Checklist for setting up & successfully running a private practice in India
M3 India Newsdesk Mar 12, 2018
Many doctors prefer to start private practice as it offers them the independence to choose their own working hours and be their own boss, but starting a clinic can prove to be a cumbersome process.
Starting and running a private practice requires extensive paperwork. Hence, it is advisable that one avails the guidance of someone who has already started their private practice. Alternatively, a doctor can also hire a professional consultant to put the system in place.
This is not a comprehensive list of formalities that is needed to start and maintain a private clinic. Both Central as well as state laws govern healthcare and each state’s laws vary. Therefore, a doctor wishing to start private practice should familiarise himself with the law of the land.
There is a host of rules and regulations that need to be adhered to. Broadly, they can be categorised into the following points, with each sub-head comprising many distinct requirements:
- Registrations and licences
- Regulations related to employment of staff
- Paperwork regarding income and expenses
- Installing a signboard in adherence with the government rules
- Maintaining records of patients as well as narcotics and biomedical waste, among other things
- Routine submission of documents to health authorities
Depending on their specialty, the laws of their state, and the municipal body, documents needed to start a clinic may vary. Nevertheless, some paperwork is essential regardless of these factors.
One of the primary requirements is registrations with different government bodies and licenses to operate. Also, registration with the local health authorities under Clinical Establishments (Registration and Regulation) Act, 2010, as well as with the local municipal authority is a must.
Signboards & displays
Merely obtaining permissions is not enough. A private clinic is also supposed to display its registration number and a host of other details on a signboard, along with consultation fees of the doctor(s). Also, there are many rules regarding what should go on a signboard and on the clinic's letterhead. Government's rules regarding issuing medical certificate to people itself involves lots of dos and don'ts. For example, the clinic is supposed to maintain a copy of every medical certificate it issues.
As is evident, extensive documentation is required not only before starting a clinic but also throughout its life span. For example, Indian Medical Council Regulations, 2002, mandate that patients' records be maintained for a specified number of years. A separate register must be maintained for medico-legal cases and the information must be furnished within three days to authorities in the event of a medico-legal case. Being aware of such rules beforehand will enable a private practitioner to escape any run-in with the authorities later.
Disease outbreak reporting
The clinic will also be duty-bound to report outbreak of any disease to the local health body. In case of communicable/notifiable diseases, public health authorities concerned should be informed immediately. In most municipal corporation acts, tuberculosis is defined as a dangerous disease. Other such diseases that require authorities to be informed are cholera, plague, chicken-pox, small-pox, leprosy, enteric fever, cerebrospinal meningitis, diphtheria, and other epidemic, endemic, or infectious diseases.
For private gynecology centres, additional registration under the Medical Termination of Pregnancy Act, 1971, and the Pre-Natal Diagnostic Techniques Act, 1994, as applicable, are compulsory. These clinics also need to maintain reports on medical termination of pregnancy and on abdominal ultrasonography done on pregnant women.
Doctors planning to start their own clinic need to recognise that besides attending to patients, they will also have to look after many administration-related tasks. This aspect alone needs a lot of attention and adherence to many rules and regulations.
To begin with, doctors need to make sure they hire their staff--including doctors, nurses and pharmacists--only after duly verifying their credentials. Also, they will need to ensure their staff is immunised from occupational health hazards and have had basic vaccinations.
Further, like any other organisation, owner(s) of a private clinic too will need to set up a committee for prevention of sexual harassment of women at the workplace. They will need to educate themselves about regulations related to hiring.
Under the Shops and Establishments Act, 1954, certain aspects such as working hours, holidays, timely payment of wages, leaves, terms of service, and other conditions have to be followed as per law. For calculating income tax, like any other business, account of receipts and expenses have to be meticulously maintained.
And since every clinic generates biomedical waste, a doctor seeking to start his/her own private practice will need to obtain authorisation from the state pollution control board to generate, collect, receive, store, and treat biomedical waste. There are many such minute but important requirements--like obtaining permission to possess spirit as well as narcotic drugs—and doctors are advised to read up extensively to familiarise themselves with all these rules.
The list of permits a doctor needs to obtain and the list of regulations they need to follow to start private practice is vast. And while the entire process may seem cumbersome, having full knowledge about the paperwork beforehand will save them from the frustration of repeated visits to government offices.
This article is part of a series on hospital/clinic set up and management. Click on the links below to read them.
Elizabeth Mani is a Bangalore-based freelance writer and a member of 101Reporters.com, a pan-India network of grassroots reporters.
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