LAHORE: The Pakistan Dental Association (PDA) Lahore Chapter has joined the medical fraternity’s protest against the Federal Board of Revenue (FBR), calling on dental practitioners to observe a symbolic strike and wear black ribbons today, Wednesday, Sept 30, as the Pakistan Medical Association’s protest against the tax authority’s digital invoicing and Point of Sale (POS) measures gets underway across Punjab.
After consultations with senior dental practitioners, academics, dental professionals and young practitioners in Lahore, the chapter said many of the issues being raised by the medical fraternity also directly affect dentists and the wider dental profession.
With the PMA’s strike call coming at short notice and many dental practitioners already carrying scheduled patient appointments for today, PDA Lahore said a complete closure of dental clinics may not be practical for every practitioner.
It has therefore asked dentists to participate symbolically, manage pre-booked appointments as practically as possible and wear a black ribbon throughout the day as a visible expression of solidarity with the medical community.
The PDA Lahore Chapter Cabinet has also said it will participate in any gathering or demonstration organised by the medical fraternity in Lahore to show support on issues common to medical doctors and dentists.
The development marks an important widening of the healthcare community’s response to the FBR measures, bringing organised dentistry alongside medical associations on an issue that PDA Lahore believes has implications extending beyond doctors and private hospitals.
PDA sees strength in a joint medical-dental position
Explaining the rationale behind its decision, PDA Lahore said Pakistan’s dental community is comparatively smaller and less organised than the medical fraternity, making cooperation with established medical organisations important when the two professions face common regulatory or professional challenges.
The chapter believes a coordinated approach can strengthen the collective voice of healthcare professionals and help protect legitimate professional interests while allowing dentists to continue attending patients whose treatment has already been scheduled.
For the dental profession, the issue is not merely one of solidarity with doctors.
Dentists themselves fall within the broader regulatory framework governing medical practitioners and record-keeping, while FBR’s online-integration framework has also encompassed categories of medical practitioners and healthcare establishments under specified conditions.
The Income Tax Rules define a “medical practitioner” broadly enough to include doctors, surgeons, physicians, dentists, psychiatrists, physiotherapists, homeopaths, veterinarians and other practitioners. Existing online-integration provisions also cover specified medical practitioners, diagnostic laboratories and hospitals or medical-care centres, subject to the classifications and exclusions contained in the rules.
PMA strike under way across Punjab today
The PDA's solidarity move comes as the PMA’s strike against the FBR is being observed across Punjab today, with private healthcare services affected in different districts.
By late morning, private clinics and hospitals in Burewala were closed as part of the protest against digital invoicing and the POS system.
In Lahore, the PMA had called on private hospitals and clinics — large and small — to participate in today’s shutdown and formed committees to coordinate with healthcare establishments across the city.
PMA branches and private healthcare representatives in Multan and other parts of South Punjab had similarly announced participation, while medical associations in Mailsi, Mianwali, Toba Tek Singh and other Punjab districts had mobilised their members ahead of today’s action.
At the centre of the confrontation is the medical community’s objection to the manner in which the FBR is seeking greater electronic documentation of transactions in the private healthcare sector.
In Burewala, PMA President Dr Abuzar Saleem called for the POS system affecting medical establishments to be withdrawn and urged FBR authorities to sit with representatives of the medical profession to develop a workable mechanism.
He warned that the protest could be expanded if the medical community’s concerns are not addressed.
The PMA maintains that imposing the present system on healthcare establishments could increase administrative and financial costs and eventually make treatment more expensive for patients. That remains the association’s position; the FBR’s broader policy justification for digital integration is increased documentation, transparency and tax compliance.
Doctors say protest is not against paying taxes
One of the central messages emerging from the medical community ahead of and during today’s strike is that doctors are not opposing taxation itself.
PMA representatives say private practitioners and healthcare institutions are prepared to meet legitimate tax obligations but want a mechanism designed around the realities of healthcare rather than one they believe treats medical consultation in the same manner as a conventional retail transaction.
In Multan, Professor Dr Masood-ur-Rauf Haraj, President of PMA Multan, called for a transparent, workable and mutually acceptable tax mechanism developed through negotiations between the government, FBR and representatives of the medical community.
