The Shanghai Health Bureau has issued new rules to rein in doctors who are spending too much time away from their home hospitals earning money on the side and committing other improprieties.

Penalties for violating the rules range from the suspension to revocation of an offender's medical license - sanctions that are making some physicians unhappy.

Under the tightened regulations, city doctors may now spend only one workday each week at out-of-town hospitals. And before leaving, they must obtain permission from their employer. They must also notify their employer when accepting surgical or consultation work away from the city on weekends.

In addition, the rules prohibit doctors from accepting gifts from patients and commissions from drug companies, and ban private clinics from hiring touts to lure patients in for treatment.

Bureau official Song Guofan said the rules were enacted because some doctors, especially surgeons, vanish after performing a medical procedure.

"Many of them fly or drive to adjacent provinces to do operations in the afternoon. If there's an emergency at home, their hospitals can't find them," Song said.

Some doctors, however, are unhappy about the new rules, saying they violate their spare-time rights.

"We never go to other provinces during workdays. Most doctors provide surgeries or consultations in areas with lower-quality medical capabilities only on Saturdays and Sundays," said a Dr Wang at Renji Hospital. "Though doctors can make money through part-time service, we also save many patients who are too sick to travel to Shanghai."

City doctors bring advanced technologies and concepts to hospitals in other provinces, he added.

Experts in medical management said Shanghai has the highest medical qualification standards in China, and its doctors are more skilled and can provide better services than their provincial counterparts. But in these cases, determining responsibility when treatment goes wrong can be a problem.

Legal authorities should establish laws to cover the medical moonlighting, said Wu Jinglei, director of Fudan University's hospital management department.

(Shanghai Daily May 11, 2005)