REGULATION ON PRIVATE HEALTH INSTITUTIONS FOR OUTPATIENT DIAGNOSIS AND TREATMENT
(Excluding Annexes)

PART ONE Initial Provisions
Objective
ARTICLE 1-(1) The purpose of this Regulation is to regulate the procedures and principles regarding the determination of service, medical technology, facility, and personnel standards, organization, planning, establishment, operation, closure, and inspection of private health institutions providing outpatient diagnosis and treatment, in order to ensure the provision of effective, efficient, and quality health services.
Scope
ARTICLE 2-(1) This Regulation covers medical centers, polyclinics, physical therapy and rehabilitation establishments, and physician's offices (muayenehane) where outpatient diagnosis and treatment services are provided.
Legal Basis
ARTICLE 3-(1) This Regulation has been prepared based on the provisions of the Law on the Practice of Medicine and Allied Arts dated 11/4/1928 and numbered 1219, Article 3, paragraph (c) of Article 9, additional Article 11, and additional Article 19 of the Basic Law on Health Services dated 7/5/1987 and numbered 3359, the provisions of the Law on Radiology, Radium, and Electric Treatment and Other Physiotherapy Institutions dated 19/4/1937 and numbered 3153, and paragraphs (a) and (c) of the first paragraph of Article 355 and Article 508 of the Presidential Decree on the Presidential Organization numbered 1.
Definitions
ARTICLE 4- (1) In this Regulation, the following terms refer to: a) Ministry: The Ministry of Health. b) EKİP: The Ministry Integrated Corporate Transaction Platform (Bakanlık Entegre Kurumsal İşlem Platformunu). c) Operating Permit (Faaliyet izin belgesi): The document, an example of which is provided in Annex-2/C, issued by the Provincial Health Directorate (İl sağlık müdürlüğü), which details the specialization branches where the licensed medical center will accept and treat patients, the laboratories and other medical service units providing services, and any changes in these, enabling the medical center to start operations, or reflecting changes in an operating medical center. ç) General Directorate: The General Directorate of Health Services (Sağlık Hizmetleri Genel Müdürlüğünü). d) Physician's Office (Muayenehane): A health institution opened independently by a physician to freely practice their profession, meeting the minimum conditions set by this Regulation, and providing services in accordance with the conditions specified in Annex-13 of this Regulation. e) Directorate: The Provincial Health Directorate (İl sağlık müdürlüğünü). f) Establishment (Müessese): A health institution providing physical therapy and rehabilitation services within the scope of Law No. 3153. g) On-Call Physician (Nöbetçi tabip): A physician conducting on-call duty, responsible for the medical procedures of patients under observation or emergency cases, during times outside the general working hours of a health institution. ğ) Polyclinic (Poliklinik): A health institution providing outpatient diagnosis and treatment services by ensuring the minimum personnel, equipment, and physical conditions, opened by persons authorized to establish a health institution under this Regulation. h) License (Ruhsat): The document issued by the Ministry in the name of the owner at the time of opening, showing the suitability of the health institution for providing health services, and containing the name, address, and capacity of the establishment. ı) Health Institution (Sağlık kuruluşu): Medical center, polyclinic, physical therapy and rehabilitation establishment, and physician's office (muayenehane). i) Health Personnel (Sağlık personeli): Physician, dentist, pharmacist, nurse, optician, and other health professionals defined in Law No. 1219. j) Certificate (Sertifika): A certificate registered according to the Regulation on Certified Training of the Ministry of Health, published in the Official Gazette dated 4/2/2014 and numbered 28903. k) Technical Review Team (Teknik inceleme ekibi): The team formed by the Ministry in the central or provincial organization to inspect whether the health institution meets the conditions specified in this Regulation before licensing, and whether its activities comply with this Regulation and other relevant legislation after obtaining the license, when necessary. l) Medical Center (Tıp merkezi): A health institution providing outpatient diagnosis and treatment services, including specialized services permitted by this Regulation, established by persons authorized to open a health institution by ensuring the minimum personnel, equipment, and physical conditions. m) TÜSKA: The Turkish Health Services Quality and Accreditation Institute (Türkiye Sağlık Hizmetleri Kalite ve Akreditasyon Enstitüsünü). n) Specialization Branch (Uzmanlık dalı): Specialization branches defined in the medical specialization legislation.
