Cash, card or cheque? A look at payment options

With so many options in the marketplace, knowing which payment options to offer patients can seem overwhelming. So we took a look at the most popular payment methods being used by GP medical practices across the country and uncovered a surprising trend.

Our graph shows that good old cash is still king, irrespective of where the practice is located.

This is in line with a recent study by Mastercard1 which found that over 50% of South Africans still transact using cash on a daily basis. This is despite the fact that some 77% of South Africans have bank accounts, and that both banks and retailers offer numerous incentives and rewards to get people to use electronic or
card-based payments.

Why is cash still king?

According to Business News, there is a common misconception that cards are unsafe, or at least less safe than cash. Of course, there is some risk associated with cards: pin numbers can be scanned and used by fraudsters, cards can be swapped or copied, and there are phishing and other scams.

There is also a fear of newer payment methods such as mobile payments, and people are reluctant to hand over their personal and financial information to third parties with unfamiliar names or unfamiliar digital functions. However, these concerns notwithstanding, more and more people are making use of cards, online and mobile payment options in their daily lives. So, why are more patients not making use of such payment options too? We explore the pros and cons, from the perspective of your practice, of four of the most popular patient payment methods according to the graph.



  • You get the money immediately
  • No transaction fees


  • You need a safe to keep the money secure and you are at constant risk of theft
  • Frequent trips to the bank are necessary to bank the money; this takes time and reduces efficiency

Card (credit/debit)


  • Popular with patients, many of whom have cards
  • Payment is immediate and goes directly into your account


  • Card machines can go offline; electronic infrastructure often poor in remote areas
  • Risk of chargebacks and fraud



  • Some older patients (40 or above) may prefer them


  • High risk of fraud, as cheques can easily be altered
  • No way of knowing if the cheque is good until it actually clears
  • It takes a long time for the cheque to clear

Mobile (Snapscan)


  • These easy-to-use mobile payment applications have enabled even small practices to accept card payments from virtually anywhere, thanks to Near-Field Communication (NFC) equipment.
  • Fast
  • Low risk, as the transaction can only go through if there are funds in the patient’s account


  • You must have NFC equipment, and your patient must have a smartphone
  • No standardisation, so you will have to figure out which of the many “mobile wallets” out there is right for you


Although cash is still a common method of payment at medical practices, the rapid evolution of digital technology has created a wide range of other payment options. They all have different advantages and disadvantages.The best payment method is ultimately the one your patient prefers. So, logic suggests that your practice should offer patients as wide a range of payment options as possible. This will reduce your risk of non-payment and bad debt.

1. Mastercard. 2017. Cash costs South African consumers R23 billion a year – Mastercard study. [ONLINE] Available at: [Accessed 28 August 2017]
2. Cape Business News. 2017. Credit Card vs Cash in Africa – on the verge of convergence. [ONLINE] Available at: [Accessed 28 August 2017]
3. IT NEWS AFRICA. 2017. Why SA banks hold the key to mobile payments. [ONLINE] Available at: [Accessed 28 August 2017]

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