An end to the uncontrolled overlap between personal doctors and the phenomenon of a doctor monitoring thousands of patients taking advantage of the institution of replacement applied by the Health Insurance Organization for the purpose of meeting the needs of citizens, in cases where their doctors are unable to serve them.
From June 1, new regulations will be implemented that set limits on both the duration of replacements and the total number of beneficiaries that a doctor will be able to serve when replacing a colleague.
The new regulations are of course not at all unrelated to what was reported last year in Parliament, when the practice followed to date by some personal doctors who, when they reached the limit of 2,500 beneficiaries allowed by law, enrolled additional beneficiaries in colleagues whom they permanently replaced, were put under discussion.
It is recalled that the discussion in the parliamentary committee on Human Rights took place after the public complaints of citizens, whose children, while being monitored by the paediatrician who monitored them and before the implementation of the General Health System, were registered in lists of other paediatricians of the GHS whom, as they stated before the Parliament, they did not know.
The HIO, during these discussions, recognizing the "loophole" of exploitation by some doctors left by the regulations that are still applied today, committed before the Parliament to promote measures to contain the phenomenon and yesterday, informed all the personal doctors of the GHS about the new regulations that will be implemented from June.
Therefore, based on the new regulations, a personal doctor will be able to replace up to four colleagues at the same time, provided that the total number of beneficiaries he serves does not exceed 5,000, including patients registered in his own list.
At the same time, each personal doctor will be able to appoint more than one replacement for the same replacement period.
In order for replacement to be possible, however, specific conditions must be met and specific reasons must be met.
According to the announcement/information of the HIO to personal doctors, substitutions will be allowed only when the doctor is unable to provide services due to an impediment, when the doctor is on duty on duty, when the doctors are co-located.
Always based on the new regulations, a personal doctor may be absent due to:
>> Illness.
>> Rest leave.
>> Maternity or paternity leave.
>> Participation in conferences.
>> Professional obligations.
>> Personal and family reasons.
The total duration of replacement due to impediment may not exceed 90 days per calendar year.
In cases of longer absence, the doctor must submit a special request to the HIO or even temporarily revoke his registration as a personal doctor service provider.
As far as the on-call duties of personal doctors are concerned, that is, when a doctor is unable to be on duty when he is included in the operating schedule of the on-call clinics of the GHS, he will be obliged to appoint a replacement exclusively for the specific period of on-call duty and not for the general service of his beneficiaries.
The new regulations also regulate the cases of co-location of personal doctors. That is, doctors who are housed in polyclinics.
And in this case, the HIO now sets limits so that the continuous replacement duration due to co-location does not exceed 60 days per request.
"The replacement due to co-location applies exclusively between personal doctors who are housed in the same premises for the provision of health care services," the HIO clarifies.
The HIO also introduces specific obligations to inform citizens in the System. Therefore, personal physicians must inform their patients about the period of absence, the duration of the replenishment, and the details of the replacement doctor.
Information can be done through a personal clinic, answering machine, SMS, e-mails or an announcement in a prominent place in the clinic.
In the written information to personal doctors about the new regulations, the Health Insurance Organization also includes specific instructions on the steps that must be followed for the purposes of registering replacements/replacements in the GHS software system.
However, concluding in its relevant announcement, the Organization clarifies that: "The substitute service of personal doctors is applied only in accordance with the provisions of the General Health System (Substitute Service of Personal Doctor) Decisions and does not replace the obligation of the personal doctor to provide the prescribed health care services to the beneficiaries who are registered in its list".
