New norms for doctors proposed: File affidavit on earnings, prefix ‘Med Dr.’

Doctors should not directly or indirectly purchase “likes”, “followers”, or pay money so that search algorithms lead to their names being listed at the top, they should prefix “Med Dr.”, file an affidavit on financial earnings  — these and other changes are proposed by the National Medical Commission (NMC).

The NMC’s Ethics and Medical Registration Board (EMRB) on May 23 released the draft regulations “National Medical Commission Registered Medical Practitioner (Professional Conduct) Regulations, 2022”. It has invited comments from the public, experts, stakeholders, organisations until June 22.

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“Only those RMPs (Registered Medical Practitioners) who are registered under NMC Act, 2019, can use Medical Doctor (Med Dr.) as a prefix before their names,” the draft rules stated under the “Professional conduct of RMPs”.

RMP means a person whose name is either in the State Medical Register or the Indian Medical Register or the National Medical Register unless otherwise specified.
“The RMP shall display as suffix to his/her name only NMC recognized and accredited medical degrees/diplomas as provided in the nomenclature of the regulations and listed on the NMC website,” it added.

For RMPs qualified abroad and seeking registration to practice after clearing FMGE/NEXT, the NMC said, “must use NMC-approved equivalent Medical prefixes and suffixes to provide clarity to patients and the public at large”.

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It also suggested that an RMP shall practice only one system of medicine. “Every RMP shall practice the system of medicine in which he/she has trained and certified (for this purpose referred to as modern medicine or allopathic medicine)… A person qualified in more than one system of medicine should decide which system he wants to practice. Once licensed to practice modern medicine under NMC Act, he shall not practice another system of medicine simultaneously. Short courses in other systems of medicine do not qualify a practitioner to practice and prescribe in that system of medicine.”

Social media conduct

RMPs need to distinguish between telemedicine consultation and social media. All written and visual communication should be truthful, respectful, and professional, the draft rules stated.

Stating that RMPs can provide information and announcement on social media, they should avoid discussing the treatment of patients on public social media or prescribing medicine to patients on the public social media platform.

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“If a patient approaches doctors through public social media, the doctor should guide the patient toward a telemedicine consultation or in-person consultation as the situation warrants,” it said.

“RMPs should not directly or indirectly indulge in the practice of purchasing “likes”, “followers”, or paying money so that search algorithms lead to their name being listed at the top or registering on software programmes (apps) that charge fees for higher ratings or soliciting patients. RMPs should not request or share patients’ testimonials or recommendations or endorsements or reviews in social media,” it added.

On social media, RMPs should refrain from “boundary crossings or violations and conduct themselves with dignity and decorum. Soliciting of patients directly or indirectly through social media is unethical.”

File ‘affidavit’ on earnings

The NMC has proposed that doctors “may be required to file an affidavit regarding their financial earnings and or benefits received in the past 5 past years from any pharmaceutical companies or allied health sector.”

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It said doctors and their families must not receive any gifts, travel facilities, hospitality, cash or monetary grants, consultancy fee or honorariums, or access to entertainment or recreation from pharmaceutical companies, commercial healthcare establishments, medical device companies, or corporate hospitals. However, this does not include salaries and benefits that RMPs may receive as employees of these organisations.

Telemedicine

As per the changes proposed, telemedicine consultation should not be “anonymous”.

“Telemedicine consultation should not be anonymous: the patient and the RMP should know and establish each other’s identities,” it said.

Doctors insisting on telemedicine, when the patient is willing to travel to a facility and/or requests an in-person consultation, amounts to misconduct, it said.

Medical students and consent

In examining patients by medical students for teaching/learning purposes, students must be educated about the process and importance of consent and the medical students should take verbal permission from their patients before examining them and the patient’s decision must be respected, including refusal to be examined by the medical student, the NMC said.

Sterilisation

On the issue of sterilisation, the consent from both the patient and the spouse is must, it has been proposed.

“In the case of operative procedures which may result in permanent sterilisation, it is prudent to take informed consent from both the patient and the spouse unless denial of consent could put the life of patients in danger. RMP should encourage honest disclosure by the patient in their best interests.

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“Particular care must be taken with consent in infertility treatments like in-vitro fertilisation, embryo transfer or artificial insemination to protect the rights of patients and donors. Patients have the right to refuse treatment, and this right should be respected. RMP should communicate all possible outcomes of the refusal to be treated especially in emergency and acute conditions. It is important to document the patient’s refusal to be treated and the reasons given for the refusal,” it said.

Use of clinical data

The NMC has proposed that patient’s identity should not be disclosed and his/her data should not be posted on social media “under no circumstances”.

“Personal data that can reveal the identity of the patient should not be disclosed under any circumstances. However, for the use of patient data in academic teaching or clinical case discussions, patient’s consent is required. Under no circumstances will the patient’s data be posted on social media,” it said.