{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T17:33:01Z","timestamp":1785432781597,"version":"3.56.0"},"reference-count":20,"publisher":"South African Medical Association NPC","issue":"1","license":[{"start":{"date-parts":[[2022,12,20]],"date-time":"2022-12-20T00:00:00Z","timestamp":1671494400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["S Afr Med J"],"abstract":"<jats:p>Background. Many patients have their healthcare needs met at primary healthcare (PHC) clinics in KwaZulu-Natal (KZN), without having to travel to a hospital. Doctors form part of the teams at many PHC clinics throughout KZN, offering a decentralised medical service in a PHC clinic.Objectives. To assess the benefit of having a medical doctor managing patients with more complex clinical conditions at PHC clinic level in uMgungundlovu District, KZN. Two key questions were researched: (i) were the patients whom the clinic doctors managed of sufficient clinical complexity that they warranted a doctor managing them, rather than a PHC nurse clinician? and (ii) what was the spectrum of medical conditions that the clinic doctors managed?Methods. Doctors collected data at all medical consultations in PHC clinics in uMgungundlovu during February 2020. A single-pagestandardised data tool was used to collect data at every consultation.Results. Thirty-five doctors were working in 45 PHC clinics in February 2020. Twenty-six of the clinic doctors were National HealthInsurance (NHI)-employed. The 35 doctors conducted 7 424 patient consultations in February. Staff in the PHC clinics conducted 143 421 consultations that month, mostly by PHC nurse clinicians. The doctors concluded that 6 947 (93.6%) of the 7 424 doctor consultations were of sufficient complexity as to warrant management by a doctor. The spectrum of medical conditions was as follows: (i) consultations for maternal and child health; n=761 (10.2%); (ii) consultations involving non-communicable diseases (NCDs), n=4 372 (58.9%) \u2013 the six most common NCDs were, in order: hypertension, diabetes, arthritis, epilepsy, mental illness and renal disease; (iii) consultations involving communicable diseases constituted 1 745 (23.5%) of cases; and (iv) consultations involving laboratory result interpretation 1 180 (15.9%).Conclusion. This research showed that at a PHC clinic the more complex patient consultations did indeed require the skills and knowledge of a medical doctor managing these patients. These data support the benefit of a doctor working at every PHC clinic: the doctor is a \u2018musthave\u2019 member of the PHC clinic team, offering a regular, reliable and predictable medical service.<\/jats:p>","DOI":"10.7196\/samj.2023.v113i1.16700","type":"journal-article","created":{"date-parts":[[2022,12,20]],"date-time":"2022-12-20T04:13:00Z","timestamp":1671509580000},"page":"24-30","source":"Crossref","is-referenced-by-count":2,"title":["A doctor at a PHC clinic: A \u2018must-have\u2019 or \u2018nice-to-have\u2019?"],"prefix":"10.7196","volume":"113","author":[{"given":"TP","family":"Kerry","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P G T","family":"Cudahy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H L","family":"Holst","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Ramsunder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N G","family":"McGrath","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4425","published-online":{"date-parts":[[2022,12,20]]},"reference":[{"key":"9831","unstructured":"South African Government News Agency. Ten districts announced for NHI pilot. SANews, 22 March 2012. https:\/\/www.sanews.gov.za\/south-africa\/10-districts-announced-nhi-pilot (accessed 27 May 2022). 2. KwaZulu-Natal Department of Health. KZN Budget Policy Statement 2022\/23 by Simelane N Hon."},{"key":"9832","unstructured":"MEC for Health, 10 May 2022."},{"key":"9833","unstructured":"Marcus T, Hugo J. Community orientated primary care: Where there is a doctor. In: Mash B, ed."