By Dr. Fiaz Maqbool Fazili

The question keeps returning to Kashmir's public debate with the persistence of a recurring fever: should doctors in government service be barred from private practice?

A recent demand by a lawmaker from Anantnag has brought it to the front pages again, stirring emotions and dividing opinion across hospital corridors and dinner tables alike.

It is an issue that touches the ethics of care, the economics of survival, and the state of our healthcare system itself.

At first glance, the idea of a ban appears simple and appealing. Supporters argue that government doctors should dedicate themselves entirely to public hospitals. After all, taxpayers pay their salaries. Patients, often poor and exhausted after long journeys to district hospitals, deserve a doctor's full attention. Instead, they often hear that the specialist they came to see is“away” or“unavailable,” which many take to mean“at a private clinic.” This fuels resentment and mistrust.

A ban, proponents say, would ensure presence, accountability, and focus. Doctors would finally be where they are most needed: inside public hospitals, serving the poor.

The argument has another layer. Banning private practice, many believe, could open the door for young doctors.

Kashmir's medical colleges produce hundreds of graduates every year, but many remain unemployed or underemployed. If senior specialists were compelled to commit fully to government hospitals, or if some left the service altogether, fresh talent could step in.

The system would renew itself, and patients would benefit from the enthusiasm of young, well-trained doctors.

But beneath this appealing simplicity lies a complex reality.

The government's health system runs on a weak balance. Salaries for government doctors, even specialists, are often modest compared to the years of study, the workload, and the emotional toll of the profession.

Private practice has long served as an informal compensation mechanism. It allows doctors to sustain their families, invest in better education for their children, and retain some measure of financial dignity.

Removing that outlet without a corresponding improvement in pay or working conditions could have serious consequences.

The risk of a brain drain looms large.

Many senior doctors, already overburdened and underpaid, could move to private hospitals outside Jammu and Kashmir, or even outside India, where their expertise is rewarded. Losing them would cripple the very public institutions we hope to strengthen. A ban might ensure presence, but what use is presence without proficiency?

There is also the question of patient volume. Kashmir's government hospitals are already overwhelmed.

At Sher-i-Kashmir Institute of Medical Sciences (SKIMS) or the Government Medical College hospitals, outpatient departments witness thousands of patients each day. Private clinics, despite their cost, help absorb part of this overflow.

If private practice disappears overnight, the pressure on public hospitals will become unbearable. Crowds will swell, waiting times will grow, tempers will rise, and the quality of care may suffer. Doctors may be physically present, but stretched beyond endurance.

Then there is the matter of enforcement. A ban might drive private practice underground, creating an unregulated parallel system.“Moonlighting” is not difficult to hide in a region where monitoring is weak and demand for care is high.

Such a system would benefit neither doctors nor patients. It would only erode trust further.

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