President’s Report 2017

The ENT Society plays a pivotal role in maintaining the standards of the practice of Otorhinolaryngology, Head and Neck Surgery in our country. A tremendous amount of work is put in by all the members of EXCO on a totally voluntary basis literally daily to ensure that our objectives and goals are reached for the benefit of all our members. Not only does the ENT Society help the Academic departments maintain standards that are among the best in the world, but it goes to extraordinary lengths to ensure that the Private practitioner, who will otherwise be fodder for the hostile business environment, is protected.

Of course all of this won’t be possible without the enduring support of our members of good standing.

1. SAMA Practice Cost Study. The South African Medical Association (SAMA) has commissioned HealthMan, PPO Serve and Medical Practice Consulting (MPC) (“the consortium”) to conduct an independent Practice Cost Study on General Practitioners and Specialists in private practice.

The purpose of the PCS is to conduct and publish a study into the actual costs associated with the running of a private medical practice in 2017. The results of the PCS will be used to establish the health of private medical practices in South Africa and whether it can be expected that our private medical doctors will be able to operate sustainably in the future without intervention.

Recently a PCS was circulated to our members to be filled in online. Unfortunately, we got a very poor response to this request. I can’t stress enough how important it is for all of you to fill in this survey. This is going to determine what you will be earning for the services you provide. If we are unable to give an objective understanding of our practices costs then we stand the risk of being under provided.

I would like to assure you that all the information that you provide is completely confidential and will not under any circumstances be shared without your consent. The most important information is your expenses and we do not have to know your income.

2. Financial Status.
The financial status of the Society has now been stabilised and in safe place in terms of our tax obligations.

You will recall that in July 2016 was entered into the register and met the requirements of a Nonprofit organisation. And I am now happy to announce that we have now received confirmation from SARS that we have been approved for income tax exemption. All we have to ensure now is that the Society is compliant according to our constitution.

I would like to thank Casper Venter for the efforts that resulted in the financial position we find ourselves in now.

As a member of the Society you have an automatic membership of SAPPF. SAPPF is constantly monitoring the healthcare environment to our advantage. One of the main functions of course is the monitoring of the developments of the NHI. medicolegal litigation etc.

One area that we will probably is going to rely on SAPPF for guidance in the future is the inevitable prospect of employment by the hospital groups. It is anticipated that very soon doctors are going to be inundated by contracts from them. Ultimately the fee for service model will become smaller and our position on the negotiation table will be critical to our earning capacity in the future.

4. Health of the Medical Aid Schemes. Worsening claim ratios and climbing healthcare costs have resulted in SA’s medical aid schemes facing a multimillion-rand deficit, according to the CMS 2016 annual report. The council regulates 82 schemes, including a total of 22 open schemes and 60 restricted schemes.

The report revealed that nearly 62% of the restricted schemes had a R1.435-bn deficit, while 78.3% of the open schemes incurred a total deficit of R955.7-m, up from R539.6-m in 2015. Schemes collected R163.9-bn in contributions as at end-December 2016, but this was undercut by a gross healthcare expenditure of R151.2-bn. Healthcare benefits, which medical schemes covered from their risk pools, amounted to R135.98-bn in 2016. The total gross relevant healthcare expenditure incurred per average beneficiary per month increased by 7.9% to R1 423. The main contributors to healthcare costs were private hospitals, specialists and medicines. Spending on private hospitals rose to R56.32-bn in 2016, while specialists and medicines amounted to R36.32-bn and R23.95-bn, respectively.

5. Membership Fees.
The Society cannot function without the membership fees that we collect from our members. For this we are extremely grateful and urge all ENT Surgeons to be members of the Society. Your fee increases are kept to the minimum as far as possible. The benefits of belonging to the Society far outweigh going it alone.

The Society speaks as a collective voice.
Maintains Member support and Practice management.
Active in Tariff negotiations.
Peer review.
Funding to Academic departments, registrars, and maintenance of the website.
Provides for online ENT Journals.
Continuing Medical Education.
Conference organisations and facilitation.

6. History Book.
By now I am sure all of you will have a copy of the History Book of the ENT Society in your possession. This has been a labour of love by Stefaan Bouwer and his daughter Tamara.

However, like in any work of this nature there will be errors and omissions. If you notice any of such, please bring this to the notice of the Society.

