Doctors should not use online forums or agents to procure patients nor should they use apps or social media platforms to improve their ratings, India’s apex board for medical ethics has proposed in new draft rules for their professional conduct.
The draft regulations, released by the National Medical Commission’s Ethics and Medical Registration Board (NMC-EMRB) on Monday for public comments, are intended to replace the current code of ethics set by the Medical Council of India two decades ago.
The proposed rules relating to online platforms will also prohibit doctors from directly or indirectly purchasing “likes” or “followers” on social media or paying money so that search algorithms lead to their names being listed at the top of the search queries.
Doctors should also not register on software programs or apps that charge fees for higher ratings or for soliciting patients, the EMRB has proposed at a time online platforms provide listings of doctors across multiple specialities, facilitating online doctor-shopping by the public.
The draft rules call on doctors to distinguish between telemedicine and social media, and provide detailed guidance for the appropriate practice of telemedicine.
The draft — open for public responses for a month — has also proposed that doctors should not claim to be clinical specialists in specific fields unless they have educational qualifications in those fields recognised by the NMC, the top regulatory body for medical education too.
“Patients should receive clear, truthful information,” said Yogender Malik, member of the NMC-EMRB. “A surgeon with a focus on urology should not claim to be a urologist, or an internal medicine specialist should not claim to be a cardiologist or diabetologist.”
The draft rules have also proposed guidelines for a concept called continuing professional development (CPD) to replace continuing medical education (CME), both aimed at enhancing doctors’ capabilities to manage patients and retain their licence to practice.
The MCI — the body that preceded the NMC — had in 2011 made it mandatory for doctors to attend a minimum of 30 hours of CMEs. The draft rules recommend 30 hours of CPD every five years, but a minimum of three hours and ideally six hours every year.
“The CMEs were primarily focused on enhancing the knowledge and skills of doctors,” said Dr Malik. “The CPD has broader goals. Around 70 per cent of the CPD will be aimed at enhancing knowledge and skills. The other 30 per cent will focus on areas such as bioethics, communication, public health and evidence-based decisions — each in some way will contribute to improving the quality of care patients get.”
In line with the earlier MCI code of ethics, the new rules will prohibit doctors or their families from receiving any gifts, travel facilities, hospitality, cash or monetary grants, consultancy fees or honorariums, or entertainment or recreation from pharmaceutical or other healthcare establishments.
Doctors “should not be involved in any third-party educational activity like CPD, seminar, workshop, symposia, workshop or conference… which involves direct or indirect sponsorships from pharmaceutical companies or the allied health sector”, the draft said.
Sections of doctors and pharmaceutical industry insiders have said the practice of industry largesse on doctors has continued despite the MCI code of ethics largely because of the government’s unwillingness to crack down on the practice.
The NMC-EMRB’s draft rules — again in consonance with the MCI rules — will prohibit fee-splitting between doctors for diagnostic, scanning, medical or surgical services. Sections of doctors themselves have over the years complained about fee-splitting and the cost it imposes on patients. Fee-splitting typically involves doctors sharing a portion of their fees with other doctors who have referred a patient, usually for a diagnostic or surgical procedure or a consultation.
