Integrating the business model concept for the development of physicians’ dual practice in public healthcare delivery systems

Physicians’ Dual practice (PDP), the simultaneous engagement in both public and private healthcare services, is a widespread phenomenon across most health systems (World Health Organization, 2024). This dual engagement presents significant challenges for public institutions, particularly in balancing public healthcare targets with the physicians’ financial and professional incentives. Absenteeism, misallocation of public resources, patient diversion to private practice, and prolonged public waiting times are among the main adverse consequences of PDP (Socha & Bech, 2011). Nonetheless, to mitigate the risk of physician brain drain, most countries find it necessary to permit dual practice (García-Prado & González, 2011). Managing the positive and negative impacts of PDP is a complex, multi-level challenge involving society, organizations, and individuals. The existing literature on PDP remains limited, primarily focusing on policymakers’ decisions or physicians’ drivers. However, hospital managers serve as a critical interface between policy decisions and physicians’ behaviors, making their role essential in the hospital’s organizational system for effectively managing PDP. Addressing the complexities of PDP requires innovative approaches to strategic business model planning for healthcare organizations. To this aim, public hospital managers can leverage Artificial Intelligence (AI) to optimize processes, enhance service delivery, and mitigate PDP-related challenges to healthcare efficiency and equity.