PART TWO Basic Characteristics, Medical Service Units and Qualifications of Health Institutions, Persons Authorized to Establish and Operate Health Institutions
Basic characteristics of the health institution
ARTICLE 5- (1) The health institution provides outpatient diagnosis and treatment services to patients with the existing specialization branches within its structure, provided that it meets the minimum building, service, and personnel standards stipulated in this Regulation.
The minimum number of physicians required to be present in a health institution is as follows: a) A Medical Center is established and operates with a staff of at least five specialist physicians in at least two different specialization branches. b) A Polyclinic operates with a staff of at least two and a maximum of four physicians. c) An Establishment (Müessese) employs a minimum of one specialist physician only in the physical therapy and rehabilitation specialization branch. (2) Sections such as cafeterias or canteens may be established to serve the personnel, patients, and patient relatives of the medical center, or services may be procured for their operation, or these services may be provided by others. These sections cannot be established in areas where medical service units are located or where they would prevent patient treatment and rest. (3) No workplace for any other purpose may be located within the health institution building, and no part of it, except for the businesses mentioned in the second paragraph, may be rented or transferred in any way to third parties to operate for another purpose. (4) It is mandatory for the buildings of medical centers, polyclinics, and establishments to have earthquake and fire reports within the scope of the relevant legislation. (5) A medical center must obtain an accreditation certificate from TÜSKA within a maximum of three years from the date it is licensed. A medical center that fails to obtain an accreditation certificate is obliged to display an information sign stating "This medical center does not have a TÜSKA accreditation certificate," in accordance with the standards set in Annex-16, in a place visible to patients. The Ministry notifies the Social Security Institution every January about medical centers without a TÜSKA accreditation certificate.
Medical service units and qualifications of the health institution
ARTICLE 6- (1) All units within the health institution must meet the minimum physical criteria specified in this Regulation. (2) Deviations of up to 2% are permitted in the measurements related to the minimum physical standards determined in this Regulation. (3) Medical laboratory, radiology, radiation oncology, and nuclear medicine services carried out within the medical center are conducted within the scope of the relevant regulations. An operating permit is issued in the name of the medical center for these units according to the relevant legislation. (4) The health institution may procure services from laboratories and imaging centers licensed independently or within the structure of a private hospital/medical center, or established within public institutions and organizations, in accordance with the relevant legislation. (5) Regarding services provided through procurement, the procuring institution and the providing institution or organization are jointly responsible for this application and its results. (6) Examination requests and results related to services provided through procurement are carried out via an electronic system and integrated into the system of the procuring institution. The institution or organization providing the service cannot demand an extra fee from the patient. (7) Emergency units are only opened in medical centers that provide uninterrupted 24-hour service, have a minimum closed area of 3000 m2, and have a staff of 10 or more specialist physicians. If institutions with an emergency unit opened under this scope request a general practitioner staff position to work in the emergency unit, these staff positions are supplemented to four. (8) If a medical center intends to conduct normal delivery, it is mandatory to add a delivery unit to the establishment's structure within the scope of the criteria specified in Annex-4/Ç. A medical center without an operating room is not allowed to establish a delivery unit. Planned cesarean sections cannot be performed in a medical center. (9) Provided that they are related to the specialization branches specified in the operating permit, medical devices, medical service units, and areas not covered by planning may be added to the health institution. The added devices or units do not grant additional staff positions to the health institution. The addition of devices covered by planning is not permitted. (10) Aesthetic/cosmetic health services may be offered within the medical center, polyclinic, and physician's office (muayenehane), within the framework of the medical applications permitted in the health institution where the physician is located, and within the scope of the competencies acquired by physicians through training curricula or certificates, provided that the necessary physical space and minimum medical equipment defined for the polyclinic room in this Regulation are provided.
