New Delhi: An internal panel formed by the National Medical Commission’s (NMC)l is planning to endorse only “ethical” advertisements by corporate hospitals, as prescribed in the Professional Conduct of Registered Medical Practitioners regulations issued last year, which were later put on hold.
In the “Regulations relating to Professional Conduct of Registered Medical Practitioners” issued in August 2023, which were withdrawn following strong protest by the Indian Medical Association, the NMC, for the first time, had addressed the issue of advertisement by corporate hospitals.
The NMC’s 2023 guidelines had said that the provisions related to advertisements would be the same for doctors and hospitals offering healthcare services.
Now, the NMC panel — which was constituted to look into the issue of advertisements by corporate hospitals — has endorsed the provision suggested last year, through which the commission had tried to impose strict “ethical standards” for both doctors and hospitals.
According to Dr Yogender Malik, NMC member and chairman of the committee, the panel was in the process of preparing a report based on the suggestions made by its members, which will then be submitted to the Supreme Court (SC).
The NMC’s seven-member panel was formed following an SC directive during the hearing of a public interest litigation (PIL) by Dr Aniruddha Malpani, a Mumbai-based infertility expert last year. The PIL contended that “there is an alarming situation created by unfettered advertising by corporate hospitals and the newly-emerged venture capital-funded healthcare start-ups”.
According to documents accessed by ThePrint recording suggestions made by the seven-member NMC panel, there is a consensus within the regulator that ethical norms related to advertisements applicable to doctors should extend to hospitals, including corporate hospitals.
“Section 10.1.(h) of the Indian Medical Council (Professional Conduct, Etiquette And Ethics) Regulations, 2002 clearly says that ‘…laid down policies and code to ensure observance of professional ethics in medical profession…’ and not by medical professionals, which clearly means that NMC can interfere in the hospitals also,” say the minutes of a meeting held by the panel last month. ThePrint has a copy of the minutes.
“So, it can be safely said that the committee (NMC panel) can make regulations in this matter if the Hon’ble Court thinks it is required,” the panel has observed.
The minutes of the meeting say that the panel members have suggested that guidelines should be issued regarding “unethical” advertisements by corporate hospitals but “they should not differ from the already existing professional conduct content, which are already in abeyance”.
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Proposed norms
According to the NMC’s professional conduct guidelines 2023, registered medical practitioners (RMPs) and entities, such as corporate hospitals, maternity homes, nursing homes, private hospitals, rehabilitation centers, and medical training institutions are permitted to publish announcements across print, electronic, and social media platforms.
“However, these should not contain anything more than the name of the institution, type of patients treated or admitted, kind of doctors and staff training and other facilities offered and the fees,” the regulations added.
Moreover, according to the proposed norms, any violation could have resulted in a penalty in the form of a warning or suspension of licence for 30 days for the doctors involved.
According to Malpani, the NMC’s proposed regulation on advertisements by large hospitals was a step in the right direction, but an SC ruling in this regard could make a “world of difference”.
Malini Aisola, co-convenor of the All India Drug Action Network, a patients’ rights group, also said that the NMC norms, which were later withdrawn, “were the best thought out”.
“It sounds positive that the panel too has taken the same position,” she told ThePrint.
‘Need restrictions on lofty claims’
The professional conduct & ethics regulations 2002 under the Indian Medical Council Act, 1956, currently prohibit physicians from engaging in self-promoting advertising. This includes any form of publicity that highlights a doctor’s professional standing, skills, qualifications, achievements, or honors in a manner that could be seen as self-aggrandising.
These norms also prohibit doctors to “boast of cases, operations, cures or remedies or permit the publication of report thereof through any mode”.
But the norms permit for a formal announcement in the press regarding the initiation of medical practice, change in the type of practice, change in address, absence of duty, or resumption of another practice.
However, the existing regulation does not mention hospitals — leaving room for private facilities, especially large corporate settings, to advertise themselves freely.
According to Malpani, corporate hospitals treat patients as customers and try to maximise their revenues, for which advertising is a crucial tool.
“To raise footfalls in their set-ups so that patients get sucked in for a higher number of diagnostic tests and treatments, which may even be unnecessary, hospitals spend a large amount of money on advertisements,” he claimed.
But, he added, the worry is that since the NMC can only regulate doctors and not corporate entities, a SC directive could be crucial.
“A restriction on advertisements by corporate hospitals will allow patients to judge for themselves what is the right treatment and approach for them rather than getting bulldozed by what large facilities are trying to sell to them,” Malpani said.
Meanwhile, some experts in the hospital industry argued that, while the proposed regulations may try to impose strict ethical standards, there are valid arguments supporting limited advertisement for hospitals and registered medical professionals.
“Limited advertisement allows hospitals and medical professionals to communicate essential information, such as practice commencement, change of address, or public declaration of charges, enhancing transparency in healthcare services and facilitating greater accessibility to healthcare services by informing the public about the availability of medical facilities and specialties offered,” said Dr Dharminder Nagar, managing director of Paras Hospitals, a group present in many northern Indian cities.
Nagar, who is also a member of the Federation of Indian Chambers and Industries (FICCI) health services committee, highlighted that limited advertisement for hospitals and registered medical professionals, guided by ethical principles outlined by the NMC, may serve as a conduit for transparent communication, public awareness, and patient empowerment.
“By striking a balance between promotion and ethical conduct, healthcare stakeholders can contribute to a more accessible, informed, and trustworthy healthcare ecosystem in the country,” he said.
Nagar — who also heads the northern regional healthcare committee at the Confederation of Indian Industry (CII) — added that some regulations on advertisement by corporate hospitals are needed, for example, when data in advertisements is not backed by evidence and on a few occasions, when lofty claims about 100 percent success for a treatment or procedure are unduly made.
(Edited by Richa Mishra)
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