Karnataka bars treatment of private in-patients by government doctors

The State government has issued guidelines prohibiting government doctors from treating in-patients in private hospitals as part of their private practice, citing concerns over disruption of services in public hospitals and lapses in continuity of care for admitted patients.

In an order issued on Wednesday (January 28), the State Health Department said that while existing government instructions allow private practice by government doctors, such practice must not interfere with official duties. The government noted that treatment of in-patients in private facilities necessarily involves longer clinical engagement, which may “adversely affect” the delivery of services in government hospitals.

Flagged by Lokayukta

The clarification follows observations by statutory authorities, including the Lokayukta, which had raised instances where neglect of patients in public hospitals had been linked to doctors attending to private in-patients. In some cases, authorities had flagged deaths of patients and attributed the lapses to diversion of time and supervision.

The Karnataka Administrative Reforms Commission had also recommended the regulation of private practice to ensure priority to public service, particularly in districts with staffing shortages. The department additionally pointed to practices in other States such as Kerala, where private practice by government doctors is limited to out-patient consultations and permitted under strict conditions.

OPD consultation only

Under the latest clarification, private practice by government doctors will be restricted to out-patient consultations (OPD) only. Such practice must be undertaken outside government duty hours and in a single private clinic or hospital, the details of which must be formally declared to the government. The government reiterated that private practice must not hamper regular duties and attendance.

Any violation of these conditions will be treated as misconduct and draw disciplinary action under the Karnataka Civil Services Rules, in addition to other legal provisions. The clarification takes immediate effect and is to be read with all existing government orders on private practice.

According to officials, the need to set clearer boundaries around private practice has been under discussion for several months in light of complaints from district hospitals and supervisory bodies about workload diversion, fragmentation in patient supervision, and delayed ward rounds. While private practice has been permitted in Karnataka for decades, the State has periodically reviewed the norms, particularly after episodes that raised questions about patient care in government facilities.

The latest order is expected to bring additional compliance requirements for government doctors who currently consult at multiple private facilities.