Persons authorized to establish and operate a health institution
ARTICLE 7- (1) A medical center shall be established by a physician with the right and authority to practice their profession freely, or by a partnership of one or more physicians and dentists, or by legal entities in which at least 51% of the shares are held by a partnership of physicians and dentists. (2) A Polyclinic is jointly established by at least two physicians with the right and authority to practice their profession freely. (3) An Establishment (Müessese) is established by physical medicine and rehabilitation specialists with the right and authority to practice their profession freely. (4) In the event of the death of the physician who owns the medical center, or a physician/dentist who is a partner in the owning company, the medical center is allowed to operate under the responsibility of the medical director (mesul müdür) for a maximum of five years on behalf of their spouse or children, if any; or for a maximum of one year on behalf of other heirs if there is no spouse or child among the heirs. If the partnership structure is not made compliant with this Regulation within the aforementioned periods, the operation of the medical center is terminated. If the deceased physician was also the medical director of the medical center, the situation must be reported to the Directorate within a maximum of fifteen working days, and actions are taken in accordance with the provisions of Article 14. (5) In the event of the death of a physician partner of a polyclinic, and two or more physicians continue the polyclinic activities, the procedures in the fourth paragraph are applied. If only one physician remains, and a physician partner cannot be found within six months, the polyclinic operation is terminated, or the polyclinic is converted into a physician's office (muayenehane). (6) In case of a change in the partnership structure of private law legal entities licensed as a health institution, this change must be reported to the Directorate within a maximum of one month. (7) Real persons convicted of crimes listed in Article 28 of Law No. 1219 and crimes against sexual inviolability, real persons prohibited from public office, and legal entities with these persons in their partnership structure are not allowed to open a medical center, polyclinic, or establishment. These persons cannot take over the license of the medical center, polyclinic, or establishment, nor can they be a partner in legal entities that hold a license for a medical center, polyclinic, or establishment. (8) New health institution licenses shall not be issued for five years to real persons and private law legal entities whose ownership resulted in license cancellation.
PART THREE Planning, Preliminary Permit, and License
Planning
ARTICLE 8- (1) Planning is carried out by the Ministry, covering the public and private sectors, in the areas of health institutions and organizations needed for operation, the health workforce belonging to them, medical service units and their qualifications, and the distribution of technology-intensive medical devices, in order to ensure that health services are provided in a quality, equitable, and efficient manner, taking into account the demographic structure and epidemiological characteristics; to ensure the balanced distribution of health institutions and organizations' service capacities, health human resources, and modern medical knowledge and technology at the national level; to establish adequate capacity in areas where collaboration is required, such as preventive health and emergency health services, and in health tourism, and to prevent resource waste and idle capacity. (2) The specialization branches and staff numbers that can be assigned to the health institution are determined by the Ministry within the framework of the planning criteria set out in the first paragraph. This planning is announced annually. (3) As a result of the planning announced by the Ministry, a planning conformity certificate (planlama uygunluk belgesi) is issued for those approved for new establishment opening and those with approved specialist physician staff requests in existing establishments. (4) For establishments issued a planning conformity certificate for the purpose of opening a new establishment, it is mandatory to obtain a preliminary permit (ön izin) within a maximum of one year for a polyclinic, and a maximum of two years for a medical center. The planning conformity certificates of those who fail to obtain a preliminary permit within this period are canceled. (5) The planning conformity certificate cannot be transferred.
