Healthcare

<p style="text-align: justify;">India is an Emerging and Developing Country (EDC) and is one of the world's fastest-growing economies. As a developing nation, India has high expectations for its healthcare industry and for medical tourism.</p><p style="text-align: justify;">The government does support its growing private healthcare sector. But the MCI (Medical Council of India) also maintains regulations barring physician and hospital advertising that are antiquated and anti-business when taken at face value.&nbsp;</p><p style="text-align: justify;">Doctors cannot print their photographs on letterheads and use elaborate signboards. Advertising is not allowed under the code of medical ethics of the MCI.&nbsp;</p><h2 style="text-align: justify;"><span style="font-size: 14pt;">Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002 for Advertising</span></h2><h3 style="text-align: justify;"><span style="font-size: 12pt;">Rule 6.1 under Chapter 6 explains about the Unethical Acts:</span></h3><p style="text-align: justify;">A physician shall not aid or abet or commit any of the following acts, which shall be interpreted as unethical:</p><ul><li style="text-align: justify;">Soliciting patients directly or indirectly by a physician, a group of physicians, institutions, or organizations is considered unethical.</li><li style="text-align: justify;">A physician shall not make use of his/her name as the subject of any form or manner of advertising or publicity through any mode either alone or in conjunction with others which can invite attention to him or his professional title, skill, qualification, achievements, attainments, specialties, appointments, associations, affiliations, or honors and/or of such character as would ordinarily result in his self-aggrandizement.</li><li style="text-align: justify;">A physician shall not give to any person, whether for compensation or otherwise, any approval, recommendation, endorsement, certificate, report, or statement concerning any drug, medicine, nostrum remedy, surgical or therapeutic article, apparatus or appliance, or any commercial product or article concerning any property, quality or use thereof or any test, demonstration or trial thereof, for use in connection with his name, signature, or photograph in any form or manner of advertising through any mode, nor shall he boast of cases, operations, cures or remedies or permit the publication of report thereof through any method.</li></ul><h3 style="text-align: justify;"><span style="font-size: 12pt;">Conditions when Advertising is Ethical&nbsp;</span></h3><p style="text-align: justify;">A medical practitioner is, however, allowed to make a formal announcement in the press regarding the following:</p><ul><li style="text-align: justify;">Starting the practice</li><li style="text-align: justify;">Changing the type of practice</li><li style="text-align: justify;">Change of address.</li><li style="text-align: justify;">Temporary absence from duty</li><li style="text-align: justify;">Resuming another practice</li><li style="text-align: justify;">Succeeding in another practice</li><li style="text-align: justify;">Public declaration of the charges</li></ul><p style="text-align: justify;">An institution managed by a doctor for a specific reason, such as a maternity home, nursing home, private hospital, rehabilitation center, or other forms of an educational institution, can be advertised specifying the institution's name, form of admitted patients, educational and other facilities provided and fees.</p><p style="text-align: justify;">A clinic should mention only the name, credentials, name of the medical college, name of the university, name of the specialty, and registration number of the state medical council.</p><p style="text-align: justify;">Printing self-photograph or any other marketing material on the letterhead or the signboard of the consulting room or any such clinical establishment shall be regarded as acts of self-advertisement and unethical conduct on the part of the physician. However, printing sketches, diagrams, and pictures of the human system shall not be considered unethical.</p><h3 style="text-align: justify;"><span style="font-size: 12pt;">Unethical Methods of Physician Advertising&nbsp;</span></h3><p style="text-align: justify;">Rule 7.11 and 7.12 under Chapter 7 explains Misconduct:</p><ul><li style="text-align: justify;">A physician should not contribute to the lay press articles nor should give interviews regarding any diseases and treatments which may be considered as advertising himself or soliciting practices; but is open to writing to the lay press under his own name on matters of public health, hygiene or deliver public lectures, give talks on the radio/TV/internet chat for the same purpose and send announcement of the same to the lay press.</li><li style="text-align: justify;">An institution run by a physician for a particular purpose, such as a maternity home, nursing home, private hospital, rehabilitation center, or any training institution, etc., may be advertised in the lay press. Still, such advertisements should not contain anything more than the institution's name, type of patients admitted, training and other facilities offered, and the fees.</li></ul><h3 style="text-align: justify;"><span style="font-size: 12pt;">Medical Regulations for Physicians</span></h3><p style="text-align: justify;">Rule 1.9 under Chapter 1 chains Evasion of Legal Restrictions:</p><p style="text-align: justify;">The physician should observe the country's laws regulating medical practice and shall not assist others in evading such laws. He should be cooperative in observing and enforcing sanitary laws and regulations in the interest of public health.