New Bill Bans Physicians From Working Two Jobs

Parliament has passed a bill that aims to ban physicians and medical specialists from working two jobs, or in other words, working in both the private and public sector.

The bill passed on January 8, with 152 lawmakers in favor, 22 against and three abstentions from among MPs present in the 290-member assembly, seeks to ban physicians and medical specialists from holding two jobs in the private and public sectors.

Like all other previous legislation this bill has to be sent to the powerful Guardian Council for consent before it can become law.  If approved, it will be implemented during the sixth economic development plan (2016-2021), the Persian-language government newspaper ‘Iran’ reported.  

Health Minister Seyed Hassan Qazizadeh Hashemi has said for the law to be effective, infrastructural facilities in the health sector should first be in place.

“Health sector challenges, like social issues, have numerous underlying causes and need to be addressed,” he said.

One challenge is the issue of physicians working in both private and public hospitals and clinics. “Ideally, physicians should not have a second job,” Hashemi noted.

However, the necessary wherewithal in healthcare to prevent physicians from working two jobs simply does not exist. At present, some of the deficiencies in the health system are: gaping hole in the earnings of doctors employed at government compared to those in private hospitals; lack of quality medical equipment in state-run hospitals; and lack of incentives to doctors working in state-run healthcare centers and public hospitals. Tax concessions for some physicians in private practice in another consideration.  

Once the law comes into effect, one concern is that it may push physicians to quit government jobs in favor of private centers. “If physicians are compelled to choose between private and state-owned healthcare centers, then the latter could well see the departure of proficient physicians,” Hashemi stressed.

“This problem exists not only in Iran. Health policymakers in many countries have debated the issue for years and have come up with solutions.”

From among the 34 Organization of Economic Cooperation and Development  (OCED) member countries, only three have banned second jobs for physicians and that too only for medical staff in inpatient care services, he noted.

“In Belgium, Denmark, Australia, Canada, the US, Turkey, Austria, Switzerland, Japan, Finland, the UK and France, physicians are allowed to work in both the private and state-run sectors (as well as for charities) simultaneously.”

  Shortage of Specialists

The minister said there is deficit of medical specialists in the country. Currently, there are about 48 specialists per 100,000 population, while the figure on average is 320 specialists in European countries.

“To bring more people under cover of quality healthcare services, our physicians should be able to work in different hospitals and health centers at the same time,” he observed.

Earlier, Mohammad Aghajani, deputy minister of health for treatment had also said there is a shortage of specialists in neurosurgery, radiology, and orthopedics.

According to the Iran Medical Council, there are 78,000 general practitioners (GPs), 36,000 specialists, 24,000 general dentists, 2,000 dental specialists, 36,000 midwives, and 15,000 physiotherapists, nutritionists, optometrists, and audiologists in the country. Almost 40% of all physicians work in Tehran Province.

In November last year, 2,000 specialists in 27 different medical fields were dispensed across 580 state-run hospitals in 378 cities. Currently, most of the specialists who are being sent to remote and deprived areas are active in the fields of internal medicine, pediatrics, obstetrics and gynecology.

Annually, 8 million people are admitted to hospitals and their average length of stay is 2.7 days.  Iran has 550 state hospitals and 350 private hospitals.