Morocco, a sovereign state under constitutional monarchy is considered to be a regional power in North Africa and the Arab World. Yet a large swath of its population is not fully employed and is reliant on daily wages to make a living. In such a nation, an epidemic such as the coronavirus could have serious consequences on the population and economy.
As the number of Coronavirus cases in Morocco has crossed 600, most private practices have suspended their services. The president of the National Council of the Order of Physicians, Dr. Mohammadine Boubekri, revealed that 11 doctors in Morocco were contaminated with Coronavirus: 7 in Casablanca, 2 in Rabat, and 2 in Tetouan. Following this public statement, many doctors in Morocco have deserted their stations to avoid getting contaminated.
This has not gone unnoticed by the Moroccan authorities, with King Mohammed VI reportedly furious about the unethical behavior of the medical practitioners. King Mohammed VI has recently validated the use of Chloroquine, an anti-malaria drug for treating COVID-19 patients.
Under the Mandatory Health Insurance Plan, more than 60% of the population working in private and public sectors have valid medical insurance. But as doctors refuse to provide medical care, the insurance has little benefit in the current pandemic.
Closure of practices causes tensions between liberal practitioners and the Medical Association
In a letter sent on March 27 to physicians in the private sector, the president of the Regional Council of the College of Physicians advised his colleagues about the obligation to justify the closure of their offices.
Doctors who decide to close their practice must provide a file with a handwritten request justifying the reason for the closure. This file must also include the doctor’s personal number and e-mail, address, as well as a copy of his national identity card, as per the letter. Also, the reopening of the practice requires a written request and “ the prior agreement of the medical practice commission of the Regional Council of the Order of Physicians ”.
As this letter suggests that several doctors in the liberal sector abandoned their stations in the midst of a crisis. A supposition that has irritated the medics concerned. It has sparked outrage among physicians who have touted their rights in closing private practices
” A small number of doctors have indeed closed their offices, but they are vulnerable doctors, the elderly or those suffering from chronic diseases,” says Badreddine Dassouli, president of the National Union of the doctors of the liberal sector.
According to him, the College of Physicians should have “ asked these people to close their offices and stay at home so that they are not exposed to a disease that could end their lives”.
Additionally, the medics claim they are also suffering from a shortage in the number of patients to justify the closure of private practices. “ Clinics and offices are seeing fewer and fewer patients. The latter are so afraid of the coronavirus that they prefer not to treat their illnesses ”, stated Badreddine Dassouli.
Private Practitioners state Moroccan Law to defend their decision to close their clinics
According to Moroccan Law 131-13, any doctor wishing to close his private medical office, on a temporary basis, must imperatively report the information to the National Council of the Order of Doctors. Besides, everything must be communicated to this council, including the doctors’ leave.
The procedure to be followed is clearly mentioned in article 13 of the law: “Any doctor who, for specific reasons, ceases to practice on a temporary basis is required to inform the president of the Regional Council of the Order who proceeds to the suspension of his registration on the regional roll of the Order and informs the president of the national council ”.
Manipulating this law to their own benefit, Mr. Hassan Kettani, legal advisor to the National Trade Union College of Private Specialist Doctors (CSNMSP) said, this closure is justified by a fear of spreading the virus by contaminating patients in offices, where the risks of contamination are very high.
“Based on the two articles, 13 and 43, of law 131.13, I consider that doctors have the right to close their private medical offices, given the nature of the Coronavirus, and must imperatively inform the council of the order of their closure notice, to be in good standing, ”says Mr. Kettani.
Additionally, according to Mr. Kettani, in the same law, no criminal sanction is mentioned against these doctors. But disciplinary sanctions exist, which make it possible to translate a cabinet that suddenly closes, without having informed the Council of the order of physicians, before the disciplinary council of the Regional Council of the order of doctors.
Teleconsultation, the best alternative
The practice of teleconsultation (or telemedicine) is authorized by law, in its article 99. Doctors practicing in public health services and doctors practicing in the private sector, as well as public and private health establishments, can use it, while respecting the conditions specified by law, and the legislative and regulatory provisions relating to the protection of individuals with regard to the processing of personal data, in particular the safeguarding of the confidentiality of the data and reports contained in the patient’s medical record.
But as teleconsultation is virtually free of charge, many doctors have instead opted simply to close their practice completely.
However, some ethically sound doctors have kept their practice open while employing all necessary safety measures. Mohamed Boughaleb, a cardiologist, said he receives urgent cases while ensuring that the office is not filled.
“We receive patient by patient,” he tells us. “It is a serious breach of ethics to close his practice. It’s not just the coronavirus; other patients risk dying from other pathologies such as diabetes if they are not taken care of, “says Mohamed Boughaleb, who says he imposed” drastic bleach hygiene measures, including on the handles of doors ”.
Public health care with free consultations is available for those in need. But while the health system has been improving for the last 5 years as the government is making huge investments in the sector, it is still not up to the targeted standards.