The National Medical Commission's Ethics & Medical Registration Board (EMRB) has introduced the Draft National Medical Commission, Registered Medical Practitioner (Professional Behavior) Regulations, 2022, to address different aspects of registered medical practitioners' professional conduct.
The NMC asked for public and stakeholder feedback when it released the new regulations, and the deadline for submissions was set for June 22.
When presenting the public domain laws, NMC stated, "The comments shall be forwarded to the email address firstname.lastname@example.org within one month, i.e. by 22.06.2022."
Some of the important regulations mentioned are as follows:
1. Professional Conduct of RMPs
- Only those RMPs who are registered under NMC Act, 2019, can use 3 Medical Doctor (Med Dr.) as a prefix before their names. Every self-employed RMP shall display the unique registration ID assigned to her/him by EMRB in his/her prescription, certificate, and money receipts given to patients. Employed RMP shall get a seal made by the employer for displaying the unique registration number below the RMP’s signatures.
- 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.
- 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 4 simultaneously. Short courses in other systems of medicine do not qualify a practitioner to practice and prescribe in that system of medicine.
- Shall not associate professionally with any unqualified person to perform any treatment, procedure, or operation.
2. Continuing Professional Development Program
- Attend continuing professional development programs regularly each year, totaling at least 30 credit hours every five years.
- Only recognized medical colleges and health institutions or medical societies accredited or authorized by EMRB/State medical Councils can offer training and credit hours.
- Renewal of License to practice should be done every 5 years, requiring submission of details of CPD credit hours.
- RMPs who wish to practice in another State (due to transfer of work or residence) should inform the State Medical Council and apply for a License to practice in that State.
3. Regarding Prescription and Remuneration
- Consultation fees and an estimated cost of treatment should be made known to the patient before the examination or treatment of the patient.
- An RMP can refuse to continue to treat a patient if the fees, as indicated, are not paid.
- Every RMP is expected to prescribe drugs using generic names written legibly and prescribe drugs rationally, avoiding unnecessary medications and 5 irrational fixed-dose combination tablets.
- An RMP shall not run an open shop to sell medicine prescribed by RMPs other than himself or for the sale of medical or surgical appliances. They are allowed to sell medication to his/her own patients.
- An RMP shall not dispense or prescribe secret remedial agents of which he does not know the composition or action in the body.
4. Regarding Medical Records of Patients
- Every self-employed RMP shall maintain medical records of patients (outpatients or inpatients) for 3 years from the date of the last contact with the patient for treatment, in a standard proforma laid down by the NMC.
- If any request is made for the medical record by a hospital or healthcare institution either by the patients / authorized attendant or legal authorities, it should be given within 5 working days in regular cases and on the same day in case of a medical emergency.
- Patients’ medical records shall be computerized for quick retrieval within 3 years from the date of publication of these regulations.
- If a signed document ( In their professional capacity ) is issued for any court or administrative purpose, it should not be misleading and a register with full details shall be maintained.
- An RMP shall cooperate in the investigation against incompetent, corrupt or dishonest conduct of other members of the profession without fear or favor.
- Before performing any clinical procedure, diagnostic or therapeutic, or operation, the RMP should obtain the documented informed consent of the patient/legal guardian/family member. In case of an emergency, the doctor should try to obtain consent, but if this is not possible, he must act in the best interest of the patient.
- An RMP shall not publish photographs or case reports of patients without their permission in any medical or another journal in a manner by which their identity could be revealed.
DUTY TOWARDS PATIENTS:
- An RMP shall endeavor to be prompt in attending to patients and should keep in time with appointments or visiting/consultation hours. If the RMP is delayed for a valid reason, the patient should be informed.
- An RMP is not permitted to practice his profession for a period of incapacity (physical or mental) which can affect his professional expertise. Use of Alcohol or other intoxicants during duty or off duty which can affect professional practice will constitute misconduct.
- Every communication between RMP and patients shall be kept confidential unless required by the laws of the state.
- In case of abusive, unruly, and violent patients or relatives, the RMP can document and report the behavior and refuse to treat the patient.
DUTIES TOWARDS THE PUBLIC AND ALLIED HEALTHCARE PROFESSIONALS:
- Disseminate scientific advice on public health issues in the public interest without self-promotion.
- When an epidemic occurs, an RMP provided with all the necessary medical protection and his own health permitting should not abandon his duty for fear of contracting the disease himself.
- RMPs 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.
- RMPs 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.
CONDUCT ON SOCIAL MEDIA :
- RMPs can provide information and announcement on social media. However, the information should be factual and can be verified. The information should not be misleading or deceptive, nor should it exploit the patient’s vulnerability or lack of knowledge.
- RMPs should avoid discussing the treatment of patients on public social media or prescribing medicine to patients on the public social media platform. 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.
- RMPs should not post patients’ photographs or scan images (ct/pet scans) on social media. Once an image is posted on social media, it becomes data that is owned by the social media company or the general public.
- RMPs behavior on social media towards his colleagues should be guided by general principles of medical ethics on professional behavior.
- 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 programs (apps) that charge fees for higher ratings or soliciting patients.
- RMPs should not request or share patients ’testimonials or recommendations or endorsements or reviews on social media.
- RMPs should refrain from sharing images of healed/cured patients, surgery/procedure videos, or images displaying impressive results under any circumstances. 8. RMP is allowed to share educative material for the information of the general public. However, communication should be limited to the expertise of the RMP.
- RMP’s webpage should also follow the same guidelines as above.
- On social media, RMPs should refrain from boundary crossings or violations and conduct themselves with dignity and decorum.
- Soliciting patients directly or indirectly through social media is unethical.