emirati residents use outpatient services around 12 times per year – a figure way above much of the rest of the world. Healthcare experts put this tendency to visit the doctor down to a number of factors such as prescription renewals, pre-marital screenings and a UAE culture of thinking (as long as we’re insured) that doctors are at our beck and call whenever we need them.
But whatever the reasons for those frequent visits, one thing is clear – it’s taking its toll on our healthcare system and is contributing to rising healthcare costs.
To get an idea of the impact these unnecessary visits are having here in UAE, it’s worth noting that only Japanese and South Koreans visit their physicians more times per year (13 and 15 visits respectively) with the lower end represented by the British at five visits and Americans at four.
What’s more, not only are UAE residents more inclined to go to the doctor’s office more than most, there is also a pattern of clogging up emergency wards with minor illnesses.
According to Abu Dhabi figures, around one third of visits to the emergency units there are for non-emergency conditions such as colds, stomach bugs or minor cuts and bruises. A 2010 study by Saqr Hospital showed that an alarming 73 per cent of emergency admissions were in fact not emergencies, while a similar study by Sheikh Khalifa Hospital put their figure somewhere between 30- 40 per cent.
Blame for our overstretched healthcare industry cannot be laid only at the door of the patients – our doctors must shoulder some of the responsibility as well. Speak to most expats and they will have a tale to tell about pushy doctors, ordering tests that, with hindsight, do not seem particularly necessary.
This anecdotal evidence is hardly surprising given that a study conducted by the magazine of the UAE Ministry of Interior found that 28 per cent of people surveyed had been advised to undergo unnecessary tests or procedures. The goal? Increasing the bill.
Not only does this add to the burden on an already overstretched healthcare industry, but it brings with it a heavy price. Consultancy group Booz Allen Hamilton estimates that the UAE loses around Dhs 3.67bn ($1bn) per year as a result of health insurance abuse.
The wider impact of excessive doctor visits
Any time that a qualified physician spends with a patient for any purpose other than medical necessity is clearly time wasted, but just how much of an impact are these needless doctor visits having on our healthcare system?
Well, the latest figures put the annual healthcare expenditure per person in the UAE at around $1,200 – which lands us in the top 20 countries per capita. Estimates for the amount of this money that is wasted on unnecessary visits vary, but even if we take the conservative estimate of around 10 per cent, this leaves us with an unnecessary spend of $120 per resident. In a country of nearly 10 million, that adds up.
Waste of this magnitude impacts on our healthcare system in two particularly damaging ways, starting with patient care. Naturally, if our physicians are spending much of their time dealing with minor issues that could be handled elsewhere, they are spending less time handling conditions that really need their attention. This has the knock-on effect of shortening the time genuine cases get to spend in the presence of their physician.
Secondly, there’s a huge financial burden as a result of wasting resources in this way. Overuse of any system ultimately results in price hikes, which get passed on to the bill payer. In most cases, the insurer must then ultimately pass those same costs on to employers by way of increasing insurance premiums. Currently, the acceptable rate of annual inflation in the medical industry should be around 10 per cent but in fact it is around double that – between 15- 20 per cent.
Practical solutions: What your company can do to alleviate the strain
While controlling healthcare expenses can often feel like an uphill battle, there is something employers can do to help lessen the strain on themselves and the industry.
The first place to start is education: By incorporating healthcare workshops into your wellness programme, you can inform employees about the types of medical complaints that require a visit to the physician. Many UAE residents visit the doctor’s office simply because they have a medical insurance card and see it as a one-stop-shop for whatever medical issue they have.
Educating them on the types of conditions that pharmacies can deal with, for example, is a great first step towards bringing down unnecessary appointments. And you can also add another element to the educational component, which is to inform your employees that reducing spend by limiting unnecessary doctor visits could allow for greater benefits in other areas – such as dental.
Next up, companies should endeavour to set up links with a local network of healthcare providers to limit where employees can go with their medical queries and concerns. By working with a set group of medical providers, employers can initiate frameworks and protocols for different types of medical conditions, meaning no test or procedure is carried out unless deemed to be completely necessary – and signed off by the appropriate representative at your organisation.
And to be clear, this in no way leads to restricted or lower cover or benefits, but quite the opposite when done right, as a closer relationship with trusted providers will only strengthen over time and result in better healthcare for your team.
Finally, employers can encourage the use of mobile medical consultations. “Skype-style” consultations are on the rise across the world, as both patients and employers look to find convenient and cost-effective ways to seek medical advice. Mobile appointments are proving so popular that around 75 million consultations in the US and Canada took place “virtually” in 2014 – a figure that has risen by around 400 per cent since 2012. Further research by accountancy firm Deloitte put the figure for virtual appointments globally at approximately 100 million. The potential savings for employers here is huge.
While rising healthcare costs can seem out of your control, there are plenty of actions that organisations can take to get a grip on their medical expenditure. Being willing to get proactive and engage with programmes such as the ones mentioned above may well hold the key to bringing down those spiralling costs.
And that’s good for your business, your employees, and everyone in the UAE.
Stephen MacLaren is head of regional sales employee benefits at Al Futtaim Willis