Patterns of unprofessional conduct by medical practitioners in South Africa (2007–2013)¹

Figures & data

Table 1: Annual frequency of guilty decisions against medical practitioners (2007–2013)

Year	Registered medical practitioners	Guilty decisions	Guilty medical practitioners		Guilty decisions per guilty medical practitioner
	(n)	(n)	(n)	(%)	Mean
2007	34 449	155	69	0.20	2.25
2008	33 529	147	57	0.17	2.58
2009	33 800	78	38	0.11	2.05
2010	36 633	102	52	0.14	1.96
2011	37 289	58	45	0.12	1.29
2012	38 742	106	65	0.17	1.63
2013	39 541	156	95	0.24	1.64

Table 2: Specific unprofessional conduct by guilty medical practitioners within each category

Unprofessional conduct category	Specific unprofessional conduct (in descending order of frequency)
Fraudulent conduct	• Charge patient for non-rendered services • Issue misleading, inaccurate or false medical statements • False or inaccurate medical aid claims • Issue medical certificates or prescriptions without examining or seeing patient
Negligence or incompetence in evaluating, treating and caring for patients	• Sub-optimal diagnostic assessment of patient • Negligent or inappropriate administration, dosage or prescription of drugs • Sub-standard surgical procedures • Negligent post-operative patient care • Failure to refer patient to a specialist for evaluation and treatment when indicated • Failure to properly manage care of patient, in some cases resulting in patient’s death
Improper professional role conduct	• Perform surgical/intervention procedures while not duly qualified or trained to do so • Failure to respond to HPCSA enquiry or investigation letter • Utter verbal derogatory, abusive or rude remarks towards patient • Failure to communicate diagnosis or treatment with patient and/or family members
Negligence regarding patient documents and records	• Issuing medical certificates and prescriptions that do not comply with HPCSA guidelines • Failure to keep proper clinical notes and medical records
Perform procedures and interventions without patient consent	• Failure to obtain consent for charging above-medical-aid fees • Failure to obtain consent for intervention procedure, including failure to obtain preoperative consent
Professional registration misconduct	• Employ a non-HPCSA-registered person as health professional • Practise as medical practitioner when not duly registered with HPCSA
Disclose confidential information without permission	• Unauthorised disclosure of patient information to third party

Table 3: Frequency of unprofessional conduct categories linked to guilty medical practitioners

Unprofessional conduct categories	Number of unprofessional conduct decisions	% of all unprofessional conduct decisions
Fraudulent conduct	436	48.4
Negligence or incompetence in evaluating, treating or caring for patients	262	29.1
Improper professional role conduct	88	9.8
Negligence regarding patient documents or records	39	4.3
Perform procedures or interventions without patient consent	36	4.0
Professional registration misconduct	18	2.0
Unlawful conduct	10	1.1
Disclose confidential information without permission	8	0.9
Criminal convictions	3	0.3

Table 4: Annual frequency of sanctions imposed on guilty medical practitioners (2007–2013)

Penalty	2007 (n = 79)	2008 (n = 67)	2009 (n = 40)	2010 (n = 56)	2011 (n = 46)	2012 (n = 68)	2013 (n = 100)	% of all penalties
Caution or caution and reprimand	9	4	2	6	4	7	7	8.55
More training	1	1						0.44
Fine ZAR1 000 to ZAR8 000	20	12	13	13	16	16	17	23.47
Fine ZAR10 000 to ZAR15 000	21	21	14	7	12	24	30	28.29
Fine ZAR20 000 to ZAR25 000					2	9	13	5.26
Fine ZAR30 000 to ZAR60 000				3		3	8	3.07
Fine ZAR70 000 to ZAR100 000							5	1.10
Cost of inquiry	4	1	1					1.32
Suspension 1 month to 1 year	18	13	8	17	9	3	11	17.32
Suspension 1.5 to 4 years	3	3	2	1	2	1	9	4.61
Suspension 5 to 10 years	1	1		1		3		1.32
Erase from register	2	3		4	1	1		2.41
Practise under supervision during suspension		3		1				0.88
Attend medical ethics course		4		1				1.10
Report of competence following period of suspension		1		1				0.44
Community service at public hospital				1				0.22
Apology to patient						1		0.22