Preliminary Permit for Medical Center, Polyclinic, and Establishment
ARTICLE 9- (1) It is mandatory to obtain a preliminary permit from the Ministry before opening a medical center, polyclinic, or establishment. The documents listed in Annex-7 for the preliminary permit are sent to the Ministry through the Directorate for examination. (2) A preliminary permit is also mandatory in the following cases: a) Before starting renovation work to convert buildings constructed for other purposes into a medical center/polyclinic/establishment building. b) In case of a change in the architectural project during the implementation of the project for which a preliminary permit was granted by the Ministry. c) In case of a request to construct an additional building on the parcel where the medical center is located, in accordance with the zoning legislation, and to add an annex to the licensed medical center building, provided that it is certified by the competent authority that it is appropriate and accessible in terms of transportation points and that arrangements for patient transfer in emergencies have been made, and that it complies with the planning in Article 8. (3) If the architectural projects listed in Annex-7 are deemed appropriate by the Ministry after examination, they are prepared in three sets by the applicant in accordance with the zoning legislation. The three sets of architectural projects, if the place where the medical center/polyclinic/establishment building will be constructed is within the municipal and adjacent area boundaries, are approved by the relevant municipality, or by the Governorship (valilik) if it is outside the adjacent area, and sent to the Ministry through the Directorate. The documents received by the Directorate and the Ministry are accepted according to an inventory list. (4) The preliminary permit application is finalized and a preliminary permit certificate is issued within a maximum of thirty days from the date it reaches the Ministry, provided that there are no deficiencies in the documents listed in this article or non-compliance with this Regulation, or the deficiencies or non-compliance detected in the preliminary permit application documents are notified to the applicant in writing. (5) Preliminary permit certificates cannot be transferred; however, in case a licensed medical center/polyclinic/establishment with a preliminary permit certificate issued for relocation transfers its license, the preliminary permit is allowed to continue in the name of the new license holder by retaining the existing duration. (6) In case of a desire to carry out work such as modification and repair that does not affect the load-bearing element in accordance with the zoning legislation in the buildings of health institutions licensed by the Ministry, without changing the total gross area permitted for the building's use and provided that its suitability in terms of fire and earthquake is also ensured when necessary, changes to the final project used for the license are permitted with the permission of the Ministry, without requiring project approval from the relevant municipality. (7) If the existing building of the medical center/polyclinic/establishment requires modification, the modification project must be approved by the Ministry before starting the modification. (8) The number of observation beds and polyclinic rooms in the medical center are specified in the medical center preliminary permit certificate. The medical center preliminary permit certificate is issued in accordance with the capacities specified in the planning conformity certificate. The medical center is licensed with this capacity. Investments in buildings and spaces exceeding the capacity specified in the preliminary permit project do not grant additional staff positions to the medical center. (9) Those authorized by the Ministry to open a medical center must obtain a preliminary permit certificate within a maximum of two years from the application date, and polyclinics and establishments within one year. It is mandatory to obtain a license within two years from the date the preliminary permit certificate is issued. The preliminary permit certificate of those who fail to obtain a license at the end of this period is canceled.
