Punjab's Specialist Doctor Shortage: Govt's Empanelment Drive Fails to Attract Enough Medics

At a critical juncture when government hospitals across Punjab are struggling with an acute shortage of specialist doctors, the state government's initiative to empanel retired and private specialists has garnered only a limited response so far. Against 300 specialist positions identified across district hospitals and sub-divisional hospitals, a mere 104 doctors have joined the scheme.

Critical Gaps in Healthcare Infrastructure

The empanelment drive was launched with the aim of plugging critical gaps in civil and sub-divisional hospitals. Under this scheme, private and retired specialists can provide clinical services in government facilities for a fixed fee per patient, without any alterations to the existing cadre structure. This move comes as Punjab faces a significant shortfall in specialist manpower. Of the 2,098 sanctioned specialist posts in the state, nearly 1,000 remain vacant despite repeated recruitment efforts in recent years.

The health department has struggled to attract and retain younger specialists in public institutions, prompting the government to explore alternative arrangements to ensure continuity of specialist care. This persistent vacancy issue underscores deeper systemic challenges in the state's healthcare sector.

District-Level Disparities in Response

At the district hospital level, 132 specialist posts were identified for empanelment, but only 50 doctors have joined so far. The response varied significantly across different specialties:

Obstetrics and Gynaecology: 35 posts identified, only 14 specialists joined.
Anaesthesiology: 26 positions identified, just 3 doctors joined.
General Medicine: 11 doctors joined against 20 identified posts.
Paediatrics: 5 doctors opted for the scheme against 14 posts.
General Surgery: 4 doctors joined against 8 identified posts.
Psychiatry: 2 joinings against 4 posts.
Dermatology: 3 against 4 posts.
Chest and TB: 2 against 6 posts.
Ophthalmology: 4 joinings against 6 posts.
Radiology: Only 1 specialist joined against 8 posts.

At the sub-divisional hospital level, 168 posts were identified, but only 54 specialists came on board. Key figures include:

Psychiatry: 27 posts identified with 14 joinings.
Radiology: 3 doctors offering services against 31 posts.
Paediatrics: 6 joinings against 20 posts.
General Surgery: 5 against 16 posts.
General Medicine: 8 joinings against 13 posts.
Obstetrics and Gynaecology: 6 joinings against 14 posts.
Orthopaedics: 7 against 10 posts.
Chest and TB: 2 against 11 posts.
ENT: 3 joinings against 15 posts.
Anaesthesiology: No joinings against 11 identified posts.

Wide Variations Across Districts

The response to the empanelment drive varied widely across different districts in Punjab. At the district hospital level, some areas saw moderate participation, while others recorded minimal or no response.

Districts with notable joinings include:

Muktsar: 4 joinings against 12 identified posts.
Nawanshahar: 4 against 11 posts.
Mansa: 5 against 12 posts.
Malerkotla: 6 against 12 posts.

However, several districts experienced very little or no response:

Firozepur: No joinings against 6 identified posts.
Jalandhar: No joinings against 1 post.
Kapurthala: No joinings against 4 posts.

At the sub-divisional hospital level, variations continued:

Ropar: 3 joinings against 19 identified posts.
Sangrur: 6 against 18 posts.
Muktsar: 8 against 14 posts.
Mansa: 4 against 12 posts.

Reasons for the Tepid Response

Under the empanelment scheme, specialists are compensated with fixed fees for various services:

Rs 100 per patient for OPD and IPD services.
Rs 3,500 for major surgeries or caesarean sections.
Rs 1,000 for minor surgeries.
Rs 500 for minor procedures.
Rs 400 for ultrasound.
Rs 1,500 per emergency visit.
Rs 2,000 as anaesthesia charges for major surgeries.

The scheme assures payment for a minimum patient load, ranging from 50 to 150 OPD patients per day and 2 to 20 IPD patients per day, irrespective of actual footfall. Additional payments are calculated monthly for patients treated beyond these limits. Specialists are required to provide services for at least 3 hours daily at designated health facilities from Monday to Saturday, while being permitted to continue private practice elsewhere.

Health department officials have cited comparatively lower remuneration as a key reason for the tepid response. Many private specialists earn substantially higher amounts per consultation or procedure in the private sector, making the government scheme less attractive. Despite repeated attempts, Health Minister Dr. Balbir Singh was not available for comment on the issue.

This situation highlights the ongoing challenges in addressing healthcare shortages in Punjab, as the state grapples with attracting medical professionals to public institutions amidst competitive private sector opportunities.