Doctors' Non-compliance with prescription guidelines continues to burden patients

Srinagar: Despite clear directives from the Health Department of Kashmir, issued in February 2025, to ensure compliance with prescription guidelines, the order remains largely unimplemented. Doctors in government hospitals across Jammu and Kashmir continue to disregard these prescription norms, leading to widespread mass medication practices that impose a significant financial burden on patients.

A 2016 order from the Health and Medical Education (H&ME) Department outlined clear guidelines for prescribing medicines in government hospitals. The order required doctors to write prescriptions in legible capital letters, including their signature, name, and designation at the bottom.

The order stated that medicines shall, in the first place, be prescribed to patients in Health Care Institutions for their treatment from the drugs available as part of government supplies in the respective health institutions. Such medicines shall only be prescribed in generic form.

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Medical dialogues had earlier reported that in a concerning revelation, it has been found that the Health Department in Kashmir has failed to effectively govern Prescription Audit Committees (PACs) in hospitals across the valley. Despite the Health and Medical Education (H&ME) Department's directive in February 2020, ordering the establishment of prescription audit committees at Government Medical Colleges, and district and sub-district level hospitals across the Union Territory, there appears to be a lack of monitoring and enforcement.

The recent directive reinforced the need for doctors to comply with these norms, warning that non-compliance would result in stringent actions. However, despite these warnings, compliance remains low, and mass medication practices persist across public hospitals in Jammu and Kashmir.

According to news reports, numerous doctors in Jammu and Kashmir have raised concerns that the prescription regulations set by the National Medical Commission (NMC) and the health department are not being adhered to. They have emphasized the need for stricter policies to ensure better compliance and accountability.

A senior doctor in the J&K Health Department posted in a Srinagar hospital noted that the doctors have failed to follow the prescription norms with mass medication continuing. He attributed this non-compliance to several factors, suggesting that multiple elements contribute to the failure to follow the established guidelines.

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He emphasized that making essential medications available at Janaushadhi Kendras could help prevent doctors from prescribing unnecessary or expensive drugs.

A resident of Bandipora, Ishfaq Ahmad, shared his frustration with the system, explaining that many doctors fail to follow prescription norms, which leads to confusion for patients.

According to Rising Kashmir, he said, “They don’t mention their names or write prescriptions in capital letters, making it difficult for patients to understand what has been prescribed. Many prescribed drugs are not available in Janaushadhi Kendras and people buy them from medical shops.”

In response to this issue, the Health Department had issued instructions to appoint nodal officers at the district level who would oversee prescription audits. The officers were tasked with collecting photocopies of prescriptions from at least 1% of daily OPD prescriptions and submitting them to a Prescription Audit Committee (PAC) at the district level. The committee’s role was to ensure compliance with the prescription norms.

However, these audits appear to be ineffective, as complaints continue to pour in hospitals and to the health department from patients over the lack of prescription audits.

Saleem Ahmad, a patient who recently was unwell and visited the nearby SDH Pattan in Baramulla said the doctor prescribed him medicines of Rs 1,200 for just cough and cold. He said that there is a lot of difference between the prescriptions of one doctor and another. A common man doesn’t know what is written on the prescription by the doctor. This must be stopped, and strict action should be taken against doctors.

Despite the presence of Prescription Audit Committees (PACs) in Jammu and Kashmir, mass medication practices persist. A senior consultant in the J&K Health Department criticized the current audit process. He argued that MBBS doctors should not be responsible for auditing prescriptions written by super-specialists. He pointed out that the audits are not being conducted effectively, calling this a significant failure in the system.

Furthermore, the CMOs and medical superintendents continue to disregard the directives issued by the Health Department, failing to ensure that the prescribed norms are enforced. The directorate has also not initiated action against the erring doctors and hospital administrators.

The problem is particularly severe in rural hospitals that do not have Janaushadhi Kendras, leaving patients with no choice but to visit private pharmacies. Despite the government's establishment of Janaushadhi Kendras to make generic medicines more accessible, reports suggest that these initiatives have not been fully implemented in many areas.

On February 2, 2023, the Directorate of Health Services Kashmir issued an order warning Chief Medical Officers (CMOs) and Medical Superintendents to adhere to prescription audit norms. The order further stated that failure to comply with these regulations would result in disciplinary action.

Also Read: Unethical Practice: J&K to conduct prescription audit at government hospitals

A senior official from the Health and Medical Education Department assured that action would be taken against those found violating the prescription norms.