Tony The ban on private practice of Govt. Doctors have been an emotive issue for last many decades. Time and again Govt. doctors have been blamed for private practice in J&K State (as well as now UT of J&K). There have been numerous allegations against doctors regarding these topics. The Govt. Doctors have been considered “greedy, money minded” mostly indulging in private practice while ignoring their duties in Govt. Hospitals. However there is another new point: State of the Private health Infrastructure in JK UT: – There is utter lack of good private Hospitals in our UT region (be it cities like Jammu or Srinagar). If you consider small towns like Udampur, Poonch, Rajouri, Baramulla, Anantnag etc., then the situation is unimaginably dismal. All neighboring states like Punjab, Haryana, Delhi have developed high quality Hospitals in private sector. Not only their big cities are wellequipped with plenty of private hospitals, their small towns also have decent private medical infrastructure. But alas, our region has been denied of thisfacility by respective governments. No effort was made by successive governments to encourage reputed private hospitals to establish their branches in the region. There are no Fortis, Max, Medanta, Appollo hospital etc. like facilities in the region (Courtesy lack of initiative by all respective governments). Just to give example, in city of Chandigarh, in addition to PGIMGR, GMCH Chandigarh, there are all more than …. to …. reputed hospital chains providing services to people. Similar is the case of cities like Ludhiana, Jalhander, Amritsar, Gurgaon etc. While people from Jammu region have to run (after gathering their lifelong savings) for medical facilities to these cities. Shortage of doctors It is a state of dismal affairs that our UT has acute shortage of doctors (Especially specialists and super-specialists). Most of the specialists & super-specialists available in the region areemployed in govt. sector. They are dutifully providing their valuable service to the private sector too. Take for example, the specialty of Neurosurgery; in Jammu region there is only one neurosurgeon available in private sector. While four neurosurgeons employed in Govt. sector are
providing their services in private sector too. The super-specialty of Urology has not more
than three or four urologists in private sector. While more than six urologists employed in Govt. sector are providing their services in private sector too. There is no Paedriatic surgeon in private surgeon available in whole of Jammu region. While, three Paedriatic surgeons working in the Govt. sector are providing services in private sector too. There is only one Surgical Gastroenterologist in whole of Jammu region employed in GMC Jammu. He is also providing his services in private sector too. The story is same for most of specialty and super specialty fields. Imagine what disaster will be created once the private practice is banned for govt. doctors. Where will the poor patients go for super specialty treatment? Will they flood the already over loaded govt. hospitals or will go outside the UT spending their life time savings? Hence, there is no doubt that blanket ban on private practice on Govt. doctors will have a impact on functioning of private hospitals/ medical institutes in the region. The private sector will collapse for want of
good doctors (especially specialists and super-specialists). The private sector at present is nearly
totally dependent on govt. doctors for provision of skilled specialists. The situation is worse in remote regions like Poonch, Rajouri, Doda, Kathua, etc. In these places, the private sector is
totally dependent on govt. doctors who provide their medical expertise after their working
hours. Take for example, the towns of Poonch or Doda, who have
only a handful of doctors (especially specialists) who are working totally in private sectors.
Most of these are either retired from Govt. job or rarely totally privately employed. In case of ban, there will be a total collapse of private health service in these regions. And can one imagine the
chaos that will be created after the ban when no doctor would be left to serve in private sector in these regions. Under such circumstances, most patients will have to run to big cities like Jammu & Srinagar who would already be suffering from same shock and chaos. Affordable health services: – There is no doubt that a govt. doctors provide affordable services to patients after their working hours as they are regulated by govt. authorities regarding their fees structure. A senior doctor
after 5 Pm is available to the poor patients at a fee of Rs. 200 (as regulated by govt.) while a doctor of similar stature in private sector will charge Rs. 500 to 700 A surgery can be done in Jammu region in private sector for Rs 30,000 to Rs. 35,000 while in cities of Punjab where private hospitals are thriving, the same operation will cost Rs. 50,000/- onwards. As govt. doctors are regulated by govt. authorities the fee structure cannot go to exorbitant levels. While in a totally private scenario, where there is no price regulation, the medical care cost is going to rise. Not conducting medical research: This is again a very pertinent issue raised many a times. A common allegation is that Govt. doctors indulging in private practice don’t get enough times for medical research and teaching. The allegation is again refuted as there is not much facility available for doctors to do high quality medical research. May I dare to ask whether those doctors in GMCs’ who are not doing private practice (especially in non-clinical streams) are doing medical research? It is the academic atmosphere backed up adequate infrastructure which will boost medical research. Banning of practice will not help. The administration has to provide high quality academic infrastructure like a separate highly equipped research wing, adequate journals in the library,highly equipped experimental laboratories to conducts tests needed for research, research grants, appointment of research associates to improve the quality of medical research. All this cost lots of money for the administration. The example is that the annual budget of medical research department in PGIMER
exceeds the total annual budget of GMC Jammu!
New Medical Colleges There are many retired faculty members who would like to provide their services in newly established Medical Colleges. If private practice is banned, they will have to give up their practice if they decide to join any of the new medical colleges. Why
would they give up their successful medical practice? Similarly,our young consultants will prefer
to join private sector rather than providing their services as teaching faculty in new medical colleges. This will surely lead to dearth of faculty in such colleges.
What needs to be done by Govt The need of the hours is not to ban private procedure but to regulate it. The govt. can take the following steps to improve the health services in this regard: i) Regulate the private practice a) See to it that no doctor does PP during working hours. b) No govt. doctor does PP on his emergency duty day. c) Fee structure needs to be regulated no one be allowed to change more than what is fixed by govt. in form of fee, operative charges, etc. d) The doctors be allowed to practice in and around their place of posting only so that they done have their duty station. e) All Govt. doctors doing PP must give the details of their private clinics / private hospitals including the fee charged, operation fee charged etc. to the regulatory authorities. All this information be made public so that nobody is allowed to charge more than declared by him/ her. f) Make it mandatory for all teaching faculty to publish a minimum number of publications in a stipulated period of time. Failing which appropriative administrative action be taken against him/her. g) Constitute a committee of Senior doctors, Senior beaurocrats, Prominent citizens who would come together for better coordination in order to regulate the whole process of medicalpractice. The committee would be meeting on regular basis and will be guiding the governmentby giving their valuable suggestions. So, till the time our UT catches up with the other states in terms of medical infrastructure (both in govt. as well as in private sector), banning of the private practice will prove to be a most people un-friendly step.This will lead to a medical chaos in whole of the region. The govt. medical services will become overburdened. The private sector which at present is mostly dependent on govt. doctors for human resources, will come to agrinding halt. firstname.lastname@example.org