Doctor can refuse to treat patient if pre-indicated fees not paid: NMC draft guidelines

New Delhi: Except in emergency situations, a doctor can refuse to continue to treat a patient if the pre-indicated fees as informed by the doctor to the patient are not paid. A clause to this effect has been included in the recent draft National Medical Commission Registered Medical Practitioner (Professional Conduct) Regulations, 2022. 

The draft guidelines lay down the model code of conduct that is expected out of each doctor practicing in India and registered with the National Medical Commission (NMC).

While the guidelines spell out a series of responsibilities of doctors including those towards the patient, towards the society as well as towards each other, there is only one point on the Right of an RMP and that relates to the "Right to remuneration"

Point 6 of the draft Guidelines state:

Right to remuneration of A RMP: Consultation fees should be made known to the patient before examination or treatment of the patient. A reasonable estimation of the cost of surgery or treatment should be provided to the patient to enable an informed decision. A RMP can refuse to continue to treat a patient if the fees, as indicated, are not paid. This does not apply to doctors in Government service or emergencies and the doctor must ensure that the patient is not abandoned. (L1)

The right to remuneration also comes with important responsibility embedded in the clause that for any physician, the consultation fee has to be made known to the patient in advance. Moreover, in case of surgery or treatment, a reasonable estimate of costs has to be given beforehand. This indeed goes in hand with what the previous MCI ethics guidelines 2002 that also mentioned that " A physician should announce his fees before rendering service and not after the operation or treatment is under way." 

However, what is indeed a first is the right of the RMP to refuse to continue to treat a patient if the patients are not ready to pay the fees as indicated. The guidelines, indeed add a major Caveat to this right that this is not going to apply in emergency situations, and in such a scenario, a doctor needs to first ensure that the patient is not abandoned.

The draft guidelines also add that this clause would not be applicable to government doctors and any kind of doctors in government service.