New Delhi: Addressing various issues of professional conduct of registered medical practitioners, the Ethics & Medical Registration Board (EMRB) of the National Medical Commission (NMC) has introduced Draft of National Medical Commission, Registered Medical Practitioner (Professional Conduct) Regulations, 2022.
While releasing the draft of the regulations, the NMC has invited comments from the public and stakeholders and the last date to send the comments is June 22.
Issuing a notice in this regard, NMC mentioned, "Draft Regulations are placed in public domain through our website on 23.05.2022 in accordance with Section 27, 30, 31 & 57 of the National Medical Commission Act, 2019 inviting comments from public in general & Experts/Stakeholders/Organisations for the following proposed regulations: "National Medical Commission, Registered Medical Practitioner (Professional Conduct) Regulations, 2022."
Introducing the regulations on public domain, NMC has invited comments and mentioned, "The comments should be sent to the email at emrb.ethics@nmc.org.in within one month i.e. by 22.06.2022."
These new regulations have addressed the issue of Professional Conduct of Registered Medical Practitioners (RMPs) including their duties and responsibilities, continuing professional development program, remuneration, prescribing generic medicine, prohibition of commission, restriction on advertisement, responsibilities regarding sale of drugs, medical reports, etc.
Apart from these, the regulations have also specified about the duties of RMPs towards their patients, responsibilities of RMPs towards each other, their duties towards the public and allied healthcare professionals. The issue of Professional Misconduct has also been addressed in these regulations. It describes the procedure for a complaint of professional misconduct, manner of inquiry into the complaint, manner of inquiry into the complaint, prohibition of review of the order, power of the SMC/EMRB, delay in decision, etc.
Further, the guidelines for prescribing generic medicine, the template for writing prescriptions, NMC code of medical ethics, guidelines on penalties, levels of disciplinary action as per breach of conduct, guidelines on informed consent in clinical practice, conduct of RMPs on social media, format for medical record, form of certificate recommended for leave or extension or communication of leave and for fitness, continuous professional development guidelines, creation of CPD Committee under EMRB, application for obtaining eligibility for conducting CPD from EMRB, format of certificate for delegates among others.
These new regulations also have addressed the guidelines for practice of Telemedicine in India including the scope of telemedicine, Technology used for telemedicine, framework for telemedicine, guidelines for technology platforms enabling telemedicine, special responsibilities of NMC, etc.
Professional Conduct of RMPs:
Referring to the duties and responsibilities of the registered medical practitioners, NMC mentioned, "At the time of making an application for registration under the provisions of the NMC Act, it shall be deemed that the RMP has read and agreed to abide by these regulations."
These regulations include issues like- Prefix, Suffix and Modern Medicine, Continuing Professional Development Program, Right to remuneration of A RMP, Prohibiting Soliciting of Patient, Prescribing Generic Medicine, Prohibition of Fee Splitting/Commissions, Prohibition of endorsement of the product or a person, Restriction on Advertisement, Responsibility of RMP regarding the sale of drugs, Responsibility of RMP regarding the Medical Records, Informed Consent.
Duties of RMPs Towards their Patients:
The duties of the medical practitioners towards their patients include their duties of keeping appointments, the duty of keeping confidentiality, duty of telling the truth, of patient care, duty of referral, signatures, consultation of telemedicine etc.
Further, the duties also include the matter of incapacity of a doctor. The regulations clearly mention, "A Registered Medical Practitioner having any incapacity (induced or otherwise) detrimental to the patient or professional practice, which can affect his decision-making or skill in treating the patient is not permitted to practice his profession for the period of incapacity. Use of Alcohol or other intoxicants during duty or off duty which can affect professional practice will constitute misconduct."
Responsibilities of RMPs to each other:
The responsibilities of the medical practitioners towards each other include the matter of- professional integrity, the issue of RMP as Locum, an RMP's duty of reporting and inspection and communication etc.
Duties of RMPs towards the Public and Allied Healthcare Professionals:
The Regulations mention that RMPs have the duty of taking part in public education and awareness. "RMPs, as good citizens, have a responsibility to disseminate scientific advice on public health issues in the public interest without self-promotion. They should particularly co-operate with the authorities in the administration of sanitary/public health laws and regulations," state the regulations.
"RMP should enlighten the public concerning quarantine regulations and measures for the prevention of epidemics and communicable diseases. At all times the RMP should notify the constituted public health authorities of every case of notifiable disease under his care, following the laws, rules, and regulations of the health authorities. RMP needs to involve in public education and awareness activities without involving in the advertisement. When an epidemic occurs, a 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," it adds.
"RMP as a team leader, should recognize the importance of teamwork and respect the practice of different paramedical services," the regulations further mention.
Referring to the issue of gifts, NMC has clearly mentioned in the regulations, "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. However, this does not include salaries and benefits that RMPs may receive as employees of these organizations. Also, RMPs should not be involved in any third-party educational activity like CPD, seminar, workshop, symposia, conference, etc., which involves direct or indirect sponsorships from pharmaceutical companies or the allied health sector.RMP should be aware of the conflict of interest situations that may arise. The nature of these relationships should be in the public domain and should not be in contravention of any law, rule, or regulation in force. An RMP himself or as part of any society, organization, association, trust, etc. should be transparent regarding the relationship with the pharmaceutical and allied health sector industry."
Professional Misconduct:
NMC in these new regulations has addressed the issue of Professional Misconduct in detail and has mentioned, "Any violation of these regulations, or other applicable Acts related to medical practice which are in force, shall constitute professional misconduct. By issuing these regulations, the EMRB, NMC, and the State Medical Councils are in no way precluded from considering and dealing with any other form of professional misconduct by registered medical practitioners which do not fall under any of the categories mentioned in the regulations or guidelines or codes appended. RMPs bound by these regulations will not engage in any activities which violate these regulations and should not enter into any employment or other contract that engages in activities in violation of any of these regulations. Conviction of RMP in cases of a cognizable offence involving moral turpitude may result in the suspension of license to practice."
The procedure for lodging a complaint, the manner of inquiry, guidelines for alternative penalties, prohibition of review, the issue of delay in decision, etc have also been addressed in the new draft regulations.
Continuous Professional Development Guidelines:
These regulations have specifically discussed the issue of Continuous Professional Development Guidelines for all medical practitioners. It also outlines the process of delivery of CPD programmes, the assignment of CPD points, the linkage of CPD points with renewal of licences by the EMRB or the State Medical Council, and the penalties involved in the event of non-compliance to mandated CPD requirements.
"Emphasis will be on creating culture where RMPs do not view CPD and recertification as a threat but as a responsibility to provide patient care and services of highest order," NMC mentioned in the guidelines.
Guidelines for Practice of Telemedicine in India:
In order to ensure that the registered medical practitioners are able to provide healthcare using telemedicine in India, NMC has discussed in detail the guidelines in this respect.
The new regulations have discussed at length about the definitions of telemedicine, its scope, technology used for it, guidelines for practicing telemedicine, the duties of RMPs in this respect including the ethical issues, medical ethics, data privacy, fee, guidelines for technology platforms enabling telemedicine, special responsibilities of NMC, among others.
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