BMC may offer its docs a pvt practice

MUMBAI: Shaken by the stream offull-time doctors who have abandoned civic hospitals for private practice, theBMC is finally moving to stanch the flow.In an attempt to retain itsfull-time doctors, the civic public health committeemay soon consider a proposalto allow doctors to practise after hospital hours. If cleared, themove may affect public health services adversely with doctors possibly payinggreater attention to their private practice.The proposal, made inJanuary 2003 by KEM hospital dean Nilima Kshirsagar to the BMC, is only beingattended to now because the problem has become critical.Mumbai''sthree major civic hospitals—Sion, Nair and KEM—are reeling under asevere shortage of full- time doctors who double up as teachers at the medicalcolleges attached to these hospitals.The shortage of clinical staffranges from 15 per cent at Sion hospital to 25 per cent at KEM hospital. As aresult both health care and medical education suffer."Departmentsare being derecognised for want of adequate staff," said a hospital official."If a department doesn''t exist, how will students learn?""We getenough applicants for the posts of lecturers but they leave after a while. Butfilling up the posts of associate professors and professors is difficult," saidadditional municipal commissioner Shrikant Singh.The main grouse ofcivic doctors, who are on University Grants Commission pay scales, is the poormoney. An associate professor with ten years teaching experience gets all of Rs30,000 a month."There''s plenty of family and peer pressure to shiftout of a public hospital. And given our talent and exposure to medicalproblems,we can get a good offer any time," said a senior doctor. Already, thereis a growing number of fulltime doctors treating patients privately on thesly.The proposal, which is open to full-time associate professorsand professors, envisages the same retirement, leave and promotion benefits buttakes away four allowances and charges market rent for hospitalquarters."The new deal would save the corporation about Rs 3 crore,"notes an official.However, there is an apprehension within themedical community that this move will divide doctors'' commitment to poorpatients and tempt them to divert patients to their privateclinics.This charge has already been made against part-timers whowork as honorary consultants. A similar formula, adopted by Tata MemorialHospital, boomeranged and resulted in an exodus of cancerexperts.There is also resistance from some BMC employees whoquestion why doctors should get privileged treatment. "If we as professionalscan draw the same salaries, why can''t they?" says an accountant working with theBMC.But civic doctors point out that private practice is a necessaryevil. Unlike other professionals employed in the public sector, the disparity inpay in the health sector is stark. "On our own, we can earn at least ten timeswhat we earn in a public hospital," they say.Meanwhile, the city''sfourth public hospital, JJ, run by the state government, is eagerly tracking theproposal. So are Gujarat and some northern states, all eager to follow suit ifit works.