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Extent and Nature of Dual Practice Engagement Among Iran Medical Specialists Publisher Pubmed



Bayat M1 ; Salehi Zalani G1 ; Harirchi I2 ; Shokri A3 ; Mirbahaeddin E4 ; Khalilnezhad R5 ; Khodadost M6, 7 ; Yaseri M8 ; Jaafaripooyan E9 ; Akbarisari A9
Authors
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Authors Affiliations
  1. 1. Center for Health Human Resources Research and Studies, Ministry of Health and Medical Education, Tehran, Iran
  2. 2. Tehran University of Medical Sciences, Department of Surgery, School of Medicine, Tehran, Iran
  3. 3. Kurdistan University of Medical Sciences, Social Determinants of Health Research Center, Sanandaj, Iran
  4. 4. University of Ottawa, Telfer School of Management, Ontario, Canada
  5. 5. Iran University of Medical Sciences, Health Management and Economics Research Center, Tehran, Iran
  6. 6. Shahid Beheshti University of Medical Sciences, Department of Epidemiology, School of Public Health, Tehran, Iran
  7. 7. Iran University of Medical Sciences, Department of Epidemiology, School of Public Health, Tehran, Iran
  8. 8. Tehran University of Medical Sciences, Department of Epidemiology, School of Public Health, Tehran, Iran
  9. 9. Tehran University of Medical Sciences, Department of Health Management and Economics, School of Public Health, Poursina St, 16 Azar St, Bolvar Keshavarz, Tehran, Iran

Source: Human Resources for Health Published:2018


Abstract

Background: Dual practice (DP) by medical specialists is a widespread issue across health systems. This study aims to determine the level of DP engagement among Iran's specialists. Methods: A pre-structured form was developed to collect the data about medical specialists worked in all 925 Iran hospitals in 2016. The forms were sent to the hospitals via medical universities in each province. The data were merged at the national level and matched using medical council ID codes, national ID codes, and eventually a combination of the first name, surname, and father's name. Results: A total of 48345 records were collected for 30273 specialists from 858 (93%) hospitals out of total 925 hospitals. Sixteen thousand eight hundred forty-nine (69% of) specialists were non-faculty members and 6317 (26% of) specialists were employed on a contract basis. Eleven thousand six hundred and thirty-eight (47.7% of) specialists were engaged in DP on total. Female specialists had 0.78 times less DP chance; faculties compared to non-faculties had 0.65 times more DP chance and full-time geographic specialists compared to non-full-time specialists had 0.15 times more DP chance. DP was more frequent in specialists with higher age and more job experience and in provinces with more population, deprivation, and higher number of specialists per facility (P<0.05). Conclusions: The level of DP is relatively high among Iran medical specialists, especially in geographic full-time specialists. However, they are totally banned and they receive extra payment for being full-time; restrictive regulations and financial incentives without considering other factors might not eliminate DP in specialists and it should be addressed based on conditions of each country and regions inside the country. © 2018 The Author(s).
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2. Implications of Dual Practice Among Health Workers: A Systematic Review, Iranian Journal of Public Health (2017)
3. Dual Practice and Multiple Job Holding Among Iranian General Practitioners: Rate and Effective Factors, International Journal of Health Planning and Management (2020)
4. Physician Dual Practice: A Descriptive Mapping Review of Literature, Iranian Journal of Public Health (2016)
5. Prohibiting Physicians' Dual Practice in Iran: Policy Options for Implementation, International Journal of Health Planning and Management (2018)
6. Effect of Dual Practice on Service Delivery Time by Surgeons in the Islamic Republic of Iran: Multi-Level Analysis of a National Survey, 2016; [Repercussions De La Double Pratique Sur Les Delais De Prestation De Services Par Les Chirurgiens En Republique Islamique D’Iran: Analyse Pluri-Niveau D’Une Enquete Nationale, 2016], Eastern Mediterranean Health Journal (2018)
7. Factors Associated With Dual Practice in Surgery Specialists: Application of Multi-Level Analysis on National Registry Data, Iranian Journal of Public Health (2019)
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