Chhattisgarh Bans Private Practice for Government Doctors, 30 Doctors Resign

In a letter sent to the state on Friday, the Indian Medical Association (IMA) recommended that the government should carefully screen policies for the government doctors. Discontent among medical professionals escalated when the government mandated that all private hospitals provide affidavits stating that they did not employ any government doctors, either on call or as visiting faculty. Even though doctors can continue their practice at home, they can't run a private clinic nor go to private hospitals.

When combined with the state's severe staffing shortages, the mass resignations will have a devastating effect on Chhattisgarh's healthcare system. The state is 33 per cent short in doctors, according to a CAG assessment covering the years 2016–2022. In order to be free to practice outside of regular business hours, doctors have asked the government to give them a choice to forego their NPA (non-practice allowance) once a year.

As several posts for doctors still lie vacant, IMA has written to the relevant government officials to bring attention to this problem, stating that the policy of prohibiting private practice should not be imposed until “after carefully assessing its long-term consequences.”

According to the Times of India, IMA president Dr Rakesh Gupta stated in the letter urged the authorities to take a holistic approach while considering the policies. “In the last 25 years, there has been a radical change in the level of health services. In the current context, there is a need for reconsideration and further improvement in service conditions of doctors in govt service. After hospital duty, doctors should be given permission to practice as per their needs and wishes. It is not practically possible to provide only consultation services from one’s residence,” he added.

Speaking to TOI, Dr Omkar Khandwal, joint secretary of the Medical Teachers’ Association, said, “Practice from home has become obsolete with so much advancement in medical care. Things have gone hospital-centric. It’s not possible for doctors to function from home clinics with limited resources.”

Some of the doctors pointed out that if a doctor requires a Non-Practicing-Allowance (NPA) in the middle of their career or at any point in the future, they won't be able to choose or renounce it as they sign an NPA while entering the government service. The Medical Teachers Association has petitioned the government to change long-standing regulations so that medical school graduates can work at private hospitals outside of regular duty hours. “What would a surgeon or a doctor with specialization do after working hours? The type of practice and variability can’t be bonded by stringent clauses. After the govt order, private hospitals have removed doctors under the looming threat that their Ayushman scheme approval is at stake,” Dr Omkar said.

A doctor told TOI that contractual doctors are especially at risk since they receive a low wage without health reimbursement accounts (HRAs), enough vacation time, or other benefits, and twenty per cent of their pay is withheld if they choose to work in other locations. Noting that the last compensation adjustment for contractual doctors was in 2018, he brought up the issue that doctors fear being fired at any moment because their contract is extended annually.