NMC NOTIFIED RMP REGULATIONS 2023

Latest Context

Recently, the National Medical Commission (NMC) notified comprehensive guidelines for the professional conduct of registered doctors in India under The NMC Registered Medical Practitioner (professional conduct) Regulations 2023.

Guidelines

• Social Media Use:

• For providing information or announcements, doctors can use social media
• Information provided by the doctors must be verifiable and not misleading.
• These regulations warn against soliciting patients through social media
• Prohibited: As per the regulations, discussing patient treatment specifics, and sharing patient scans online are denied. Patient privacy must be maintained.
• While interacting online, it has been advised to follow decorum

• Prescription Practices

• Doctors need to prescribe generic medicines
• Exceptions for cases requiring specific brand names because of narrow therapeutic index or exceptional situations
• It is expected that doctors are encouraged to educate patients about the equivalence of generic and branded medicines

• Right to Refuse Treatment

• As per the guidelines, doctors have the right to refuse treatment for abusive, unruly, or violent patients and relatives
• Doctors must not refuse treatment in medical emergencies
• Doctors must not prohibit discrimination based on various grounds

• Continuous Professional Development

• Doctors are necessitated to undergo continuous learning throughout active years
• In addition, doctors must accumulate 30 credit points in relevant fields every five years
• Annual sessions of at least three credits (ideally six)
• Online training must not be more than 50%.

• Professional Conduct

• Doctors are denied from participating in conferences, CPD sessions sponsored by pharmaceutical companies
• Each Doctor must display the unique registration ID assigned to them in prescriptions, certificates, and money receipts given to patients.
• They cannot be involved in fee splitting, a commission from diagnostic services, endorsement of a product or person, operating an open to all medical stores, etc.
• They are prohibited from receiving gifts, hospitality, or monetary benefits from pharmaceutical companies, medical device companies, or corporate hospitals.

• Disciplinary Actions

• In case of violation of the above-mentioned guidelines, five levels of disciplinary actions ranging from warning to permanent debar from practice for RMP

Issues with Guidelines

• Related to Generic Medicines

• Quality of Generic Medicines: According to the doctors, the quality of available generic medicines is very poor.

• Generic Medicines A generic medicine is a medicine that is developed to be the same as a medicine that has already been authorised. Generic medicines provide cost-effective alternatives to branded drugs while maintaining the same therapeutic effects.

  Limited Availability: There is a high shortage of these medicines in pharmacies due to low-profit margins.
• Ineffectiveness: Due to the poor quality of generic medicines, prescribing generics without standard quality control might lead to ineffective treatments.
• Loss of Doctor’s Choice: Doctors may lose the ability to prescribe the best-suited medication for a patient by considering their medical history and specific needs.

• Other Issues

• Medical Negligence: Cases of medical negligence, where doctors fail to provide the standard of care expected, have been a concern. This could lead to serious harm or even death of patients. Inadequate diagnosis, improper treatment, and lack of proper communication are some factors contributing to medical negligence.
• Lack of Transparency: Transparency in doctor-patient interactions and medical procedures is essential. There have been cases of doctors not providing clear information to patients about their conditions, treatments, and potential risks, leading to a breakdown in trust.
• Inadequate Communication: Effective communication between doctors and patients is crucial for proper diagnosis and treatment. Poor communication can lead to misunderstandings, wrong treatments, and dissatisfaction among patients.
• Inappropriate Behavior: Instances of disrespectful or inappropriate behavior towards patients, especially towards women and marginalized groups, have been reported. Such behavior can discourage patients from seeking medical care and compromise the doctor-patient relationship.
• Quackery: The presence of unqualified and unregistered individuals posing as doctors, often referred to as "quacks," is a serious issue in India. These individuals lack proper medical training and can pose a significant risk to patients' health.
• Commercialization of Healthcare: The increasing commercialization of healthcare has led to doctors being pressured to prioritize financial interests over patients' well-being. This can lead to overcharging, unnecessary treatments, and compromised medical ethics.
• Doctor-Patient Ratio: The doctor-patient ratio in India is often unevenly distributed, leading to overcrowded hospitals and clinics. This can result in rushed consultations, inadequate time spent with patients, and compromised quality of care.

National Medical Commission

• Origin: The National Medical Commission (NMC) has been constituted by an act of Parliament known as the National Medical Commission Act, 2019
• Objective: The objectives of the National Medical Commission are

• improve access to quality and affordable medical education
• ensure the availability of adequate and high-quality medical professionals in all parts of the country;
• promote equitable and universal healthcare that encourages community health perspective and makes services of medical professionals accessible to all the citizens;
• encourages medical professionals to adopt the latest medical research in their work and to contribute to research;
• objectively assess medical institutions periodically in a transparent manner
•  maintain a medical register for India
•  enforce high ethical standards in all aspects of medical services; (vii) have an effective grievance redressal mechanism

• Members: Presently, it has 33 members including Chairman.

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