PESHAWAR: The number of patients visiting hospitals in evening for consultation in the institution-based practice (IBP) has been increasing due to the availability of qualified doctors and investigative services on the same premises, according to health experts.

IBP is an integral part of Medical Teaching Institutions Reforms Act, 2015, under which consultants examine patients on getting fee from them in afternoon in the same hospital where they see patients in the morning shift.

The system began in 2016 in a few hospitals. Now it has been extended to 10 hospitals where the law is enforced.

Consultants in private sector say that the system is beneficial for the patients because they find senior doctors in all specialties. The consultants have been recruited as assistant professors and allowed by the government to do practice.

“In private sector, there are scores of doctors claiming to be consultants but in reality, they aren’t allowed under the law to charge patients.

The system has been extended to 10 hospitals of KP

This situation has been causing embarrassment to highly-trained consultants in the private sector. The government needs to check this practice,” a senior surgeon told Dawn.

He said that as opposed to private sector, the consultants sitting in IBP were selected after proper interviews with no chance of deployment of unqualified people. “Same is true for diagnostic services,” he added.

Pathologists, radiologists and other diagnostic consultants sitting in IBP have been recruited through proper procedure to work in the morning and evening in respective medical teaching institution.

“In private sector, the situation with regard to investigative services is pathetic,” said the surgeon.

A senior radiologist told Dawn that he retired from one of the teaching hospitals few years ago as professor but was receiving fewer patients than some very junior doctors because of the culture of commissions and kickbacks.

“There is no law to check the sprawling private medical services, especially the area of diagnostics on which the whole treatment of a patient depends. In IBP, there is no room for unqualified doctors and the patients receive quality services,” he added.

Another senior consultant, who is also dean at one of the MTIs, told Dawn that there were many benefits of IBP for the patients.

“There are fixed rates for all investigations and consultation. Patients get receipts of the fees. Patients receive all services under one roof. In private sector, patients are sent to one building from another for investigations, which causes them monetary and health problems,” he said.

He said that prior to launch of IBP in MTIs, the hospitals wore deserted looks after 2pm. Now the same space, which is used for morning OPDs, is being utilised by consultants for IBP patients. Similarly, the operation theatres and diagnostic services are also used in IBP that generate money for the consultants, staff and hospitals.

The dean said that fees in IBP were lesser than private sector. He said that there were still allegations that some doctors were doing private practice illegally because according to the law, the consultants hired under the MTI law should be doing IBP.

“However, with the passing of time, we are resolving these and other issues,” he added.

A senior physician said that the MTI-covered hospitals were managed by the respective boards of governors.

“They are facing plethora of problems, such as appointment of doctors on high salaries, using government’s budget in accordance with their own needs with liberty as compared to the non-MTIs hospitals and colleges, which are run in line with the instructions of health department. However, IBP has been facilitating the patients,” he added.

Published in Dawn, February 28th, 2023