Professional Conduct Review - Lessons from Case Archives: NMC unveils its first publication

New Delhi: Through a recent release, the National Medical Commission (NMC) has unveiled its first publication, an E-Book titled "Professional Conduct Review - Lessons from Case Archives" by the Ethics and Medical Registration Board (EMRB).

The launch event took place on October 5, 2023, at the Board's Conference Room in NMC, New Delhi, in the presence of NMC Chairman Dr. B.N. Gangadhar, the release by NMC Media/Publication Division further mentioned.

Apart from Dr. Gangadhar, eminent figures including Dr. Aruna Vanikar, President of UGMEB; Dr. Vijay Ojha, President of PGMEB; Dr. Vijayendra Kumar, Member of UGMEB; Dr. J.L. Meena, Member of MARB; Dr. Vijaya Lakshmi Nag and Dr. Yogender Malik, Members of EMRB; Shri Pankaj Aggarwal, Director (IT & Coordination); Shri Shambhu Sharan Kumar, Director (UGMEB); Shri Aujender Singh, Deputy Secretary (PGMEB); and Ms. Purnima Tudu, Deputy Secretary (EMRB) were also present at the event.

The Commission has now published Volume-I of the book, which has been edited by Dr. Yogender Malik, a full-time member of the NMC Ethics Board and Head of the Publication Division of NMC.

Altogether nine (9) case archives have been discussed in Volume I. In respect of each and every case, the book has discussed different topics including- Communication Between Doctor and Patient's Relatives, Allegation of Wrong Diagnosis Leading to Delay in Treatment, Specialty Practice-Without Adequate Qualification/Training, Clinical Drug Trial and Role of Registered Medical Practitioners, Elective LSCS done by a General Surgeon Leading to Maternal Death, General Surgeon doing Hysterotomy, Documentation of Surgical Procedure, Misrepresentation of Qualification and Alleged Overcharging by a Medical Practitioner, Life-Threatening Events: A Dilemma for Patient Family.

For each of the cases, the book elaborates on different aspects such as the keywords, context/category, abstract, summary of the case, discussion, decision of State Medical Councils or NMC Ethics Board, lessons learned from the case, take-home message, etc.

In the words of Dr. Yogender Malik, Editor of the booklet and Member of the Ethics and Medical Registration Board and Head Media Division at NMC "This pivotal E-Book comprises comprehensive case studies adjudicated by seasoned professionals in their respective domains. Drawing from real-life examples, it sheds light on professional errors and their consequences, offering valuable lessons to stakeholders, particularly medical practitioners. The aim is to enhance awareness, mitigate professional errors, and safeguard patients from potential ethical lapses."

As an appellate body EMRB, NMC has been hearing cases of misconduct and passing judgments. The need to disseminate the learnings from the complaint cases against Doctors (RMPS) was felt right from the beginning. The thought was shared with the Board and a group of experts was formed. They worked very hard, going through hundreds of pages of each case, and summarizing them without losing the essence of the case and the message. There were apprehensions regarding the identity of doctor and patient, but anonymizing solved this problem, the release by NMC mentioned.

It is very difficult for a patient to differentiate between ethics, conduct and negligence. Then there is the issue related to patient's understanding of constraints of the hospital system; they don't understand duty shifts of doctors and expect the same doctor to be available 24x7 for their patient, especially in corporate hospitals. The patients feel dejected when they don't find the behavior of doctor up to their expectations. Doctors too feel that patients have no right to complain unless there is harm, it further added.

NMC further mentioned in the release that apart from known causes of litigation against doctors like problems related to communication consent and medical records etc. a new problem faced is fixing responsibility when the treatment is by a team of doctors. A doctor may attend only for a consultation and will not own responsibility for the rest of the treatment protocol.

The Commission pointed out that the problem of understanding with respect to differentiation of ethics, conduct and negligence exists even among experts. They sometime go too deep into legal aspects of ethical problems by citing earlier court cases, that essence of the problem at hand is lost.

While the book has been prepared by the members of the NMC Ethics Board including Dr. Malik, Dr. Vijaya Lakshmi Nag, and Dr. Sahajanand Prasad Singh, several other experts from across the country also contributed to it. The list of contributing experts includes Dr. Suresh Bada Math Professor of Psychiatry Department Head of Forensic Psychiatry, NIMHANS Bangalore, Dr. Olinda Timms, Professor, Division of Health & Humanities, St. John's Research Institute, Bangalore, Dr. Kuldeep Singh Dean Academics, Professor & Head, Pediatrics, AIIMS Jodhpur, Dr. Vivek Malik Professor of Anatomy, Pt. B.D. Sharma, University of Health Sciences, Rohtak, Dr. Sushma Sagar Professor & Head, Division of Trauma Surgery & Critical Care, JPNATC, AIIMS Delhi, Dr. Subodh Kumar Professor, Department of Surgical Disciplines, JPN Apex Trauma Center, AIIMS, Delhi, Dr. Girish Tyagi Secretary & Registrar, Delhi Medical Council, Dr. Deepam Pushpam Assistant Professor, Department of Medical Oncology, AIIMS, New Delhi, and Dr. B. R. Arun Assistant Professor, Nuclear Medicine, Government Medical College, Trivandrum.

To view the NMC Release, click on the link below:

https://medicaldialogues.in/pdf_upload/nmc-press-release-222034.pdf

To view the E-Book, click on the link below:

https://medicaldialogues.in/pdf_upload/nmc-e-book-222037.pdf

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