Multiple job - holdings by government health personnel in developing countries

In the absence of any recorded data relating to this issue, the authors initiated their own data collection exercise and chose India as a location. Health facility staffing patterns, use, and earnings were studied with an eye towards eventual implementation of a greater private sector role. Data on working physicians and patient characteristics, such as their choice of facilities and satisfaction with medical treatment, were examined. Using this information, this paper details ramifications of the private sector"s proposed enhanced role in health services. Data analysis indicated several factors that will have an impact on eventual decisions, including: (1) private hospitals employ fewer physicians and utilize their services more than do public hospitals; (2) there are many advantages and many disadvantages to the common practice of dual job holdings by physicians; and (3) several factors, such as incentives based on in-house ratings and introducing competition in physicians" primary employment, could be applied to reduce disadvantages and influence physicians" allocation of effort between their public and private employments. (Author abstract, modified)