New Delhi: The National Medical Commission (NMC) has decided to form a committee to evaluate the nature of advertisements employed by corporate hospitals, ThePrint has learnt.
In the 12th meeting of the NMC Thursday, a decision was made to present a report to the apex court following the recommendations of this newly constituted committee.
As ThePrint has reported earlier, rules on the nature of advertisements by corporate hospitals were part of the Professional Conduct of Registered Medical Practitioners issued and subsequently put into abeyance by the NMC earlier this year.
The NMC’s decision comes on the back of a notice issued to the regulatory body for doctors by the Supreme Court in this regard.
Earlier this year, Mumbai-based infertility expert Dr Aniruddha Malpani had filed a Public Interest Litigation (PIL) in the SC contending that “there is an alarming situation created by unfettered advertising by corporate hospitals and the newly emerged venture capital funded healthcare start-ups”.
The petition, a copy of which is with ThePrint, argued that this led to an “arbitrary, intra-class distinction between medical professionals and encroaches upon patients’ right to make informed healthcare choices, by manipulating and misleading them, besides making healthcare unaffordable to a majority of population by way of corporatization, which is in flagrant violation of Articles 14, 19 and 21 of the Constitution”.
Article 14 of the Constitution deals with right to equality before law, Article 19 with freedom of speech and Article 21 with right to protection of life and personal liberty.
According to the petition, instances of unethical advertising and illegal direct or indirect solicitation of work by corporate hospitals as well as medical practitioners affiliated with them, are reported regularly.
This, the petition termed a direct contravention of NMC’s statutory regulations, which expressly prohibit direct or indirect solicitation of work by medical practitioners, whether practising independently or as part of a clinic or hospital.
“These norms,” Malpani told ThePrint, “are vague and while they bar individual doctors from advertising since corporate or large hospitals are considered businesses that exploit them to advertise doctors.”
When contacted, NMC spokesperson Dr Yogender Malik told ThePrint that the newly constituted committee will suggest whether there should be extensive rules governing advertisements by corporate hospitals.
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Advertising norms for medical practitioners
The Indian Medical Council Act, 1956 (Professional conduct & ethics) regulations, 2002, which is still applicable to doctors, prohibit a physician from using “his/her name as subject of any form or manner of advertising or publicity through any mode either alone or in conjunction with others which is of such a character as to invite attention to him or to his professional position, skill, qualification, achievements, attainments, specialities, appointments, associations, affiliations or honours and/or of such character as would ordinarily result in his self-aggrandisement”.
The rules also forbid a medical practitioner to “boast of cases, operations, cures or remedies or permit the publication of report thereof through any mode”.
However, the norms allow 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.
The regulation also says: “Printing of self photograph, or any such material of publicity in the letterhead or on sign board of the consulting room or any such clinical establishment shall be regarded as acts of self-advertisement and unethical conduct on the part of the physician.”
However, Malpani told ThePrint that he feared NMC may skirt the issue by saying that hospitals are allowed to advertise because they are commercial establishments while prohibiting the use of names or photos of doctors in their ads.
“This does not really help, because it still puts doctors in private practice who run their own clinic at a huge disadvantage,” he said, adding that even though many doctors run private commercial establishments including clinics and nursing homes, the NMC rules “do not allow them to advertise”.
“To harmonise this, and ensure a level playing field, either all doctors should be allowed to advertise or medical establishments which employ doctors should not be allowed to advertise,” Malpani said.
“Their ability to advertise gives them an unfair edge, which leads to commercial exploitation of patients, and drives private practitioners out of practice.”
‘Developing health seeking behaviour’
On their part, representatives of corporate hospitals maintained that advertising was a mode of making patients “aware”.
Ayanabh Debgupta, joint managing director of Kolkata-based Medica Group of Hospitals, said current NMC norms have adequate safeguards, wherein direct soliciting of any kind of business by the clinical fraternity is prohibited.
For hospitals, marketing in today’s age and time is more about creating awareness among the larger population, and enabling them to make informed decisions about healthcare choices, he said.
Debgupta, who is also a member of the health services committee of the Federation of Indian Chambers of Commerce and Industry (FICCI), added that communicating information and behaviour change are also important parts of developing health seeking behaviour among the masses.
“Universal healthcare is a reality today across India through schemes like Ayushman Bharat and state-specific schemes run by various state governments; the very purpose of these schemes, operated on a public-private partnership model, is to enable more people to access quality healthcare across both private and public healthcare facilities,” he said.
Debgupta added that one needs to be mindful of the fact that health seeking behaviour varies drastically in India. “For instance, Kerala and Bihar are two extremes; so any form of curbs imposed further will not help the larger cause of ensuring universal healthcare and better access for the masses.”
Dr Dharminder Nagar, managing director of Paras Hospitals, a group that runs several super-specialty hospitals in northern India, was also of the opinion that existing NMC norms are sufficient though violation of these norms may be an issue.
“Of course, marketing of doctors and surgeries is not allowed but hospitals can project their services,” he said, pointing out that many countries including the US and New Zealand allow advertising in healthcare and the healthcare in these nations is neither worse nor better because of it.
“But of course, no ads are allowed in western Europe where healthcare is socially funded and there is no or little privately run healthcare,” he added.
In the “Regulations relating to Professional Conduct of Registered Medical Practitioners” — issued in August this year before they were subsequently withdrawn — the NMC had, for the first time, addressed the issue of advertisement by corporate hospitals.
“RMP (registered medical practitioner) or any other person including corporate hospitals, running a maternity home, nursing home, private hospital, rehabilitation center, or any type of medical training institution, may place announcements in the print, electronic and social media, but 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 proposed regulations said.
This provision, some who advocate patients’ rights said, could have addressed the issue to a large extent.
“So by putting the code in abeyance all of the really needed clarifications and regulations that are missing from the code of conduct for doctors cannot be implemented,” said Malini Aisola, co-convenor of the All India Drug Action Network, a group that advocates for patients’ rights.
(Edited by Amrtansh Arora)
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