Courts can't legislate, let govt decide on Dr prefix for physiotherapists: Kerala HC

Ernakulam: While hearing an appeal challenging a single-bench verdict allowing physiotherapists and occupational therapists use the 'Dr' prefix, the Kerala High Court has clarified that the decision lies with the government, and not the court. 

Previously, a single bench dismissed pleas seeking a ban on Physiotherapists and Occupational Therapy Professionals to proclaim themselves as the first health care provider and use the 'Dr' prefix.

Challenging that order, the Indian Medical Association and the Indian Association of Physical Medicine and Rehabilitation approached a Division Bench of the High Court. In their appeal, they sought directions that the professional services of physiotherapists and occupational therapy professionals should be confined to a supportive role within the medical profession.

When the matter came up on Monday (February 23), the Division Bench of Justice Sushrut Arvind Dharmadhikari and Justice P.V. Balakrishnan orally remarked that it is not up to the Court to make a decision as to whether medical professionals or physiotherapists can use the prefix 'Dr.' and the same has to be decided by the government or the legislature.

According to LiveLaw, asking the appellants to submit a representation to the government, the bench said, 

"You have to get the Act amended. We cannot legislate sitting here. You make a representation to the government. We can't legislate. Legislation is the jurisdiction of the legislature...Let them decide. That is the only step. Step-by-step, we have to go. Whatever they decide, you can challenge that. Or show us any provision how doctors are permitted to affix 'Dr.' before their name. Our hands are tied. We can't do anything...This Court, in any case, cannot decide whether you can prefix 'Dr.' or not prefix...It is better let the government take a decision...You can all file additional representations also. Can be disposed of. If you agree, we will dispose it of. And let them do it in a time-bound manner...We can't do anything, we can't legislate, we can't declare that you can affix 'Dr.' It is for the government or legislature to do it...After they decide, whatever they decide, it will be open for anybody to challenge it."

During the hearing, senior counsel appearing for the appellants argued that neither the National Commission for Allied and Healthcare Professions Act, 2021 nor its Schedule permits physiotherapists and occupational therapists to use the prefix “Dr.”

He contended that only the Curriculum for physiotherapists mentions such usage, and this could lead to serious consequences, as even MBBS and MD-qualified doctors, including specialists such as cardiologists, nephrologists and neurologists, would technically not be entitled to use the “Dr.” prefix.

The Bench, however, questioned whether there is any specific enabling provision in law even for medical doctors to use the “Dr.” prefix.

The court stated, 

"There must be some enabling provision to prefix...Show us any provision where Dr. is allowed to be prefixed. And whether this will be applicable to them, these persons? [Physiotherapists] That is the issue. Otherwise, in earlier days, even though physicians were not called doctors, only persons who were teaching were called doctors. Now slowly, the physicians also came to be known as doctors."

On this, the senior counsel agreed that there is no specific legal provision permitting medical doctors to use the prefix "Dr.", while physiotherapists and occupational therapists who function on the advice of medical practitioners are allowed to use it. 

The appellants also referred to a notification issued by the Director General of Health Services under the Ministry of Health and Family Welfare on September 9, 2025, which stated that physiotherapists cannot use the prefix "Dr." However, the notification was withdrawn the very next day for further deliberation. In view of this, the Court felt that it is upon the government to take a decision in this regard.

The Bench remarked, 

"Let them take a decision. Without there being any decision, we cannot, you know, deal with these matters like this. Competent authority is the Ministry of Health and Family Welfare, who has to take a call and decide that...They can always amend. They can always place it before the legislature. For consideration, deliberation....objections are invited, suggestions are invited. That is the way. Courts can't declare what is not provided in the Act itself."

Observing that courts cannot declare what is not provided in the Act, the Bench suggested disposing of the appeal with a direction to the government to take a decision within a fixed time.

The matter has now been posted to March 3, after the senior counsel sought time to obtain instructions from the parties.

Also read- 'Doctor' title not exclusive to medical professionals! Kerala HC allows physiotherapists to use Dr prefix

Background:

The issue arose when, earlier last year, the National Commission for Allied and Healthcare Professions (NCAHP) had recommended the use of 'Dr' prefix for physiotherapists.

In the Competency-Based Curriculum for Physiotherapy 2025, which was released on 23.04.2025, NCAHP suggested the title "Physiotherapist" with the prefix "Dr" and suffix "PT."

On September 9, the Directorate General of Health Services (DGHS), under the Health Ministry, mentioned in a letter addressed to the IMA National President, Dr Dilip Bhanushali, that by using the 'Dr' prefix, physiotherapists will be in legal violation of the Indian Medical Degrees Act, 1916.

DGHS had issued the directive after receiving several representations and strong objections from various organisations, including the IAPMR, regarding the use of the prefix "Dr." and suffix "PT" by Physiotherapists in India.

However, only a day later, the DGHS announced its earlier letter as withdrawn. DGHS changed its decision after receiving representations in this regard requiring further examination.

Pleas before Kerala HC:

Pleas were filed before the Kerala High Court seeking an order to nullify, rather read down, the wide scope of the connotation "Physiotherapy Professional" as enlisted vide Sl. No. 3 as well as Serial No. 6- Occupational Therapy Professional of the Schedule appended to the National Commission for Allied and Health Care Professions Act, 2021 so as to make and confine the scope of discharge of such professional services of Physiotherapists and Occupational Therapy Professionals only as a supporting group for the qualified Medical Professionals under the provisions of the National Medical Commission Act, 2019 and Indian Medical Degrees Act, 1916.

Further, the petitions prayed for quashing certain provisions in the Competency Based Curriculum for Occupational Therapy, to the extent to which they purported to place Physiotherapists and Occupational Therapy Professionals on a high pedestal as a First Health Care provider and in allowing them to use prefix 'Dr' in their names.

Another prayer was for a writ of mandamus or other appropriate order directing the authorities and their officers to issue necessary orders interdicting Physiotherapists and Occupational Therapy Professionals in proclaiming themselves as the First Health Care provider and in using the prefix 'Dr' in their names, and to ensure that their professional services should be confined only to a supporting group for the medical profession.

These pleas were filed by the Kerala State Branch of the Indian Medical Association, the Indian Association of Physical Medicine and Rehabilitation (IAPMR), and several other medical professionals.

Also read- Doctors weigh legal, policy options after Kerala HC allows physiotherapists to use 'Dr' prefix