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Context: National Medical Commission (NMC) notifies guidelines for the professional conduct of registered doctors of modern medicine.

More about the guidelines

It was notified by the ethics and medical registration board under the country’s apex regulator National Medical Commission (NMC).

Provisions

Curb on sponsorships

• The guidelines warn against receiving commissions from pharmacies or diagnostic laboratories or attending conferences sponsored by the pharmaceutical industry.

Right to refuse treatment

• Doctors may refuse treatment to abusive, unruly, or violent patients and relatives.
• Such patients should be referred for further treatment elsewhere

Use of social media by doctors

• Doctors may provide information or make announcements online, but the information should be verifiable and not mislead people.
• The doctors have been asked not to discuss the specifics of the treatment of their patients or post their scans online.
• Doctors have also been asked to refrain from sharing testimonials by patients or images and videos of cured patients.
• No doctor can deny birth control measures or abortions due based on religious beliefs.
• The guideline also forbids doctors from “purchasing” likes, followers, or any fees to boost their profile on search algorithms.
• Doctors should not participate in telemedicine platforms that provide ratings, reviews, and promotions of certain doctors by any means.

Prescriptions 

• Doctors have been asked to write prescriptions in legible, capital letters.
• Doctors have been asked to prescribe only generic medicines, except for cases where medicines have a narrow therapeutic index – drugs where a small difference in dosage may lead to adverse outcomes – and other exceptional cases.

Telemedicine guidelines also list the type of drugs by the type of consultation provided. For example,

• list O, with over-the-counter medicines such as cough suppressants, some pain medicines, and antacids among others, can be prescribed for any kind of online consultation whether through messages, telephone calls, or video calls.
• List A are drugs that can be prescribed only after a video consultation.
• List B are drugs that can be prescribed after any type of consultation but only for follow-up patients.

Continuous Professional Development (CPD)

• The guidelines say that with constantly evolving medical practices, new diseases emerging like Covid-19, new technologies coming in, along with a more aware patient base means that doctors must keep re-training.
• Doctors should have studied 30 credit points in their relevant fields at the time of renewal of their license every five years.
• The doctors have been asked to undertake these sessions every year, ideally for six credits a year but at least three credits.
• Not more than 50% of this training should be online.
• Even professors at medical college hospitals have to undergo such training despite staying in touch with academics.

There are several issues with prescribing generic medicines.

• First, medical stores generally do not stock them because the profit margins are narrow for generics. This would mean my patients will have to go from shop to shop looking for these medicines that might cost just Rs 50, not a big spend for people going to private clinics and hospitals.
• Second, if the generic version is not available then the responsibility of substitution is then shifted to pharmacists. This would promote only the brands that have good profit margins.
• Third, the quality of all generic medicine is not the same.

Importance of guidelines

• The previous guidelines are from a time when social media was not prevalent. Now, doctors are on social media platforms discussing developments in their field, sharing knowledge, or putting out educational material. All of this is still allowed but the new guidelines ensure that a patient’s privacy is not violated, and their scans do not end up online. This was much needed.
• The guidelines are progressive and are looking out for patient privacy.
• For the first time, the regulator has made it mandatory for doctors to continue to learn throughout their active years.
• Issue of high prices of drugs due to None being -prescription of generic drugs would be addressed.

Conclusion

• Guidelines should clarify whether this point in the guidelines is a must or suggested. Rather than urging doctors to prescribe generics, the government should promote the manufacturing of generics alone.

PRACTICE QUESTION Q. The recent National Medical Commission (NMC) guidelines for the professional conduct of registered doctors of modern medicine will have a far reaching impact on the reducing out of pocket expenditure on health, maintaining ethical standards of doctors. Critically evaluate.( 250 words)

https://indianexpress.com/article/explained/explained-health/doctors-new-national-medical-commission-guidelines-8890632/