Starts on June 1: 2-institution limit for doctors in private hospitals
A new regulation that will change the working model for physicians in the private healthcare sector will come into effect on June 1, 2026. Under the new system, it is envisioned that doctors will largely work under 4A status, and a physician will be permitted to work in a maximum of two private healthcare institutions.
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The regulation that will reshape the working system of physicians serving in private healthcare institutions will come into effect on June 1, 2026. With the new implementation, provincial health directorates will cancel the existing work permits of doctors working in private hospitals and reissue them in accordance with the new rules.
TWO-INSTITUTION LIMIT FOR PHYSICIANS
Within the scope of the new regulation, it will be essential for doctors to work primarily as salaried employees under 4A status. Furthermore, the number of private healthcare institutions in which a physician can work simultaneously will be limited to two.
The implementation in question has sparked debate, particularly due to the narrowing of opportunities for doctors to work in multiple health centers and the limitations imposed on the freelance working model.
EVALUATION FROM THE TTB
Speaking to Cumhuriyet, Dr. Güray Kılıç, Head of the Private Practice Branch of the Turkish Medical Association (TTB), stated that the regulation has been on the agenda for a long time and that the limit of working in two healthcare institutions should be monitored carefully.
Kılıç expressed that the new model carries some positive aspects in terms of job security but that there are various risks in its implementation.
“We advocate for physicians to work in a single workplace with secure and decent income that allows for a humane life. The 4A system provides significant advantages in terms of severance pay, annual leave, and social rights. However, if the implementation is not structured correctly, it could create pressure on physicians,” said Kılıç, noting that the self-employment and service procurement models applied in the past led to serious grievances.
IMPACT ON INCOME AND RETIREMENT RIGHTS
Stating that the new system will have direct effects on income tax, Social Security Institution (SGK) premiums, and retirement rights, Kılıç said that changes in cost-sharing could lead to differences in doctors' net incomes.
Noting that they are approaching the regulation with caution, Kılıç said, “This system may eliminate some uncertainties. However, if it creates risks such as pressure for dismissal, loss of income, and insecurity, we will stand against it. We will be following the process closely.”