Discussions on private medical practice have started once again and, as usual, it is coming from some practitioners themselves.
This time, though, it is the ministry that is going to study the good and the bad of allowing private practice in a country where health care is provided by the state.
The starting point is to first define what private health care means, because no such written definition exists as of now with the Bhutanese health care policy, as there never was a need for it in the past.
Generally speaking, private practice is understood as having to pay for health care. You go and see the doc, and you pay for examination, diagnosis and treatment.
But the need to have some kind of a definition has become paramount, particularly after all the confusion following the start of the first privately run diagnostic clinic, almost a year ago, by some medical practitioners, who had retired from the public health care system.
The existence of the private diagnostic clinic soon led to questions on whether consultations would be considered private practice, because patients were consulting them, and whether prescribing medicines could be considered private practice.
In the meantime, the special off-hour clinic, which the referral hospital has introduced, and for which patients pay some kind of a fee, is not considered private practice because it is being done by government hospital doctors, and happening within the premises of a government hospital.
As some health professionals have pointed out, the privatisation of health care in Bhutan is inevitable and will happen. This is partly because some sections of the population want more specialised services, and have the means to pay for it. Many continue to take the government sponsored referrals, despite having the income to pay on their own.
Yet the majority cannot afford private health care. This fact is perhaps the reason why the health ministry is not too comfortable with private practice.
But if privatisation is going to happen, then it makes sense to start planning for it. There is so much that can be gleaned from the challenges health care systems around the world faced and continue to do so.
For now, the cautious steps the ministry is taking is perhaps the best way to go about it. That the discussions have begun is a good sign, and the steps that will be taken must be well thought out ones that include views from all concerned, and results in a well regulated system.