Dictates for doctors

News: The National Medical Commission (NMC) has published a draft of the regulations it proposes for the professional conduct of doctors and invited comments by June 22.

The draft regulations have overlapping with the existing regulations of the erstwhile Medical Council of India.

What are the constituents of the draft regulations?

Chapters 2 to 6 deal with the a) professional conduct of doctors, b) the duties of registered medical practitioners towards their patients, c) the responsibilities of doctors to each other, d) the responsibilities of doctors to the public and allied health professionals, and professional misconduct, respectively.

The guidelines are a mix of templates for certificates and extensive instructions.

It is interesting that guideline 3, the NMC code of medical ethics, has dropped the controversial Charak Shapath and returned to the Declaration of Geneva. This is a wise move. India is a founder member of the World Medical Association and contributed to the drafting of the declaration.

What are some associated issues?

Patient records: Every registered medical practitioner will have to maintain patient records for three years from the last consultation.

– This will be difficult to implement for most general practitioners who provide high-quality services at low prices and depend on high volumes of patients to earn a decent income.

– It will reduce the number of patients who can be attended to, add considerably to costs, and delay treatment.

This measure is unwise and should be withdrawn.

Informed consent: In the section on informed consent, the statement that “in an operation that may result in sterility, the consent of both husband and wife is required” is poorly thought out and must be redrafted.

– It is possible that the person requiring such surgery may be single. Even if the individual is married, this regulation is contrary to the principle of individual autonomy.

The guidelines on continuous professional development resemble a decree. All practitioners of medicine need to keep abreast of evolving knowledge in medicine to provide competent care to patients. Such continuing education cannot be a repetition of college education. The rules suggested demonstrate a schoolteacher’s approach with excessive regulation and control.

– Medical practitioners are mature learners and do not need the stick to be forced to learn.

The blanket prohibition on medical practitioners participating in educational activities sponsored directly or indirectly by pharmaceutical companies and the allied health sector will severely restrict access to the latest developments.

In the guidelines on social media, the prohibition of sending scan images on social media will considerably impair communication and needs rethinking.

The guidelines on telemedicine read more like a briefing paper than a guideline. It is one of the most elaborate sections and there is some repetition, but it provides a good framework.

Way forward

There is a lack of harmony in the draft. The first part, the regulations, read like typical bureaucratese.

In summary, the draft needs extensive reworking.

Source: This post is based on the article “Dictates for doctors” published in The Hindu on 15th June 22.