},{"key":"9834","unstructured":"Handbook of Family Medicine. 4th ed. Cape Town: Oxford University Press, 2017:334-359."},{"key":"9835","doi-asserted-by":"crossref","unstructured":"Nkosi PH, Horwood CM, Vermaak K, Cosser C. The role of doctors in provision of support for primary healthcare clinics in KwaZulu-Natal, South Africa. S Afr Fam Pract 2009;51(5):408-412.","DOI":"10.1080\/20786204.2009.10873893"},{"key":"9836","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1080\/20786204.2009.10873893","DOI":"10.1080\/20786204.2009.10873893"},{"key":"9837","doi-asserted-by":"crossref","unstructured":"Gaede B. Revisiting the doctor\u2019s role at the primary healthcare clinic. S Afr Fam Pract 2020;62(1):a5242.","DOI":"10.4102\/safp.v62i1.5242"},{"key":"9838","unstructured":"https:\/\/doi.org\/10.4102\/safp. v62i1.5242"},{"key":"9839","doi-asserted-by":"crossref","unstructured":"Mash R, Ogunbanjo G, Naidoo SS, Hellenberg D. The contribution of family physicians to district health services: A national position paper for South Africa. S Afr Fam Pract 2015;57(3):54-61. http:\/\/ hdl.handle.net\/10019.1\/99785 (accessed 5 January 2022).","DOI":"10.4102\/safp.v57i3.4217"},{"key":"9840","doi-asserted-by":"crossref","unstructured":"Pillay S, Lutge E, Aldous C. The burden of diabetes in KZNs public sector: A 5-year perspective. S Afr Med J 2016;106(4):384-388. https:\/\/doi.org\/10.7196%2FSAMJ.2016.v106i4.9920","DOI":"10.7196\/SAMJ.2016.v106i4.9920"},{"key":"9841","doi-asserted-by":"crossref","unstructured":"Couper I, Malete N, Tumbo J, Hugo J. The role of the visiting doctor in primary care clinics. S Afr Fam Pract 2003;45(6):11-16.","DOI":"10.4102\/safp.v45i6.1935"},{"key":"9842","unstructured":"National Department of Health, South Africa. Standard Treatment Guidelines and Essential Medicine List for South Africa: Primary Health Care Level. Pretoria: NDoH, 2018. http:\/\/www.health.gov.za\/edp. php (accessed 20 September 2020)."},{"key":"9843","doi-asserted-by":"crossref","unstructured":"Tumbo J, Hugo J, Couper I. The involvement of private general practitioners in visiting primary health care clinics. S Afr Fam Pract 2006;48(7):16-16d. https:\/\/doi.org\/10.1080\/20786204.2006.10873420","DOI":"10.1080\/20786204.2006.10873420"},{"key":"9844","unstructured":"Department of Health, KwaZulu-Natal. KZN Department of Health Item Catalogue for Provincial"},{"key":"9845","unstructured":"Pharmaceutical Supply Depot. KZN DoH, 2022."},{"key":"9846","unstructured":"National Department of Health, South Africa. Adult primary care: Symptom-based integrated"},{"key":"9847","unstructured":"approach to the adult in primary care. Pretoria: NDoH, 2019\/2020. https:\/\/www.knowledgehub.org."},{"key":"9848","unstructured":"za\/system\/files\/elibdownloads\/2020-08\/APC%202019-20%20eBook.pdf (accessed 27 May 2022)."},{"key":"9849","unstructured":"SouthAfricanSocialSecurityAgency.Youandyourgrants2020\/21.https:\/\/www.sassa.gov.za\/publications\/"},{"key":"9850","unstructured":"Documents\/You%20and%20Your%20Grants%202020%20-%20English.pdf (accessed 27 May 2022)."}],"container-title":["South African Medical Journal"],"original-title":[],"link":[{"URL":"https:\/\/samajournals.co.za\/index.php\/samj\/article\/download\/631\/337","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/samajournals.co.za\/index.php\/samj\/article\/download\/631\/337","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T10:21:24Z","timestamp":1782123684000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.co.za\/doi\/abs\/10.7196\/SAMJ.2023.v113i1.16700"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,20]]},"references-count":20,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,12,20]]}},"URL":"https:\/\/doi.org\/10.7196\/samj.2023.v113i1.16700","relation":{},"ISSN":["2078-5135","0256-9574"],"issn-type":[{"value":"2078-5135","type":"electronic"},{"value":"0256-9574","type":"print"}],"subject":[],"published":{"date-parts":[[2022,12,20]]}}}