Dr Imran Haider Qaisrani, General Secretary of PMA Multan, similarly said the medical community’s opposition was directed at the mechanism being implemented rather than the principle of paying tax.
Medical representatives have also raised concerns about the possible presence of tax officials inside healthcare establishments and the implications any intrusive enforcement could have for the clinical environment and patient confidentiality.
They argue that a taxation and documentation system for healthcare must recognise the sensitive relationship between a patient and healthcare professional.
Karachi protest adds pressure ahead of strike
On Tuesday, Sept 29, a day before today’s strike, PMA leaders and representatives of the Young Doctors Association (YDA) gathered at the Karachi Press Club, publicly challenging the FBR’s taxation measures, mandatory POS integration and what they described as administrative harassment of private clinics and hospitals.
The protest brought together central PMA leaders, PMA Karachi office-bearers, senior members of the medical profession and YDA representatives.
Among those participating were Dr Abdul Ghafoor Shoro, Secretary General of PMA Centre; Dr Ismail Memon, President of PMA Karachi; Dr Shahid Mamsa, General Secretary of PMA Karachi; Professor Tipu Sultan; Dr Mehboob Noonari, Chairman of the Young Doctors Association; Dr Mehran Shar; Dr Mirza Ali Azhar; Dr Hamid Manzoor; Dr Altaf Khatri; Dr Abdul Rahman; Dr Sana Yasir; Dr Ameer Solangi; Dr Rasheed Lakhair; Dr Jan Muhammad; and Professor Sirajuddaula Syed.
The medical organisations demanded withdrawal of mandatory POS integration for healthcare providers, an end to what they describe as heavy penalty notices, threatening communications and harassment of private practitioners, and safeguards against inappropriate access to confidential patient information.
They also called on Prime Minister Shehbaz Sharif and the federal finance authorities to intervene before the confrontation escalates.
Why POS has become the flashpoint
The dispute is more complex than a simple objection to using a billing machine.
Under the existing Income Tax Rules governing online integration, notified businesses can be required to register their points of sale and use approved electronic fiscal devices capable of recording transaction data, generating fiscal invoices and transmitting information electronically to the FBR system.
The framework expressly provides for electronically recorded services and POS-generated invoices, including transmission of fiscal data and QR-coded bills.
For medical practitioners, however, the rules also contain longstanding record-keeping requirements that recognise the special nature of clinical services. They require professionals to maintain patient slips, invoices or receipts and record treatment or services rendered, while expressly stating that confidential details are not required in those records.
That distinction is now particularly relevant because patient confidentiality has become one of the issues raised by doctors opposing the way they fear the new enforcement regime could operate.
The FBR, for its part, has been pushing electronic invoicing and digital integration across the economy as part of an effort to document transactions and improve tax compliance. Its digital invoicing framework requires covered registered persons to integrate invoicing systems electronically, with PRAL also available as an integrator for eligible taxpayers.
The medical community is therefore not challenging the existence of tax documentation as such. Its argument is that healthcare requires a sector-specific mechanism that achieves the government’s revenue and documentation objectives without disrupting clinical practice or compromising the professional relationship between doctor and patient.
Section 175C adds to medical community’s concerns
Another major source of friction is Section 175C of the Income Tax Ordinance, which permits the posting of Inland Revenue personnel at the premises of a person or class of persons for monitoring the production or supply of goods, provision of services and other activity relevant to determining tax payable.
The provision gives the Board or Chief Commissioner authority, subject to applicable conditions and restrictions, to post Inland Revenue officials at premises for such monitoring.
PMA representatives have cited actions under Section 175C alongside POS integration, penalties and raids as part of the broader set of enforcement measures they want the government to review.
For doctors, the possibility of revenue officials operating inside hospitals or clinical environments has become one of the most sensitive elements of the dispute.
For dentists and other healthcare professionals now watching the confrontation closely, it also raises the larger question of where legitimate fiscal oversight should end and the protected clinical environment should begin.
What happens after today could prove decisive
Today’s strike is being described by sections of the PMA leadership as a symbolic action, but the message accompanying it is considerably stronger.
PMA Punjab has announced that a major convention will be held in Gujrat on Sunday, Oct 11, bringing together district leadership and representatives from other provinces to decide the medical fraternity’s next course of action.
Medical leaders have warned that the protest movement could expand if no mutually acceptable solution emerges before then.
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