The Karnataka government has issued a clarification restricting private inpatient (IPD) practice by government doctors similar to Kerala, while allowing limited private outpatient (OPD) consultations under strict conditions. The order, issued by the Health and Family Welfare Department, states that treating in-patients at private hospitals as part of private practice may interfere with the discharge of doctors’ regular government duties.
According to the clarification, government doctors are strictly prohibited from treating in-patients or proposed in-patients at private hospitals. The government noted that inpatient care typically requires extended time commitments, emergency availability, and continuity of care, which could conflict with responsibilities in public healthcare facilities.
The order has come into effect immediately and is to be read alongside existing government orders governing private practice by government doctors in the state.
While banning private inpatient care, Karnataka has allowed government doctors to continue private outpatient (OPD) consultations, provided certain conditions are met. The order specifies that OPD practice must:
Be conducted outside official duty hours
Not interfere with regular government responsibilities
Be limited to only one declared private clinic or hospital
Be formally disclosed to the government
The Health Department has warned that violations of these conditions will be treated as misconduct and may attract disciplinary action under the relevant Karnataka Civil Services Rules, in addition to other legal action if applicable.
In contrast to Karnataka’s conditional approach, the Bihar government is considering a complete prohibition on private practice by government doctors. According to reports, the state has proposed banning all forms of private practice and has constituted a high-level committee to study the issue and frame a comprehensive policy.
The proposed move is part of broader discussions on strengthening public healthcare delivery, addressing absenteeism, and ensuring full-time availability of doctors in government hospitals. The committee is expected to examine service conditions, remuneration, and possible safeguards before finalising recommendations, especially in rural areas.
Karnataka and Bihar currently represent two distinct policy directions on private practice by government doctors:
Karnataka has adopted a regulated model, banning private inpatient care while allowing limited outpatient consultations under strict conditions.
Bihar is exploring a comprehensive ban that would prohibit all private medical practice by government doctors.
Karnataka’s approach seeks to balance workforce retention with public accountability, while Bihar’s proposed policy prioritises exclusive public service in an attempt to improve availability and continuity of care in government hospitals.
Both states aim to tackle similar challenges, including uneven distribution of doctors, high patient loads in public facilities, and concerns over divided professional commitments.
The differing approaches adopted by Karnataka and Bihar reflect a wider national debate on private practice by government doctors. While some states permit regulated private practice to retain skilled professionals, others argue that exclusive public service is essential to ensure accountability and equitable access to care.
Both policies aim to address common challenges in public healthcare systems, including doctor shortages, uneven availability of specialists, and patient load management.
As states reassess healthcare workforce policies, the balance between public service commitments and private practice continues to evolve, with implications for healthcare access, quality, and governance across India.
(Rh/TL/MSM)