Directive number 4-BYT/CT stipulates the regulation on private medical examination and treatment.

DIRECTIVE

OF THE MINISTRY OF HEALTH NO. 4-BYT/CT ON FEBRUARY 14, 1984 REGULATING
PRIVATE MEDICAL PRACTICE

Under socialism, the State bears responsibility for protecting the health of the people and managing all activities in the medical and pharmaceutical sectors. Medical staff have the duty to wholeheartedly serve the health of the people. Any monetary transactions between doctors and patients are inconsistent with the ethics of socialist medical personnel. Based on this spirit, the Ministry of Health does not advocate private medical practice. However, following April 30, 1975, due to the living conditions of some doctors in newly liberated areas, and based on Resolution 6 of the Central Committee of the Party, Decisions No. 25-CP, 26-CP, and 64-CP of the Council of Ministers, the Ministry of Health issued Circular No. 14-BYT/TT on August 20, 1980, guiding and defining the subjects eligible to register for practice in the medical and pharmaceutical fields: On March 31, 1982, the Ministry of Health issued Notice No. 3456-BYT/CB regarding the "strengthening of management over private medical activities." Since then, these regulations have not been strictly enforced.

Through public feedback and reports from various organizations, it has been observed that unauthorized private medical practices are increasing significantly, particularly in southern provinces, especially in Ho Chi Minh City. Many private clinics and medical facilities operate without registration. Some medical practitioners conduct their activities covertly. In some cases, provincial health departments permit state medical staff to provide private services outside regular hours under collective forms, but they do not adhere to established regulations. Some use hospital facilities, equipment, and chemicals for private services outside regular hours, which is inappropriate.

These forms of activity are illegal, primarily engaging in fraudulent practices to deceive patients for profit, often charging exorbitant prices for medications, exploiting patients. There have been serious complications and even fatalities. Such actions are unjustifiable, contrary to socialist medical policies, damaging the noble reputation of medical professionals and the profession's credibility. Given this situation, the Council of Ministers now advocates prohibiting state medical staff from engaging in private medical practice.

To quickly address the negative aspects of private medical practice, the Ministry of Health requests People's Committees at provincial, municipal, and special zone levels, local health departments, and units directly under the Ministry to strictly implement the following directives:

1. Prohibit all private clinics, private medical facilities, collective prescription writing outside regular hours, private dental clinics, private traditional medicine clinics, private midwifery services, private injections, etc., from operating contrary to Circular No. 14-BYT/TT dated August 20, 1980.

2. Prohibit all medical staff working in state medical institutions, university medical students who have graduated but refuse assigned positions, and medical staff who have abandoned their posts from engaging in any form of private medical practice.

Medical staff (professors, doctors, dentists, pharmacists, traditional medicine practitioners, secondary and primary level medical staff) who continue private practice (openly or covertly) violate the law. Those who violate will be dealt with according to the severity of their offenses. They will not be considered for commendations, academic titles, salary increases, postgraduate studies, or overseas training programs. If they continue private practice or sell medicines from now on, measures must be taken to educate and assist them to stop; if they repeat such violations, strict disciplinary action must be taken.

3. If registered according to the circular, private medical practitioners may not perform surgeries in the fields of general surgery, obstetrics, gynecology, otolaryngology, ophthalmology, maxillofacial surgery, including trauma care, diagnostic procedures, tonsillectomies, abortions, and intrauterine device removals. Only certain aesthetic procedures can be performed in beauty clinics, as specified by the Ho Chi Minh City Health Department. Surgical procedures are prohibited.

4. Local Health Department Directors should inspect all private clinics, private medical facilities, private traditional medicine clinics, private dental clinics, private midwifery services, private injection services, private laboratories, and private radiography services, including collective prescription writing outside regular hours, to:

4.1. Immediately halt the operations of unauthorized private medical practitioners and medical staff conducting private practice or working outside regular hours contrary to Point 1, Section C, of Circular No. 14-BYT/TT. Appropriate legal actions must be taken against those violating the law during their practice.

4.2. Reconsider registration for practice:

- During the current period, the Health Department temporarily suspends registration for practice for certain individuals previously registered according to Point 1, Section C, of Circular No. 14-BYT/TT dated August 20, 1980, until new instructions are issued.

- Other cases contrary to Circular No. 14-BYT/TT and the above provisions shall not be permitted to register for practice.

For medical staff working in medical facilities, additional work hours at hospitals can only be conducted when requested by the unit director and organized by the unit. Medical staff assigned to provide additional services will receive overtime pay according to Decision No. 150-HĐBT dated December 7, 1981, of the Council of Ministers.

In order to continuously strengthen health protection work for cadres and people, the Ministry of Health requests the People's Committees of provinces, cities, and special administrative regions to assign responsibilities to the Departments of Health with the task of reinforcing and expanding the network of outpatient clinics and hospitals with many patients to avoid waiting times, allowing outpatient medical services outside regular hours at hospitals, which will be paid for by the hospitals without charging patients (possibly operating two shifts, two teams at outpatient and specialized ambulatory clinics), enhancing outpatient treatment work, improving treatment quality, and meeting the requirements for medical services for the people. The important point is to continuously care for and educate healthcare staff to have a high sense of responsibility, good morals, and a dedicated service style towards patients, worthy of being socialist healthcare cadres trusted and beloved by the people.

Upon receiving this Directive, the Departments of Health, units under the Ministry, and in coordination with relevant departments of the People's Committees of provinces, cities, and special administrative regions, quickly implement and organize strict enforcement, disseminating it to all employees in the sector.

Any difficulties encountered during implementation should be reported immediately to the Ministry for research and resolution.