Multiple jobs and parallel contracts.

In a single month the same doctor may bill under contracts in several public facilities. Each knows only its own part — its own hours and its own invoices. Nobody adds them together: neither the hours nor the money.

For years not even AOTMiT (the Agency for Health Technology Assessment and Tariff System), the agency that collects pay data in healthcare, did so. As it admitted in an interview with the daily Rzeczpospolita,¹ it saw earnings only within a single facility: a doctor working in four places was, for the agency, four unconnected entries. Menedżer Zdrowia, a health-management magazine, has also described why this happens.²

Since 5 August 2026 the minister of health may request from facilities pay data linked to the PESEL number (the Polish personal identification number) and the number of the licence to practise (PWZ), so one person’s payments can now be added up. Facilities, however, hand them over only at the minister’s request, and the act does not provide for their publication.³ We discuss the provisions in our analysis The state will count, the citizen will not see.

Three conditions the Polish system meets

Working in several places is not in itself an abuse. The problem is that the total cannot be seen. For one person to combine facilities without a limit and without anyone knowing, three things must happen at once — in Poland all of them do.

1. A contract instead of employment. Employment is limited by the Labour Code: 48 hours a week, up to about 78 with an opt-out clause. A contract — B2B or a civil-law contract — is outside these limits, and about 73% of specialists work this way. More in our text Contract or employment.
2. No common register. No institution compiles one person’s hours or payments from different workplaces. The total for one doctor does not exist in any public database — since 5 August 2026 the minister may calculate it from data requested from facilities, but does not have to publish it (analysis of the act). What we propose instead is set out in our demand.
3. A shortage of doctors. In specialties with shortages, directors compete for anyone who will cover an on-call shift, and do not ask where else that person works or how many hours they already have. Staff shortages do not curb the phenomenon; they drive it. More in our analysis Why Poland is short of doctors.

The provision that allows it, and its expiry date

Record rotas do not come from a gap in the law but from a specific provision. Article 96 of the Act on medical activity, the opt-out clause, allows an employee with higher medical education who works in a 24-hour hospital and performs on-call duty to agree in writing to work more than an average of 48 hours a week. The provision will expire on 1 January 2028. That date was written into a 2018 amendment, not the current reform.

The opt-out, however, applies only to employment — it does not cover civil-law contracts or self-employment. The limit therefore hits the form of employment that is visible in the documents anyway, and bypasses the one whose totals nobody counts. On the employment side the effect will be felt. A doctor who today works an average of 260 hours a month would have to cut about 52 hours, mainly at the expense of the best-paid night and holiday on-call shifts, and hospitals estimate that they will need about 25% more full-time posts, Rynek Zdrowia reported.⁴

Standby “on the phone”

Employment has one more paid form of availability that does not require being in the hospital. The employer may oblige a doctor to remain on standby to provide services: the doctor is reachable by phone and comes in when called. For each hour of such standby the doctor is entitled to half the hourly rate of base pay, and when called in, the work is settled as on-call duty — as provided in Article 98 of the Act on medical activity.⁵

Standby in itself is not an abuse. But since nobody compiles one person’s hours, it is also impossible to see whether standby in one facility overlaps with work or standby in another.

A case from 2026: 331 hours a month

The mechanism is best seen in a case the media described in 2026. It is not about the size of the rate, but about the fact that no register added up the hours or payments of one person spread over several hospitals.

A Warsaw doctor — a resident doctor without a completed specialisation who coordinated a hospital emergency department (SOR) — worked simultaneously in four public facilities. In 2025 the doctor earned more than PLN 1.6 million (≈ €363,000) from self-employment, according to the doctor’s asset declaration.¹⁰ According to data from the hospital where the doctor coordinated the SOR alone, 3,976 hours of work were reported there over the year, an average of 331 hours a month.¹⁰¹¹ On top of that, for four months of 2025 the doctor had a contract in another Warsaw hospital and reported 732 hours there, an average of 183 a month, Rzeczpospolita reported.¹² The case was also covered by Polsat News¹³ and Interia.¹⁴

331 hours a month is almost two full-time posts — and that is in just one of the several hospitals where this doctor worked.

1. Full-time post168 h
2. Average in this case 1 hospital331 h
3. Round the clock for 30 days720 h

That was not the full picture. During the affair it emerged that since February 2026 the same doctor had also been deputy coordinator of the SOR in a fifth Warsaw hospital. In March alone 290 hours were reported there, for which the doctor was owed more than PLN 104,000 (≈ €23,600) (PLN 350 (≈ €79) an hour, in some cases PLN 400 (≈ €91)). Regardless of the hours, the doctor was entitled to a function allowance of PLN 25,000 (≈ €5,670) a month, Polsat News reported.¹⁵ If these hours were added to the average from the hospital where the doctor coordinated the SOR alone, the result would be about 620 hours a month — more than 20 hours a day, every day, and that without the other facilities. This is an illustrative calculation, because the average refers to 2025 and the 290 hours to March 2026. Nobody added these hours up.