License Application and License
ARTICLE 10- (1) The person who will open a health institution applies to the Directorate with the file containing the documents listed in Annex-1/A. The file is accepted with an inventory list. (2) The license application file is examined by the Directorate within seven working days from the application date. If deficiencies or non-compliance are detected in the file, they are notified to the applicant. If there are no deficiencies or non-compliance, the file is sent to the Ministry within fifteen working days. (3) The application sent to the Ministry is first examined by the General Directorate based on the file. If there are deficiencies or non-compliance in the file, they are completed, and the file is referred to the technical review team. If there are no deficiencies in the application file examined and evaluated according to this Regulation, the health institution is inspected on-site in accordance with the technical review report provided in Annex-17. If the health institution is decided to be suitable, a technical review report is prepared and submitted to the Ministry. A license, as provided in Annex-2, is issued by the Ministry for the health institution for which no deficiencies or non-compliance have been detected with this inspection report, and it is sent to the Governorship (valilik). A copy of the application file, the records of the issued documents, and the approved final preliminary permit project are kept at the Directorate. The original copies of the issued documents are given to the medical director (mesul müdür) upon signature. (4) The licensing procedures of the health institution are finalized within thirty working days from the date it is sent to the Ministry, provided that there are no physical deficiencies and no deficiencies or non-compliance in the application documents. (5) If the technical review team detects deficiencies or non-compliance as a result of the inspection, the detected deficiencies or non-compliance are notified to the applicant in writing by the Directorate. The provisions of the third paragraph are applied from the date the applicant notifies the Directorate in writing that the deficiency or non-compliance has been remedied. (6) The applicant may object in writing to the licensing procedures before the Ministry. An evaluation is made within thirty working days from the date the objection petition is registered with the Ministry, and the result is notified to the relevant party. (7) The Ministry may delegate the authority to issue a license, conformity certificate (uygunluk belgesi), and operating permit (faaliyet izin belgesi) to the Governorships. (8) After a license is issued to the medical center, a personnel list containing the number, name, title, specialization branch, or other professional careers of the personnel listed in Annex-5, and the originals or certified copies of the contracts made with physicians, including those working outside the official staff quota (kadro dışı), are submitted to the Directorate. The medical center operating permit provided in Annex-2/C is issued by the Directorate within seven working days for the medical center whose personnel is found to be complete, and the medical center begins patient admission and treatment upon the issuance of this document. (9) The license of a medical center that fails to obtain an operating permit and start patient admission and treatment within six months from the date it is licensed by the Ministry is canceled by the Ministry.
Transfer of the Health Institution
ARTICLE 11-(1) In case of the transfer of the health institution to persons within the scope of this Regulation, an application is made to the Directorate along with the documents listed in Annex-1/B. Upon application, a license is issued in the name of the new ownership by following the procedure in Article 10. (2) In case of the transfer of the health institution, a license is issued in the name of the transferee by evaluating the Annex-1/B documents, without the need to repeat the on-site inspection by the technical review team, provided that there were no deficiencies or non-compliance in the inspection conducted within the last four months and there is no change in the service areas. (3) The person taking over the health institution must apply to the Directorate for a license within fifteen working days from the final transfer date. Until the license is issued by the Ministry in the name of the transferee, the health institution may continue its activities solely under the responsibility of the former ownership and the medical director. (4) The transferee is deemed to have also assumed the responsibilities of the transferor due to the deficiencies or non-compliance detected during the inspection of the health institution. The period granted to the transferor due to the deficiencies or non-compliance detected during the inspection is granted again upon the request of the transferee. If the operation of the health institution is suspended, the transferee must wait for the completion of the suspension period. (5) The license of a health institution whose license is suspended can only be transferred once during the suspension period. (6) A health institution taken over under the provisions of this article cannot be transferred again within two years.
