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Alt 09-13-2010, 16:39   #1
aerol
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Standart Hekimlere muayenehane denetimi bilgisi

Türk Tabipleri Birliği (TTB), Sağlık Bakanlığının muayenehanelere yaptığı denetimlerle ilgili hekimleri bilgilendirdi.

TTB’den yapılan açıklamada, Tam Gün Yasası’nın Anayasa Mahkemesinde bazı maddelerinin kısmen iptali sonrasında, Sağlık Bakanlığının muayenehaneleri denetlemeye başladığı anımsatıldı. Muayenehanesi olan hekimlerden gelen sorular ışığında soru-cevap bilgi notu hatırlayan TTB, 3 Ağustos 2010 tarihinden önce açılmış olan muayenehanelerde aranacak özelliklerin, bu tarih itibariyle Ayakta Teşhis ve Tedavi Yapılan Özel Sağlık Kuruluşları Hakkında Yönetmelik’in Ek 1/d ekinde belirtilen “Muayenehane Açma Başvurusunda İstenecek Belgeler” ile sınırlı olduğunu vurguladı.

TTB tarafından hazırlanan soru-cevaplar şöyle:
- Muayenehaneler hangi saatlerde açık olmalıdır?
Muayenehane, hekimin bireysel olarak hizmet sunduğu sağlık kuruluşudur. Çalışma saatleri hekim tarafından belirlenir. Çalışma saatlerinin herhangi bir idari makama bildirilmesine gerek yoktur. Ancak hekim tarafından belirlenerek ilan edilen çalışma saatlerine mümkün olduğunca uyulması gerekir.

- Muayenehane, kamu mesai saati içinde açık olabilir mi?
Muayenehanenin ne zaman açılacağı ve ne kadar açık kalacağına hekim karar verir. Hekim aynı zamanda kamu kurum veya kuruluşlarında görevli ise mesai saatleri içinde muayenehanede hizmet sunması söz konusu olmamakla birlikte hastalara randevu verilmesi ve iletişimin açık tutulabilmesi için mesai saatleri içinde de muayenehanenin açık olması, sekreterlik hizmetlerinin sunulması mümkündür.

- Kamuda çalışan hekim muayenehaneye ne zaman gelebilir?
5947 sayılı Yasa ile yapılan değişiklikler sonrasında hekimin kamudaki mesaisi haftalık 40 saattir. Bu sürenin hafta için günlere bölünmesiyle günlük sekiz saat çalışılacağı anlaşılmakla birlikte söz konusu mesainin başlama ve bitiş saatleri İdare tarafından belirlenir. Kamuda çalışan ve aynı zamanda muayenehanesi olan bir hekim, muayenehanesinde, resmi kurumdaki mesaisi dışına kalan zamanlarda hizmet sunabilir.

- Muayenehanede hangi defterlerin tutulması zorunludur?
Muayenehanede tıbbi mevzuat uyarınca bulundurulması zorunlu olan defter, hasta kayıtlarının tutulduğu Protokol Defteridir. Bunun dışında, mali kuralların gerektirdiği defter ve belgelerin tutulması gerekir.

- Muayenehaneleri idari bakımdan denetleme yetkisi kime aittir?
Muayenehaneler, İl Sağlık Müdürlüğü tarafından en az altı ayda bir yerinde denetlenir. Denetim, bu iş için görevlendirilen biri tabip olmak kaydıyla, en az üç personel tarafından gerçekleştirilir.

- Denetimde nelere bakılır?
Denetimde, genel olarak muayenehanenin sağlık hizmet sunumu ile ilgili kurallara uyumu, özel olarak da Ayakta Teşhis ve Tedavi Yapılan Özel Sağlık Kuruluşları Hakkında Yönetmeliğin (EK-1/d) ekinde belirtilen hususların varlığı kontrol edilir. Ancak belirtmek gerekir ki, 3.8.2010 tarihinden önce açılmış olan muayenehanelerin ilgili Yönetmelik ekindeki kurallara uyumu için bir yıl süre tanınmıştır.

- Denetim sonrasında hangi yaptırım uygulanabilir?
Ayakta Teşhis ve Tedavi Yapılan Özel Sağlık Kuruluşları Hakkında Yönetmelik uyarınca “Denetim sırasında noksanlıkları bulunan muayenehaneler uyarılır ve noksanlarını tamamlamak için yedi gün süre verilir. Süre bitiminde noksanlıklarını tamamlamayan muayenehanelerin noksanlığı giderilinceye kadar faaliyeti durdurulur.” Ancak, özellikle belirtmek gerekir ki, 3.8.2010 tarihinden önce açılmış olan muayenehanelerde aranacak özellikler bu tarih itibariyle Yönetmeliğin (Ek 1/d) ekinde belirtilen “Muayenehane Açma Başvurusunda İstenecek Belgeler” ile sınırlıdır.

- Denetim görevlilerinin yetki sınırı nedir?
Denetim ile görevlendirilmiş olan personel idare denetim görevini yerine getirmektedir. Bu niteliğin doğal sonucu olarak müfettiş ya da savcı yetkilerini kullanmaları söz konusu değildir. Hiçbir iş ve işlemi zorla yapamayacağı ya da yaptıramaz; herhangi bir belge veya deftere el koyamayacağı gibi muayenehanede arama ve benzeri bir faaliyette de bulunamaz. Yetkisinin sınırı denetim yapıp, saptadığı hususları gerektiğinde tutanağa bağlamakla sınırlıdır.

- Muayenehanede görevli personelin yetki sınırı nedir?
Muayenehanede çalışan sekreter ve diğer çalışanlar hekimin talimatlarını yerine getirmek zorundadır. Hekimin talimatı olmadan hasta kayıtları, protokol defteri ve benzeri bilgi ve belgeleri denetim ekibi de dahil olmak üzere kimseye veremez.

- Denetim ne zaman yapılabilir?
Denetim, denetim kurulunun gereksinim duyduğu bilgi ve belgelere erişimin sağlanabilmesi için, hekimin muayenehanede olduğu zamanda gerçekleştirilmelidir.

- Muayenehanelerle ilgili bilgi toplama yetkisinin sınırı nedir?
Sağlık Bakanlığı tarafından son zamanlarda kimi hekimlere gönderilen yazı ile yürüttükleri bazı çalışmalarda yararlanmak üzere muayenehanelerin giderlerine ilişkin sorular bulunan bir formun doldurularak gönderilmesi istenmektedir.
Sağlık Bakanlığının hekimlerden istediği bilgileri öğrenebilmesine ilişkin yetkisi olmadığı gibi hekimlerin de muayenehane işletmesine ilişkin giderlerinin Sağlık Bakanlığına bildirilmesi yükümlülüğü bulunmamaktadır.
Bu çerçevede, Sağlık Bakanlığından istenen istatistiki bilgilerin verilmesi tamamen hekimin isteğine kalmıştır. Bu bilgilerin verilmemesi sebebiyle bir yaptırım uygulanması söz konusu değildir.

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Alt 09-13-2010, 16:52   #2
draynali
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draynali is an unknown quantity at this point
Standart

Bakanlık çok zorluyor walla...
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Alt 09-17-2010, 10:57   #3
gonca85
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Zaten kaç kişi kaldı ki

çoğu yerde üç -beş muayenehaneci var.. aslında onlarda sürmeli
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