In June 2026 the doctor gave up the seat of district councillor and returned about PLN 0.5 million (≈ €113,000) to the hospital.¹⁶ On 6 October the doctor was charged with fraud involving property of significant value: according to the prosecutor’s office, the doctor submitted unreliable invoices for more than PLN 583,000 (≈ €132,000). The prosecutor’s office announced this a day later. The doctor did not plead guilty, and a charge is not a verdict.¹⁷¹⁸¹⁹

Hours that do not exist

At the county hospital in Braniewo (Warmian-Masurian region), one doctor under contract was at times paid for more than 1,000 hours in a month that has at most 744. The doctor did not need several facilities for this: the same hours were billed under two or three headings at once, for example as on-call duty in an ambulance and as cover for a ward.

In 2024 one doctor billed 2,793 hours more than there were in the whole year.

1. The whole of 2024 366 × 24 h, leap year8,784
2. Billed by one doctor11,577

There were days billed as 72 hours.²³ Payments reached PLN 1,772,879.50 (≈ €402,000). The hospital estimates the loss over three years at about PLN 3.8 million (≈ €863,000) — this is an internal calculation prepared by the hospital’s lawyer and accountant, not a finding of investigators.²⁴ It was only discovered by the new management board during a review of payments. The doctor handed in a notice of termination and issued the last invoice in July 2025.²⁴ The investigation opened on 2 March 2026 concerns the actions of the former president of the company running the hospital, not the doctor.²⁵ By July nobody had been charged,²⁴ and on 15 September 2026 the prosecutor’s office suspended the investigation pending an expert opinion.²⁶

Braniewo is not an exception:

• At the Sosnowiec Municipal Hospital a surgeon reported about 4,812 hours in 2023 — more than 13 hours a day for the whole year, including weekends and holidays. After the case came to light, the hospital itself introduced a limit of 350 hours a month.²⁷
• In Tomaszów Lubelski the hospital director, who is also a doctor, reported 491 hours in one month, of which 351 as a doctor. The National Labour Inspectorate (PIP) took up the case.²⁸
• The longest single on-call shift documented by the PIP lasted almost 176 hours — more than a week without a break. Another doctor accumulated more than 1,200 hours of overtime.²⁹

Each time, the limit was set only by an inspection or by the hospital itself, not by the law.

A public case: the same arithmetic, only visible

Not every such case means abuse — and the next one shows well why. The director of the county hospital in Łosice (Mazowsze, about 7,000 inhabitants) reported in her asset declaration for 2025 about PLN 1.7 million (≈ €386,000) gross from work: about PLN 437,000 (≈ €99,200) for running the hospital and about PLN 1.3 million (≈ €295,000) from on-call duty as a doctor, plus about PLN 111,000 (≈ €25,200) of pension. This was described by Wirtualna Polska,³⁰ Money.pl³¹ and TVP Warszawa.³² She is 72 years old, a paediatrician and neonatologist. She takes on-call shifts because — as she explained on Radio dla Ciebie³³ — otherwise there would be nobody to staff the children’s ward. Her rate is the same as that of other doctors in this hospital: PLN 205 (≈ €47) an hour.

Let us do the calculation: PLN 1.3 million ÷ PLN 205/h ≈ 6,300 hours a year, an average of about 17 hours a day, without a day off — alongside working as director until 15:35. If some of the on-call shifts were paid at a higher rate, there would be fewer hours, but the workload would still be hard to imagine. This is our calculation from the declared amount and the rate, not an official number of hours.

And most importantly: this is not an accusation. The case is public and declared, and according to the director, it keeps the ward going. It can be seen, however, only because a hospital director must file an asset declaration. A doctor on an ordinary contract — and about 73% of specialists work this way — files none. The same total would be just as real, but nobody would see it. Transparency here is not a punishment, but the only difference between a case we know about and those we do not. We do not give the name, although this is a public figure: we describe the mechanism and its transparency.

“Travelling doctors”: the opposite movement, the same gap

The same invisibility has another side. Instead of collecting hours in many places, some specialists do the opposite: in each facility they take only what pays best — they perform a well-priced procedure and move on, without on-call duty, complications or “expensive” patients. The director of the hospital in Płońsk calls them travelling doctors (lekarze objazdowi); the media call them tourists.

In an interview with Wirtualna Polska³⁴ he described a hospital in which one of three surgeons is on call without a break, while the contract is filled by visiting orthopaedists and neurosurgeons. Everyone is satisfied: the hospital fulfils its contract without treating costly cases, and the visitors earn well and do not have to take on-call shifts. His summary: “They leave the patient and drive off” (our translation).

