The Ministry of Health made a regulation in line with the request of private practice doctors in the Private Hospitals Regulation, known as the 6 Doctors Regulation, which restricts private practice. According to the new regulation, “Physicians who have a practice before January 7, 2023 will not be subject to team restrictions in one of the health institutions they will contract with”
Amendment to Private Hospitals Regulation
Istanbul Medical Chamber Law Office made a detailed explanation about the revision study of the 6 Doctors Regulation. The work of the Law Office on the new regulation is as follows: “As it is known, doctors who practice their profession freely, diagnose and treat patients who apply to their practices, in accordance with the Law No. It can be done in private health institutions, the cost of which is borne by the patients. However, with the amendments made on both the Private Hospitals Regulation and the Regulation on Outpatient Diagnosis and Private Health Institutions on October 6, 2022, doctors who practice their profession freely can diagnose and treat patients who apply to their practice in private healthcare institutions. The condition of finding a specialist medical team and making an annual contract was introduced. It has been regulated that in the absence of empty specialist doctor teams, private health institutions can only sign contracts with the doctor up to 15% of the total number of specialist doctor teams. Numerous professional organizations, specialization associations and doctors have been appointed to the Council of State for the stay of execution and cancellation of these regulations, which are not the result of any neediness in the provision of health services, are incompatible with the requirements of the service and public benefit, make it impossible for doctors to practice freely and violate the rights of patients. a has been applied for; We have filed a lawsuit against both 206 doctors and the Istanbul Medical Chamber.”
6 What Has Changed in the Medical Regulation?
Regarding the regulations that caused a great reaction of the physician public, it was announced by the Minister of Health Fahrettin Koca on 27 December 2022 that the demands were addressed and the new study that would establish stability would be announced before 7 January 2023. Finally, the changes in the regulation were published in the Official Gazette dated 7 January 2023 and numbered 32066 and entered into force on the same day. “ı) Physicians who have a practice can carry out the treatment of their patients who apply to their practice in private hospitals that have a license in the relevant branch, by making an annual contract, provided that the service fee is covered by the patient and not requested from the Social Security Institution, pursuant to the third paragraph of the 12th article of the Law No. 1219. Private hospitals can contract with physicians in a form that does not exceed one third of the total number of teams in the relevant branch. Doctors over the age of 60 who have a practice are not subject to this team restriction in one of the hospitals they have contracted with. In the hospital where the contract was signed, in cases where the prescribed intervention could not be performed for the patient coming from the practice, special permission may be given by the Provincial Health Directorate on an event basis, in order to carry out this process in another hospital requested by the doctor.
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What Changed in Private Practice Regulation?
According to the same regulation, “Doctors who had a practice before the publication of this issue are exempted from the team limitation in the first paragraph of the additional 5th item in one of the hospitals they will make a contract with.” Discontinuous Section 20 has been added. Parallel to these regulations, an amendment was made in the 12th paragraph of Annex 1 of the Regulation on Private Healthcare Institutions where Outpatient Diagnosis and Treatment is made. As can be seen, the requirement to find empty sets in medical centers and hospitals has been abolished for practice doctors, but; The rule has been introduced that the hospital and medical center with which the physician will make an annual contract must have a license in the relevant branch. The number of doctors that hospitals and medical centers can make contracts with has been finalized with one third of the total number of teams in the relevant branch. Two exceptions have been made to the limit on the number of staff: Doctors who have a practice before January 7, 2023, will not be subject to the team restriction in one of the health institutions they will make a contract with. Doctors over the age of 60 who have a practice or will open a practice will not be subject to team restrictions in one of the health institutions they will contract with. In addition, it has been regulated that in cases where the practice doctor cannot intervene in the health institution with which he has signed a contract, he can do this process in another hospital he wishes, by obtaining special permission from the Provincial Health Directorate. Thus, although it seems that the rightful demands of the practice doctors have not been met again, and a step back has been taken from the unlawful regulations dated October 6; This time, a restriction has been imposed based on the rule that the relevant branch should be included in the hospital license and the number of teams in the relevant branch. The exemption granted for a single health institution to physicians who already have a practice and to doctors over 60 years of age is not granted for new practice openings and for those under 60 years of age. The element of equality has also been violated, both in the midst of existing practices and those to be opened, as well as among doctors under the age of 60 and above, without a justification for the distinction. The restriction on the free exercise of the profession continued in its essence. Just like the amendments dated 6 October, the 7 January amendments were not used to the higher legal norms of Law No. 1219 and Law No. 2219. It violates the constitutional rules such as the right to work, freedom of contract, the element of equality, the rule of law and the elements of legal security and certainty, vested rights and legal expectation elements. In this sense, the Istanbul Medical Chamber will follow the process and continue to work in order to re-apply to the judiciary and to remove the restrictions on the practice of free profession. (BSHA – Science and Health News Agency)