Merger, Relocation, and Conversion
ARTICLE 12-(1) A medical center, polyclinic, and establishment may only be relocated within the province in which it is located, with the permission of the Ministry. (2) In case of a request to relocate the health institution mentioned in the first paragraph, an application is made to the Ministry. The following rules must be followed in relocation procedures: a) For the relocation of a medical center, it is mandatory to complete the relocation procedures within a total of four years by obtaining a preliminary permit certificate within two years and being licensed within two years from the date of the preliminary permit. During this period, the health institution may continue its activities with its existing capacity or suspend its activities and vacate the establishment building by notifying its notification address to the Directorate. b) For the relocation of a polyclinic and establishment, it is mandatory to complete the relocation procedures within a total of three years by obtaining a preliminary permit certificate within one year and being licensed within two years from the date of the preliminary permit. During this period, the health institution may continue its activities with its existing capacity or suspend its activities and vacate the establishment building by notifying its notification address to the Directorate. (3) If polyclinics licensed under different names request to relocate, relocation is permitted within the same province, provided that the conditions sought in this Regulation are met. (4) Medical centers, polyclinics, and establishments, along with licensed independent radiology centers and medical laboratories within the scope of the relevant legislation, may merge within the structure of a medical center only within the province in which they are located, with the permission of the Ministry. The physician staff positions, planning-scope devices, units, and centers registered in the licenses of the merging institutions are registered in the license of the institution they merge with. The merger process is completed within two years. However, if the merger involves relocation to a medical center, the merger process is completed within the period specified in the second paragraph. During this period, the health institution may continue its activities with its existing capacity or suspend its activities and vacate the establishment building by notifying its notification address to the Directorate. (5) If two or more polyclinics within the same province merge and meet the staff and building requirements sought for a medical center, they are allowed to be licensed as a medical center. The number of specialist physician staff positions deemed appropriate by the Ministry within the scope of planning, corresponding to the number of merging licenses, is added to the establishment's license. (6) A medical center may merge within the structure of a private hospital, provided that it complies with the planning. (7) Private health institutions requesting a merger or relocation cannot make a new request before these procedures are completed or before they submit their cancellation petitions regarding these requests. (8) Private health institutions that have completed the merger process cannot request separation again.
Physician's Office (Muayenehane) Standard and Opening
ARTICLE 13- (1) Physicians who will open a physician's office (muayenehane) apply to the Directorate with the documents listed in Annex-1/C. The Directorate inspects on-site whether the physician's office intended to be opened meets the conditions specified in Annex-15/B. A conformity certificate (uygunluk belgesi), an example of which is provided in Annex-2/Ç, is issued by the Directorate in the name of the physicians for the physician's office that is deemed suitable and meets the conditions. (2) A maximum of three physicians may operate a physician's office in the same apartment, provided that a separate examination room is available for each physician, under the conditions specified in Annex-15/B, and that the conditions required by the specialization branch are met. In this case, a separate conformity certificate is issued for each physician.
PART FOUR Employees of the Health Institution and Personnel Standards
Medical Director (Mesul Müdür)
ARTICLE 14- (1) A physician/specialist physician on the establishment's staff serves as the medical director (mesul müdür) in the health institution, excluding the physician's office (muayenehane), to perform the duties defined in this article during general working hours. The medical director may practice their profession in the health institution, provided that a working certificate (çalışma belgesi) is issued in their name. The medical director certificate, provided in Annex-3, is issued for the medical director. (2) It is mandatory for a physician/specialist physician on the establishment's staff, to whom the medical director has made a written delegation of authority, to be present in place of the medical director during the hours the establishment provides services outside of general working hours and in cases of legally acceptable excuses for the medical director. (3) The medical director practices the profession of medicine freely only in the health institution where they are the medical director. It is forbidden for the medical director to practice their profession freely in another health institution, including a physician's office (muayenehane). (4) The physician to be appointed as the medical director must have the following qualifications: a) To have the right and authority to practice their profession in Turkey in accordance with Law No. 1219. b) To be a Turkish citizen. c) Not to be employed in public or private health institutions or organizations. ç) To possess documents showing that they have practiced medicine for at least three years in Turkey, including two years in public or private