This is above all a rational response to a badly designed system, not the doctors’ fault. It is driven by two things: a contract without an obligation to take on-call duty (contract or employment) and pricing in which some procedures tend to be overvalued, while treating complications and difficult patients is undervalued (pricing of services).

Lack of transparency, however, plays a specific role here: nobody sees the whole pattern. Each facility knows its own contract and its own procedure. That the same person collects well-paid procedures in five counties and nowhere takes an on-call shift does not follow from any database. Compiling one person’s settlements would show this pattern immediately: a high total, many facilities, zero on-call shifts.

There is a bitter paradox in this. A doctor who stays on call and takes on complications looks less productive in the documents and usually earns less than a colleague who only performs procedures. “Tourist” is, in any case, a media shorthand — many commuting doctors fill real staff gaps.

What these cases prove, and what they do not

Notes 34laws, data and statements we relied on

1. Rzeczpospolita, “625 lekarzy w Polsce zarabia powyżej 100 tys. zł — AOTMiT o danych z poziomu jednej placówki” (“625 doctors in Poland earn more than PLN 100,000 — AOTMiT on data at the level of a single facility”, in Polish). ↩

2. Menedżer Zdrowia, “Dlaczego pracują po kilkadziesiąt godzin? Bo mogą” (“Why do they work dozens of hours at a stretch? Because they can”, in Polish). ↩

3. Act of 19 June 2026 amending the Act on publicly funded healthcare services and the Act on medical activity (in Polish; Dz.U. 2026 item 972), in force from 5.08.2026 — new wording of Article 27a of the Act on medical activity. ↩

4. Rynek Zdrowia, “Koniec opt-outów od 2028 r. — skutki dla dochodów lekarzy i obsady dyżurów” (“The end of opt-outs from 2028 — effects on doctors’ income and on staffing on-call duty”, in Polish), 20.07.2026. ↩

5. Act on medical activity, Article 98 (in Polish) — standby to provide services (LexLege). ↩

6. Rynek Zdrowia, “Limit 240 zł za godzinę i 76,8 tys. zł miesięcznie dla medyków, maksymalnie dwa etaty. Jest projekt” (“A limit of PLN 240 an hour and PLN 76.8 thousand a month for medical staff, at most two full-time posts. There is a bill”, in Polish), 25.07.2026 — bill published in the RCL on 24.07.2026; a limit of two full-time posts, at least a half-time post in each place, consent of the main healthcare provider. ↩

7. Rynek Zdrowia, “Limity wynagrodzeń przyjęte przez rząd” (“Pay limits adopted by the government”, in Polish), 22.09.2026 — a ceiling of 16 times the minimum wage for 320 hours a month, half a year to adjust contracts. ↩

8. Rynek Zdrowia, “Komisja Zdrowia za rządowym projektem ustawy dot. wynagrodzeń medyków” (“Health Committee backs the government bill on medical staff pay”, in Polish), 8.10.2026 — first reading on 7.10.2026. ↩

9. Sejm of the Republic of Poland, 67th sitting, 22.10.2026 — vote no. 149 (in Polish) on the bill on pay limits for medical staff as a whole: 229 in favour, 144 against, 67 abstentions. ↩

10. TVN Warszawa, “1,6 mln zł w rok — kontrola w szpitalu i interwencja izby lekarskiej” (“PLN 1.6 million in a year — an inspection at the hospital and an intervention by the medical chamber”, in Polish) — more than PLN 1.6 million from self-employment according to the asset declaration; 3,976 hours in 2025 in the hospital where the doctor coordinated the SOR alone, and work in three other facilities. ↩ ↩²

11. Rynek Zdrowia, “Lekarz na celowniku izby lekarskiej — średnio 331 godzin w miesiącu” (“A doctor in the medical chamber’s sights — an average of 331 hours a month”, in Polish), 15.06.2026 — 3,976 hours in 2025 according to data from the hospital where the doctor coordinated the SOR; work in four facilities. ↩

12. Rzeczpospolita, “Naczelna Izba Lekarska proponuje limit godzin pracy lekarzy” (“The Supreme Medical Chamber proposes a limit on doctors’ working hours”, in Polish), 24.06.2026 — 3,976 hours in one hospital and 732 hours over four months of 2025 in a second. ↩

13. Polsat News, “1,6 mln zł w rok dla lekarza bez specjalizacji. Warszawa zapowiada kontrolę” (“PLN 1.6 million in a year for a doctor without a specialisation. Warsaw announces an inspection”, in Polish), 15.06.2026. ↩

14. Interia, “Afera wokół zarobków warszawskiego lekarza — NIL wszczyna postępowanie” (“Affair over a Warsaw doctor’s earnings — the NIL opens proceedings”, in Polish). ↩

