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Prohibiting Physicians' Dual Practice in Iran: Policy Options for Implementation Publisher



Bazyar M1 ; Rashidian A2 ; Jahanmehr N3 ; Behzadi F4 ; Moghri J5 ; Doshmangir L6
Authors
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Authors Affiliations
  1. 1. Department of Public Health, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran
  2. 2. Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Safety Promotion and Injury Prevention Research Center, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  4. 4. Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
  5. 5. Management and Social Determinants of Health Research Center, Department of Management Sciences and Health Economics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
  6. 6. Tabriz Health Services Management Research Center and Iranian Centre of Excellence in Health Management, Department of Health Services Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran

Source: International Journal of Health Planning and Management Published:2018


Abstract

Background: In Iran, based on the recent national policy documents, physician dual practice (PDP) has been prohibited. This study aimed to develop policy options (POs) to implement physicians' dual practice prohibition law in Iran. Methods: International evidence published in English and local documents published in Persian about PDP analyzed and results (advantages, disadvantages, challenges and requirements to ban PDP, and applied policies to limit the dual practice) were extracted. Results discussed among the research team in 5 rounds of meetings. In each meeting, any possible PO to limit PDP in Iran was proposed based on brainstorming technique and 12 POs were developed. These 12 POs and their advantages and disadvantages were discussed in a focus group discussion attended by 14 informed policy makers, and 3 additional POs were added. Results: Fifteen POs were developed. Each PO has its own advantages and disadvantages. It is worth to highlight that not only are the proposed POs not mutually exclusive but they are also mutually reinforcing; that is, each of these POs can be applied alone or they can be implemented alongside each other simultaneously. Conclusion: No single optimal PO exists for dealing with the dual practice in Iranian health system. Implementing a mix of POs could reduce possible complications of each PO and increase the chance of successful implementation of the law. It is advisable to follow a conservative and incremental approach and start with POs that will cause less resistance and political challenges. Copyright © 2018 John Wiley & Sons, Ltd.