The Problems of the Healthcare System and Non-Quota Doctors Amid Quota Doctors and the Medical Mafia in Iran:
A Threat to Public Health Introduction A nation’s health system is a component of public health and has to be founded on meritocratic and fair principles. In Iran, the establishment of medical quotas and the pervasive impact of organized medical interests have caused several obstacles to this important system. Not long ago, the health system…
8/25/20253 min read
A Threat to Public Health
Introduction
A nation’s health system is a component of public health and has to be founded on meritocratic and fair principles.
In Iran, the establishment of medical quotas and the pervasive impact of organized medical interests have caused several obstacles to this important system.
Not long ago, the health system in Iran—completely free treatment and state medical facilities—ranked among the best and most effective in the Middle East.
The following article discusses the negative impact of quotas and the medical mafia on the quality of treatment, the well-being of patients, and the fate of non-quota doctors and the entire medical system in the country.
Quota Doctors and the Challenges They Bring
Medical school quotas were initially established to create equal opportunities for specific segments in society, including war veterans, university staff, individuals from disadvantaged groups, and families of fallen heroes. Poor implementation has, however, created major issues:
Low Professional and Academic Standards: Quota students are admitted to medical universities with scores below the established minimum, and this has a detrimental impact on the academic standards and consequently their performance in healthcare facilities.
Erosion of Public Trust in Doctors: Frequent medical errors and declining quality of care have caused some to question Iranian doctors.
Greater Risk of Medical Mistakes: Physicians who have gained admission to the profession primarily based on quotas or connections, rather than sufficient qualifications, are bound to exercise poor judgment in emergencies because of a deficient knowledge base and skill set—thereby endangering patient safety.
The Medical Mafia: A Source of Monopoly and Corruption in the Healthcare System
Iran’s medical mafia are influential groups and individuals who use their influence and wealth to determine who gets medical treatment. They take advantage of the system to acquire a lot of money, and sometimes they even launder money.
Some of the negative impacts of this mafia include:
Monopolization of Medical Equipment and Supplies: The import of medicines and medical equipment is controlled by the medical mafia. This has created an issue, as outdated anesthetic medicines and low-quality surgical threads are imported—resulting in severe infections and even death for patients.
Skyrocketing Healthcare Costs: Medical expenses in Iran have increased dramatically because the medical mafia has complete control over the market and dictates pricing.
Barriers to Establishing Private Clinics: Young doctors who wish to open their clinics face financial and bureaucratic obstacles because powerful groups do not allow competition to thrive.
Harm to the Public and the Healthcare System
The combination of quota doctors and the medical mafia has had devastating consequences for the public:
Decline in the quality of healthcare services and increased patient dissatisfaction.
Increased cost of treatment, imposes economic burden on families.
Brain drain, as skilled physicians emigrate abroad.
(According to official statistics, 35,000 general practitioners have already left the country.)
Increased growth of “reverse medical tourism,” whereby Iranian patients travel to nearby countries for higher-quality care.
Solutions and Recommendations
To solve these problems, the steps that should be taken include: Revitalizing the Quota System: Abolishing the present quota system and introducing scholarship programs that ensure academic merit.
Fighting Monopoly in the Healthcare Sector: Increasing transparency in the licensing procedure and managing healthcare costs.
Facilitating Career Stability for Non-Quota Doctors: Provision of enough career prospects and elimination of administrative impediments to motivate them to stay in the country.
A Historical Perspective on Medical Progress:
All this comes at the opposite end of a comparatively recent past, when people such as Dr. Abdolhossein Samii—who received his education at Stanford and Harvard and was Minister of Science under Prime Minister Hoveyda, as well as Deputy Minister of Health—came back to Iran full of enthusiasm and eagerness to establish an educational base for prospective medical professionals.
Dr. Samii played a pivotal role in advancing medical education in Iran by establishing numerous public universities and hospitals. Among his significant achievements was the 1975 agreement between the Shah’s Medical Center (which he chaired) and Quinnipiac University in the U.S. to establish a health college within the center. The program aimed to reverse the brain drain by attracting Iranian students studying in the U.S. to this college.
Known as the “Father of Nephrology in Iran,” Dr. Samii devoted his life to enhancing Iran’s medical and healthcare systems. According to those close to him, his entire focus was on perfecting the medical system and creating a better environment for healthcare professionals.
Conclusion
The prevalence of quota doctors and the influence of the medical mafia in Iran are a serious threat to public health and have helped increase healthcare costs. To combat this phenomenon requires bold decision-making, greater transparency, and a national commitment to justice in the healthcare industry. Only through the application of these measures can the quality of medical care be improved, and with it, public trust in Iranian doctors.