15. Polsat News, “Ten sam lekarz dorabiał w piątym szpitalu” (“The same doctor earned extra in a fifth hospital”, in Polish), 18.06.2026. ↩

16. Bankier.pl (PAP), “Lekarz koryguje 33 faktury i rezygnuje z mandatu radnego” (“Doctor corrects 33 invoices and gives up councillor’s seat”, in Polish), 18.06.2026 — resignation from the seat of district councillor, return of about PLN 500,000, correction of invoices. ↩

17. Portal Samorządowy (PAP), “Lekarz z warszawskiego szpitala usłyszał zarzut oszustwa” (“Doctor from a Warsaw hospital charged with fraud”, in Polish), 7.10.2026 — a charge of fraud involving property of significant value (more than PLN 583,000), police supervision, a property guarantee of PLN 200,000, a ban on leaving the country. ↩

18. RMF24, “Zarzuty dla lekarza — prokuratura o aferze w warszawskim szpitalu” (“Charges for a doctor — the prosecutor’s office on the affair at a Warsaw hospital”, in Polish), 7.10.2026 — charge brought on Tuesday 6.10.2026; the doctor did not plead guilty. ↩

19. Bankier.pl (PAP), “Lekarz usłyszał zarzuty — prokuratura o nierzetelnych fakturach” (“Doctor charged — the prosecutor’s office on unreliable invoices”, in Polish), 7.10.2026. ↩

20. Do Rzeczy, “Rezydent zarządzał SOR-em bez uprawnień — relacje pracowników” (“A resident ran the emergency department without the qualifications — staff accounts”, in Polish). ↩

21. wPolityce, “Relacje pracowników SOR o najcięższych przypadkach prowadzonych przez rezydenta” (“Accounts of emergency department staff about the most serious cases handled by a resident”, in Polish). ↩

22. Rynek Zdrowia, “Lekarz nadal może wystawiać recepty i L4 — NIL komentuje (data uzyskania PWZ)” (“The doctor can still issue prescriptions and sick notes — the NIL comments (date the PWZ was obtained)”, in Polish). ↩

23. Interia, “Braniewo — doby rozliczone na 72 godziny w szpitalu powiatowym” (“Braniewo — days billed as 72 hours at a county hospital”, in Polish). ↩

24. Dziennik Elbląski, “Zarobki lekarza sięgnęły prawie 1,8 mln zł” (“A doctor’s earnings reached almost PLN 1.8 million”, in Polish), 9.07.2026 — 11,577 hours in 2024, the estimate of the loss by the hospital’s lawyer and accountant, notice of termination, last invoice in July 2025, no charges. ↩ ↩² ↩³

25. Regional Prosecutor’s Office in Elbląg, announcement on the investigation by the District Prosecutor’s Office in Elbląg concerning the company running the county hospital (in Polish), 13.07.2026 — the investigation opened on 2.03.2026 concerns the actions of the company’s former president in 2018–2024. ↩

26. TVN24, “Śledztwo w sprawie chirurga zawieszone” (“Investigation concerning a surgeon suspended”, in Polish), 15.09.2026 — suspended pending an expert opinion. ↩

27. TVN24, “Sosnowiec — niemal 5 tys. godzin w rok w szpitalu miejskim” (“Sosnowiec — almost 5,000 hours in a year at the municipal hospital”, in Polish). ↩

28. Money.pl, “Tomaszów Lubelski — dyrektor i lekarz pracował niemal bez przerwy” (“Tomaszów Lubelski — director and doctor worked almost without a break”, in Polish). ↩

29. Dentonet, “Rekordowy dyżur lekarza — prawie 176 godzin (dane PIP)” (“A doctor’s record on-call shift — almost 176 hours (PIP data)”, in Polish). ↩

30. Wirtualna Polska, “Łosice — 1,7 mln zł w rok z pracy lekarki i dyrektorki szpitala” (“Łosice — PLN 1.7 million in a year from work as a doctor and hospital director”, in Polish). ↩

31. Money.pl, “Łosice — prawie 1,7 mln zł w rok jako lekarz i dyrektor” (“Łosice — almost PLN 1.7 million in a year as a doctor and director”, in Polish). ↩

32. TVP Warszawa, “Łosice — większość zarobków dyrektorki z dyżurów lekarskich” (“Łosice — most of the director’s earnings from on-call duty as a doctor”, in Polish). ↩

33. Radio dla Ciebie, “Łosice — bez dyżurów dyrektorki oddział trzeba by zamknąć” (“Łosice — without the director’s on-call shifts the ward would have to close”, in Polish). ↩

34. Wirtualna Polska, “Płońsk — dyrektor szpitala o „lekarzach turystach”” (“Płońsk — the hospital director on ‘tourist doctors’”, in Polish), 09.07.2026. ↩