PESHAWAR: Patients complain that they have to wait for long to undergo different types of surgeries when they visit outpatient departments of medical teaching institutions (MTIs) for checkup.

They allege that those patients, who can pay charges of consultants in institutionbased practice, are facilitated the same day or next morning toundergo surgery.

`Waiting lists for surgeries at MTIs continue to rise as surgeons prefer to operate on patients in institution-based practice (IBP) on payment.

This is happening in all MTIsbecause of clear conflict of interest,` a senior surgeon told Dawn.

He said that the consultants hired through MTI Act could not do private practice so they were doing IBP at the same hospitals in evening shift as it was mandatory for them.

`They give painfully long dates to patients in morning OPDs. As a result, patients consult surgeons in IBP and get operated upon soon,` he added.

Prior to introduction of Me dical Teaching Institutions Reforms Act (MTIRA), patients visiting hospitals were given dates for surgeries within months. Now the situation has completely changed and patients have to wait for one to three years to undergo operations.

A former dean of a medical teaching institution said that previously, patients got short dates for operations because there was no conflict of inter-est. `Now surgeons want to facilitate patients in IBP, which benefits both the former and the latter as one gets money and the other gets relief from the disease,` he added.

He said that a patient, who visited one of the 10 MTIs recently, was asked by surgeon to come for operation in January 2027.

It surprised his relatives but they were told by a ward orderly to consult the same medic in IBP, he said. `The patient did so and was shifted to operation theatre the same night after paying Rs50,000, he added.

He said that there were long waiting lists for ENT, eye, surgery, neurosurgery, orthopaedic, urology, paeds surgery and gynecology etc because most of the consultants were preoccupied with IBP patients for which they got paid.

He said that operating onpatients in official worlcing hours (morning shift) did not bring any financial incentives to surgeons or hospitals. `The system has become so complicated that MTI consultants also get financial incentives in addition to their salaries but their total concentration is on IBP,` he said.

A medical director at another MTI said that the launch of IBP was an integral part of MTIRA and it was meant to provide cheap and quality consultation to patients and utilise the space of hospitals that remained unused after 2pm.

`Not only financial incentives but only MTI consultants qualify to be head of departments despite the presence of senior non-MTI consultants,` he said.

Most of the MTI consultants have started their careers from IBP where they get reputation and are known by people so now many ofthem earn more than Rs2.5 million per month.

The Boards of Governors, which govern their respective MTIs, are also silent over this matter because most of them have been made members owing to their political influence and being not experts in hospital affairs, such issues continue to come up and cause trouble to patients.

As opposed to private clinics outside hospitals where non-MTI consultants pay rents, electricity bills and bear other expenses, MTI consultants utilise the hospital premises without mal(ing any payment, except surrendering part of their income to hospitals and deduction of income tax at source to government.

However, all MTI consultants are not the same and many facilitate patients in the morning shift too but most of them want to see people in IBP for economic reasons.