HMC BoG finally decides to implement institution-based private practice

PESHAWAR: The administration and the Board of Governors (BoG) of Hayatabad Medical Complex (HMC) has finally decided to implement the long-awaited institution-based private practice and directed the faculty members to stop their practices outside the institution’s premises.

The hospital administration has given a month to shift their clinics to HMC.

The Institution-Based Private Practice (IBPP) is at the heart of Medical Teaching Institution Reforms Act 2015 so as to achieve financial stability, regulate the private practice of MTI consultants and ensure availability of specialist services to patients till late in the evening.

It was mandatory for all consultants, deans and medical directors appointed under MTI-Reforms Act 2015.

The Lady Reading Hospital (LRH) has taken the lead by implementing IBPP in letter and spirit. The reason the LRH implemented the IBPP and other regulations of the MTI Act was Dr Nausherwan Burki’s presence in the hospital board of governors. He is chairman of the LRH BoG.

Dr Burki is the architect of the MTI Act, though criticised by the medical community by giving all the powers to a non-teaching cadre doctor of general cadre to run the hospital as hospital director.

The post of medical director, which is held by a faculty member from the teacher cadre, is having less powers than of the hospital director.

“In the MTI Act, the hospital director is stated to be a king with all powers of recruitment and purchase. On the other hand, the medical director is mostly a professor but is powerless and has the least role in the show,” one former dean told The News on condition of anonymity.

He said despite being mentioned in the MTI Act that the hospital director would neither practice outside the installation nor inside the hospital, but some hospital directors are regularly attending their private clinics.

“One medical director is not only attending his private clinic but running his private hospital just in front of the MTI hospital where is posted,” he said.

It was apparently implementation of the MTI Act in letter and spirit or then the strict regulations that annoyed the doctors to leave LRH and serve in other MTIs particularly the Hayatabad Medical Complex.

There was a time when doctors would quit jobs and prefer to work in the LRH. It is no longer a good choice for the hospital.

Despite these issues, LRH promoted the IBPP and encouraged doctors to join it.

It even started paying special IBPP incentive to the consultants appointed under the MTI Act

The then appointed dean and MD shifted their well-established private practices into LRH premises, thus making it a success.

Other MTI’s half heartedly implemented IBPP, with the excuse that since they are not paid special IBPP incentive salary, therefore, they can simultaneously carry out private practice outside hospital premises.

Most of the consultants in other MTIs wanted to be given the same IBPP incentives which are given to the doctors in LRH.

Some MTIs including Qazi Hussain Medical Complex in Nowshera, Bannu and Dera Ismail Khan didn’t bother to start IBPP at all.

Now under the MTI Reforms (Amended) Act promulgated in January 2019, IBPP is also mandatory for all administrative positions in the MTIs.

However, a number of dean’s, directors and consultants are still daringly carrying out private practice outside hospital premises against the dictates of the MTI Act. After the promulgation of MTI Act (Amended) Act, LRH has replaced non-IBPP practicing department chairpersons with acting chairpersons, who are carrying out IBPP.

It has also advertised some of these positions.

Some of the critics said that blue-eyed people were still officiating as head of departments. Others carry out private practice outside the hospital over the weekends.

The Khyber Teaching Hospital (KTH) followed suit. Prof Dr Mahmood Aurangzeb on his appointment as Dean Khyber Medical College (KMC) had to relinquish his well established private practice in Dabgari Gardens.

He ensured the appointment of IBBP practicing consultants as chairpersons and heads of departments.

It is widely discussed in the medical community that two persons had suffered heavy financial losses after their appointment as Dean and Medical Director. One is Prof Mahmood Aurangzeb and the second is Prof Mukhtiar Ali, medical director of Mardan Medical Complex (MMC).

Both are very skilled and fine surgeons and used to earn a handsome amount from their private practice and surgeries.

The surgeons are these days earning a lot from Sehat Insaf Cards.

HMC has started appointing chairpersons who have also started IBPP.

However, it can be verified that some of these consultants as well as key administrative officers are also carrying out private practice outside hospital premises.

“Whereas, some faculty have disguised their private practice, others are openly carrying it out,” a faculty member told The News.

LRH for the most part of the Covid19 crises had stopped IBPP.

The board announced a special salary benefit of a minimum of rupees one hundred thousand per month for these consultants. However, some consultants started seeing patients outside hospital premises.

Even Junior doctors working in these MTIs (registrars, trainee medical officers, medical officers and even house officers, who are not entitled to carry out private practice) dare to do clinics in private setups.

“Ideally, their PMC licenses should be revoked as they are involved in sheer violation of the law. Whereas violation of MTI law of practicing outside hospital premises should result in immediate termination, how some escape this penalty even when being reported upon,” the faculty member of HMC opined.

He said he didn’t understand how they get clinics registered with the Khyber Pakhtunkhwa Health Care Commission. “Will the health department and MTIs coordinate to identify and prosecute the cheats?” he said.