Going forward, the book will be updated regularly, so if you have articles, pictures and such, please forward it to the Society for inclusion.
7. Academic Departments.
I am pleased to report that despite the enduring problems that beset the Academic departments, which have not changed much from previous years, the training of Registrars continue at a very high standard. Testament to this is the very high rate of success of our candidates at the Fellowship Examinations. In addition, last year in excess of 20 papers were published in internationally recognised journals.

The Society has decided to increase the Departmental grants that is paid on an annual basis to R40000 from R16000, this figure being adjusted by CPI every year. This is money that the society awards to each of the academic departments for use in improving facilities for training of the registrars. This grant is subject to a report that needs to be presented to the President of the Society annually detailing what the funds were used for.

Shazia Peer has been elected to the Young Physicians Committee of IFOS. She will also serve on the education committee of this IFOS committee, and is planning to coordinate an open access textbook on basic sciences in ENT.

Professor Johan Fagan has been elected to represent Africa and the Middle East on IFOS.

8. Registrar Committee.
The new chairperson of the Registrar is Dr Nadia Karrim. We have requested the Registrar committee to appoint a Chair and a vice chair to afford continuity of purpose.

The Society continues to fund the Registrar committee to the tune of R135 000 per year. This helps fund attending of courses and conferences to deserving recipients. A significant portion of the funding next year will go to the training day in Durban and Bloemfontein.

The Registrars have requested that a Registrar exchange programme be implemented that ensures a more rounded and holistic approach to their experience, which will also help in examination preparation. The EXCO was very supportive of this suggestion and asked them to come up with a proposal that we can implement.

9. Journals.
Up until now members have had access to three online Journals that have been sponsored. The EXCO has decided that the number of Journals available to members will be increased to five and the cost will be absorbed by the Society. We encourage you to access this very important facility as much as possible.

10. Congresses.
The EXCO would like to thank John Black and his LOC for arranging a superb conference this year.

Next year the conference will be in Cape Town and will be a joint effort with the World Audiology conference. It will be co-ordinated by Professor James Loock and will run over a 6 day period. The first part of the conference will be predominantly Otology and the second half will concentrate on Rhinology and Laryngology.

A tender process was implemented this for selection of our Conference organisation company. 5 companies tendered for the conferences and the Society can announce that after a unanimous vote, Eastern Sun Events have been awarded the conference organisation until 2019.

The 2019 conference will be held in Durban.

11. ENT Society Website.
The Website is maintained by E2 Solutions, the cost of which is borne very kindly by Aspen Pharma. The Society also pays for registration and use of the surgeon domain. We however, have noticed that very few of our members are making use of this facility. We encourage you to use this as it is a monthly expense that is fixed for the society.

We are exploring the possibility of reducing the cost of this service.

12. AAO-HNSF 2018 Annual Meeting & OTO Experience. The Society was recently approached by the President elect of the AAOHNS, Gavin Setzen, who is an Ex South African and alumni of Wits University. They have selected South Africa as one of the four International Guests of Honor for the AAO-HNSF 2018 Annual Meeting & OTO Experience. The meeting will be held in Atlanta, Georgia, USA from October 7-10, 2018.

As International Guests of Honor, all South African attendees of the AAO-HNSF 2018 Annual Meeting & OTO Experience will enjoy a range of exclusive benefits, including, but not limited to:

  1. $100 discount on the AAO-HNSF 2016 Annual Meeting & OTO Experience registration fee.
  2. High-profile recognition at the Opening Ceremony and the elegant AAO-HNSF International Reception.
  3. Opportunity to publish an article about our Society in the Bulletin.
  4. And, extensive marketing and communications recognition in specialty trade publications leading up to Atlanta conference.

To that end, they are ready to assist with promoting South Africa’s designation as a 2018 International Guest of Honor country and the AAO-HNSF International Symposium throughout their networks.

I think this is a great opportunity to encourage South African ENTs to attend the meeting.

Given the wide international distribution of the Bulletin, this presents a great opportunity to market the South African Society of ORL-HNS.

We also encourage members to submit abstracts for posters and podium presentations at the meeting.

Thank you very much for supporting the ENT Society this last year. I like to thank the EXCO and Janette my secretary, without whom none of this will be possible.


28 October 2017.