health institutions, in order to perform the duty of medical director in a medical center. d) Not to be prohibited from the medical profession within the scope of Article 28 of Law No. 1219. e) To be registered with the relevant chamber of physicians. (5) The duties of the medical director are as follows: a) To carry out all kinds of procedures related to the activity of the health institution after obtaining the license. b) To ensure the protection and maintenance of the infrastructure and health quality standards defined in this Regulation and the internal service operation. c) To timely notify the Directorate of any changes occurring in the conditions for licensing during the activity of the health institution. ç) To return the working certificates of health personnel who leave their duty for any reason to the Directorate within a maximum of five working days. d) To ensure that the services in the health institution are carried out regularly and continuously. e) To approve the relevant documents in the name of the health institution. f) To examine, upon starting their duty, whether the responsibilities related to the medical director position have been regularly and continuously performed by the physician to whom they delegated the medical director duties in writing outside of working hours and in cases of acceptable excuses. g) To organize on-call services. ğ) To ensure compliance by the relevant parties with this Regulation, other relevant legislation, and the internal operating procedures of the health institution prepared and announced to the employees, and to conduct the necessary internal audits for this purpose. h) To present the necessary information and documents to the authorities and to assist in inspections. ı) To ensure the implementation of the provisions of the Regulation on the Control of Medical Waste, published in the Official Gazette dated 25/1/2017 and numbered 29959. i) To ensure the sterilization of the devices and materials in the health institution and the calibration of the devices. j) To have the health institution employees undergo periodic examinations and tests, deemed necessary, regarding hepatitis markers and infectious diseases for occupational health, at least once a year. k) To notify the Directorate of changes in partners within fifteen working days. l) To perform the duties stipulated in other legislation related to the health institution's field of activity and intended to be carried out by them. (6) The medical director is the primary point of contact for the Directorate and the Ministry in all procedures related to the activity and inspection of the health institution. The medical director is personally responsible for administrative matters and jointly responsible with other physicians for medical procedures. (7) In cases such as the medical director's resignation, termination of duty, loss of medical director qualifications in any way, or death, a new medical director is appointed by the operator in accordance with the provisions of this Regulation within a maximum of fifteen working days from the emergence of such a situation. An application is made to the Directorate with the required documents for issuing the medical director certificate. In these cases, a physician who is employed in the health institution and meets the medical director qualifications is notified to the Directorate in writing until a certificate is issued in the name of the new medical director. (8) If the medical director leaves the health institution due to leave rights specified in the employment contract, illness, and other acceptable compelling reasons, the operator must notify the Directorate in writing, within a maximum of three working days from the date of separation, of a full-time physician employed in the health institution who meets the medical director qualifications and will perform the medical director duties during that period. (9) Those temporarily banned from the profession according to the relevant legislation cannot serve as a medical director during the period of this ban. The operator must appoint a full-time physician employed in the health institution who meets the medical director qualifications to perform the medical director duties during the period of temporary ban from the profession and notify the Directorate in writing within a maximum of three working days from the date the ban begins to be implemented. (10) If a replacement for the medical director is not appointed within one month from the medical director's separation from the health institution, the establishment's activity is suspended until the appointment procedures for the new medical director are completed. The maximum suspension period in this context is 2 years for a medical center and 1 year for a polyclinic and establishment.
Personnel Employment
ARTICLE 15- (1) The specialist physician staff positions of the medical center are recorded in the electronic system created by the Ministry. New staff positions to be granted to these centers, as well as physician departures and starts, are carried out through this system. (2) The following conditions must be met for personnel employment: a) Health personnel, excluding the physician's office (muayenehane), work on the staff of the health institution with a contract, and by having a personnel working certificate issued via EKİP, as insured within the scope of subparagraph (a) of the first paragraph of Article 4 of the Social Insurance and General Health Insurance Law dated 31/5/2006 and numbered 5510. The personnel working certificate is presented and checked via EKİP when necessary. b) Health personnel in the title determined by the Ministry and also a secretary may be employed in a physician's office (muayenehane). Health personnel other than physicians work in a physician's office by having a personnel working certificate issued. (3) The health institution is obliged to employ the minimum number of