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345SIUJ.ORG SIUJ  •  Volume 2, Number 6  •  November 2021

UROLOGY AROUND THE WORLD

Private Practice in Jordan
Zeid AbuGhosh

Soc Int Urol J.2021;2(6):345–346

DOI: https://doi:10.48083/AHOP2343

“Nothing prepares you for this!” This is what you will 
hear from every urologist working in the private sector 
in Jordan. So, why am I here?

When I finished my fellowship in Canada in 2010, 
there were no jobs available at the university or in the 
public sector hospitals, so the only options for those 
beginning their careers were to go abroad and work in a 
foreign country or to try their luck with private practice. 
For those of you who do not know what private practice 
means in this system, I will explain. Basically, you rent 
a space and become licensed to operate a urology clinic. 
Then, since physicians are prohibited by law from adver-
tising, word-of-mouth recommendations bring patients 
to you (they may refer themselves), and if you are lucky, 
other physicians will refer their patients to your care.

You have the choice to admit your patients to any 
private hospital. Patients pay a fee for service, which is 
often covered by their private insurance, but is some-
times paid out of pocket. After surgery, although there 
are hospitalists to take care of the patients, the surgeon 
is responsible for more than the usual follow-up care—
including things like the insertion of a Foley catheter 
at 2:00 a.m. on a weekend. If you are not available at all 
times, the emergency room physician will automatically 
call another urologist next time.

Your patients also expect you to be available all the 
time: it is not unheard of for patients to call at midnight 
for advice or to interrupt a special occasion to book an 
appointment. Even if you have a good office assistant, all 
the logistics other than answering the phone are your 
job. For example, if you need to book an operation, you 
have to call the hospital to negotiate a suitable time and 
date, as well as to establish that they have the necessary 
equipment and related disposables. Most of the time, 
you then have to call a supplier for the device or the 
disposables, and you have to coordinate with everyone. 
Getting to know your essential clinic supplies and where 
to buy them is an art in itself. It takes time—and a lot of 
disappointment—to perfect that art and find the reliable 
suppliers.

Another thing is sub-specialization. I trained as a 
urologic oncologist, but I was faced with a market in 
which a urologist cannot afford not to do the “bread and 
butter” work. Therefore, any case that comes into the 
clinic is served, regardless of specialization. Further-
more, I do my own diagnostics too. Urodynamics, ultra-
sounds, and minor procedures like flexible cystoscopy, 
Foley catheter insertion, suprapubic catheter change, 
percutaneous tibial nerve stimulation and shock wave 
therapy and intravesical instillations—all are done by 
me in the clinic without any assistance.

So why do I keep on doing this? For one thing, it pays 
relatively well. You never get rich being a physician, but 
you and your family live a comfortable life. It has not 
been easy: the first year of my private practice generated 
just enough money to pay the rent and the office assis-
tant. The income doubled in the second year, so there 
were some earnings to take home. Even so, to support 
myself and my family during the first 5 years in practice, 
I had to supplement my income with a salaried job from 
8:00 a.m. to 2:00 p.m., working in my own clinic after 
2:00 p.m.

Another good thing about private practice is that you 
are your own boss. Nobody can tell you when and where 
to work, although your workday is 12 to 16 hours, and 
you work 6 days a week. Hospitals look at the doctor as a 
respected client who brings them his patients’ business. 
Some pamper you more with free services to attract you 
and your patients, and this makes your life easier. As 
my practice has expanded, I prefer to do all my outpa-
tient and inpatient care at one hospital for convenience; 
however, when a patient has a lower budget, we will 
move to another, less expensive, hospital. What hospi-
tals charge the patients depends on the level of care and 
prestige. Most of the time you know in advance what the 
costs will be, and you can tell the patient what to expect. 
In the rare event of a complication, however, everything 
changes, so if your patient is paying out of pocket, it is 
best to be cautious.



You can see that with all this disorganized organi-
zation, a little standardization would be a big improve-
ment. To that end, I implemented cloud-based electronic 
health records to ensure patient data are secure and 
accessible, and I work with laboratories and radiology 
departments that have online access to the images and 
information. As collecting my patients’ data is one of my 
responsibilities, this system makes my life easier; with-
out it I would have to ask patients to bring in their results 
and reports.

Finally, to reach a broader population and to promote 
our services without breaking the rules on advertising, 
I established a TV show. Seven Doctors runs on a local 
Jordanian television channel and delivers medical tips 
for the general public in plain, non-technical language. 

A few colleagues and I funded the development of the 
programme and learnt the tricks of trade, and for the 
past seven years, we have produced a one-hour weekly 
show that we sell (without profit) to the local TV 
station, which benefits from having a less expensive but 
much higher quality programme than they could have 
produced themselves. To increase the reach, we also 
turned to social media to offer advice and short tips 
to the public. All this, combined with word-of-mouth 
referrals based on honest scientific practice, has resulted 
in a fairly busy practice.

My next goal? To work to establish here the style 
of practice I saw in Canada, with group practice and 
specialization.

346 SIUJ  •  Volume 2, Number 6  •  November 2021 SIUJ.ORG

UROLOGY AROUND THE WORLD


