Features of obtaining a medical license for a sole proprietorship specializing in surgery

This material will cover the following issues:

• Is it possible to obtain a medical license in the specialty of surgery for a sole proprietorship?
• What are the features of obtaining the license?
• What is stipulated about the issue in the Licensing Terms?
• Position of the Ministry of Health of Ukraine as a licensing authority.

Since January 2018, medical reform came into force in Ukraine, which entailed a number of changes in the medical industry. However, many questions remain open. In particular, this applies to obtaining a license by sole trader to carry out economic activities of medical practice in the specialty of surgery. Currently, an issue has arisen in the legislation that allows the Ministry of Health of Ukraine to issue such a license only in certain areas of surgery. In this article we will review what types of surgical interventions in Ukraine can be performed under a license for medical practice, and who can receive it.

Legislative definition

According to the legislation, certain types of activities in Ukraine can be carried out only after the business entity gets an appropriate license. The License Conditions for conducting business activities in medical practice indicate that the licensee must carry out surgical interventions, the implementation of which requires hospital settings, on the material and technical basis of healthcare institutions that provide the appropriate type of medical care. Such institutions are:

• operating units, which should be separated from all groups of premises of the healthcare institution;
• healthcare institutions providing secondary (specialized) and tertiary (highly specialized) types of medical care and are provided with appropriate material and technical equipment. [1]

A healthcare institution is defined in the legislation as a legal entity of any form of ownership and legal form (its separate division), which provides medical services to the population on the basis of the appropriate license and professional activities of medical (pharmaceutical) employees. [2]

In practice, this norm gives the Ministry of Health grounds to prohibit sole traders from carrying out any surgical interventions, not just those that require hospital settings.

After reviewing the legislation and regulatory acts that govern the basic processes of medical activity in Ukraine, four types of medical care can be singled out:

• stationary;
• secondary (specialized);
• tertiary (highly specialized);
• ambulance.

In our case, we will consider only in-patient and secondary medical care.

In-patient medical care is provided in urgent cases and in cases of acute illness, and secondary medical care - as planned or in emergency cases. [3] In-patient medical care is hospitalization, round-the-clock medical supervision and intensive care, secondary medical care also includes diagnostics and counseling. Secondary care can be provided on an in-patient or out-patient basis by doctors of the appropriate specialization. The current legislation provides for the possibility of conducting surgeries not only in stationary conditions, but also in outpatient ones - which are not subject to the restriction of conditions. [4]

The provision of secondary medical care in stationary conditions is provided by - multidisciplinary hospitals of planned, intensive, and recovery (rehabilitation) treatment, specialized medical centers, hospices; on an outpatient basis - consultative diagnostic centers and consultative diagnostic units of hospitals. Secondary medical care can also be provided by doctors who carry out business activities in medical practice as sole traders. [2]

Thus, a doctor who is a sole trader can carry out surgeries that do not require hospital settings only if he/she has a license issued by the Ministry of Health of Ukraine. But, in the realities of our time, a license for medical practice in the specialty of surgery is issued mainly to sole traders who are dentist surgeons and perform such types of surgeries as:

• 7EB surgeries on the upper jaw;
• BE7 01 Extraction of teeth of the upper jaw with forceps;
• BE7 02 Surgical extraction of teeth in the upper jaw, etc. [5]

Conclusions

It follows from the above that in the Ministry of Health of Ukraine, there are no specific criteria based on which they issue a license for performance of surgeries by doctors who are sole traders. On the one hand, the state takes care of its citizens and is trying in every possible way to protect us from poor-quality medical care; on the other hand, without a clear sequence, such selectivity is not entirely legal. If there are rules that allow surgeries that do not require stationary conditions, then sole traders also need to be allowed to perform such operations.

The lawyers of our company are in constant contact with representatives of the Ministry of Health of Ukraine and review the innovations in this area, so if you have any further questions, please use the communication forms on our website.
If you want to come to grips with the process of formalizing documents for a license through your own effort, you can get information in our video material.

Regulatory framework

[1] – paragraph 14 of the “License conditions for the conduct of economic activities in medical practice”.

[2] - Art. 3, 35-2 “Fundamentals of the legislation of Ukraine on health care”.

[3] - paragraph 2 of the “Program for providing citizens with state-guaranteed free medical care”.

[4] - paragraph 8.7 of the Order “On the organization of control and prevention of postoperative purulent-inflammatory infections caused by microorganisms resistant to antimicrobial agents”.

[5] - industry classifier of medical procedures (services) and surgical operations.