physicians and non-physician health personnel of the qualifications listed in Annex-5 for the specialization branches where patients are accepted and treated. (4) The following conditions must be met for health personnel working in more than one health institution: a) Physicians/specialist physicians and dentists working in a health institution covered by planning may also work temporarily outside the official staff quota (kadro dışı geçici çalışma) in a health institution covered by planning in the same province, other than the one they are officially employed in, provided that they comply with Article 12 of Law No. 1219, in line with the employment planning of the Ministry. b) Physicians who have reached the age of 60 and physicians with a disability rate of at least 60% may work in two private health institutions covered by planning in the same province, without requiring a staff quota, provided that they comply with Article 12 of Law No. 1219. Physicians working under this paragraph cannot work officially (kadrolu) or temporarily outside the official staff quota (kadro dışı geçici) within the scope of other articles of this Regulation. c) Physicians who have practiced their profession abroad for at least two years, excluding public official physicians sent abroad with or without pay leave and those who have obligations arising from the relevant legislation, may work temporarily outside the official staff quota (kadro dışı geçici çalışma) in private health institutions covered by planning, excluding physician's offices (muayenehane), which they prefer to work in Turkey after returning from abroad, as a one-time exception from planning. ç) The provisions for temporary work outside the official staff quota (kadro dışı geçici çalışma) within the scope of this Regulation are a right granted to physicians and do not grant an acquired staff quota right to the private health institution. The personnel working certificate provided in Annex-3/B is issued by the Directorate in the name of the physician working temporarily outside the official staff quota. The days and hours of temporary work outside the official staff quota are explicitly stated in the contract made with the officially employed institution. The specialization branches for which the physician works temporarily outside the official staff quota are added to the institution's license/operating permit/conformity certificate, specifying the working method. If these specialist physicians leave the health institution where they work and a replacement specialist physician to work in the same manner cannot be found within three months, the relevant specialization branch is removed from the health institution's license/operating permit/conformity certificate. d) A polyclinic examination room may be established for each physician working officially (kadrolu) and temporarily outside the official staff quota (kadro dışı geçici) in the health institution, and a missing polyclinic room may be added for this purpose. The presence of more polyclinic rooms than the number of physicians working officially and temporarily outside the official staff quota in the establishment does not grant the right to increase the number of physicians. e) The health institution, excluding the physician's office (muayenehane), may employ foreign physicians and non-physician health professionals, provided that permission is granted by the Ministry. However, the permission granted in this manner does not grant the health institution the right to add devices and units covered by planning. Applications made in line with this subparagraph are carried out within the framework of the Regulation on the Procedures and Principles for the Employment of Foreign Health Professionals in Private Health Institutions in Turkey, published in the Official Gazette dated 22/2/2012 and numbered 28212. f) Physicians/specialist physicians working in private health institutions may be on call in the emergency unit of another medical center in the same province outside their working hours at the health institution where they are employed, provided that they comply with Article 12 of Law No. 1219. The on-call list of these physicians is prepared monthly and approved by the Directorate. g) Non-physician health personnel working in the health institution may also work in a maximum of one other health institution in the same province. (5) Departures of health personnel from work must be reported to the Directorate within a maximum of ten working days, and the personnel working certificate is canceled. A physician in the same specialization branch may be employed to replace the specialist physician who has left. Those with a minor specialization may be employed in the main specialization branch with the positive opinion of the commission established by the Ministry for planning purposes. Furthermore, if no other specialist physician in that branch works in the medical center and polyclinic besides the specialist physician who has left, patient admission is immediately stopped in the relevant specialization branch, and the situation is reported to the Directorate. (6) If no officially employed physician works in a specialization branch recorded in the EKİP system by the Ministry for a period of two years, this staff position is canceled by the Ministry. Work periods shorter than six months are not taken into account in the calculation of the two-year period.
Patient Treatment by Physician's Office (Muayenehane) Physicians in a Medical Center
ARTICLE 16- (1) Physicians who have a physician's office (muayenehane) may treat their patients who apply to their physician's office by making a contract, provided that the service fee is covered by the patient and is not requested from the Social Security Institution, in accordance with the third paragraph of Article 12 of Law No. 1219, in the medical center that has a staff position in the relevant branch and at least 3000 m2...