</p><p style="text-align: justify;">A physician should observe the provisions of the State Acts like the following:</p><ul><li style="text-align: justify;">Drugs and Cosmetics Act, 1940</li><li style="text-align: justify;">Pharmacy Act, 1948</li><li style="text-align: justify;">Narcotic Drugs and Psychotropic Substances Act, 1985</li><li style="text-align: justify;">Medical Termination of Pregnancy Act, 1971</li><li style="text-align: justify;">Transplantation of Human Organs Act, 1994</li><li style="text-align: justify;">Mental Health Act, 1987</li><li style="text-align: justify;">Environmental Protection Act, 1986</li><li style="text-align: justify;">Prenatal Sex Determination Test Act, 1994</li><li style="text-align: justify;">Drugs and Magic Remedies (Objectionable Advertisement) Act, 1954</li><li style="text-align: justify;">Persons with Disabilities (Equal Opportunities and Full Participation) Act, 1995</li><li style="text-align: justify;">Bio-Medical Waste (Management and Handling) Rules, 1998</li></ul><h2><span style="font-size: 14pt;">Medical Regulations Regarding Advertising&nbsp;</span></h2><p style="text-align: justify;">Apart from those mentioned above, the physician should also observe other acts, rules and regulations made by the central/state governments or local administrative bodies, or any other relevant acts relating to protecting and promoting public health.</p><p style="text-align: justify;">According to the Drugs and Magic Remedies Act 1954, advertisements by doctors are prohibited in any medium. According to the Medical Council of India, a doctor cannot make any form of promises or advertisements of 'guaranteed treatment' according to the Code of Ethics.</p><p style="text-align: justify;">"No doctor can make high claims about any procedure."</p><p style="text-align: justify;">In August 2016, the Indian Medical Association issued a Press Release with a strict warning to disallow all forms of advertisements on expertise in medicine. They violate the Medical Council of India (MCI) Code of Ethics Regulations, 2002, and the Drugs and Magic Remedies (Objectionable Advertisements) Act, 1954.</p><h2 style="text-align: justify;"><span style="font-size: 14pt;">Online Advertising</span></h2><p style="text-align: justify;">While searching online, there are bound to be mentions of healthcare professionals, most of which is user-generated content &amp; reviews. Just as people check online before buying a product, in the same way, people check out for doctors in an area or a specialty and check what other people say.&nbsp;</p><p style="text-align: justify;">So, it is not entirely incorrect to opt for a listing or provide quotes as an influencer to the press. One cannot escape the information age. These days there are two ways people choose doctor referrals from people and online searches. And with increasing super-specialties, people must identify and make informed decisions.</p><p style="text-align: justify;">Considering the changing dynamics, the MCI should consider redrafting the code to bring more clarity. Many doctors have a presence on social media platforms where they can educate and update patients in real-time. Now, this is relationship building that should not be considered unethical. Many such issues need to be clarified.</p><p style="text-align: justify;"><span style="font-size: 10pt;"><em>This <a href="https://www.linkedin.com/pulse/advertising-regulations-physicians-india-sujeet-katiyar/">article </a>was contributed by our expert Sujeet Katiyar</em></span></p><p style="text-align: justify;">&nbsp;</p><h3 style="text-align: justify;"><span style="font-size: 18pt;">Frequently Asked Questions Answered by Sujeet Katiyar</span></h3><h2><span style="font-size: 12pt;">1. What are the legal concerns about physician advertising?</span></h2><p style="text-align: justify;">As per the Professional Conduct, Etiquette and Ethics Regulations notification clause 6.1.1 of the Medical Council of India, it is a misconduct for RMPs to advertise themselves, their practice, qualifications, associations, affiliations, honors, and skills in order to solicit patients and professional gain (except for formal announcement for a short period as exempted in the said clause), the circular said.&nbsp;</p><p style="text-align: justify;">The circular noted that online advertisements on websites promoting such activity commercially would be considered a misconduct and would attract appropriate action by the State Medical Council. The display of photographs is also not permissible.</p><h2 style="text-align: justify;"><span style="font-size: 12pt;">2. What are some of the ethical issues in advertising by physicians?</span></h2><p style="text-align: justify;">Medical Council of India Code of Ethics regarding advertising, which is applicable to doctors in our country. These are classified under &ldquo;Unethical practices&rdquo; in their code of conduct, and is punishable by a fine, being debarred from practicing medicine, and/or imprisonment.</p><p style="text-align: justify;">A physician shall not make use of him / her (or his / her name) as subject of any form or manner of advertising or publicity through any mode. either alone or in conjunction with others which is of such a character as to invite attention to him or to his professional position, skill, qualification, achievements, attainments, specialties, appointments, associations, affiliations, or honors and/or of such character as would ordinarily result in his self-aggrandizement.</p><p style="text-align: justify;">A physician shall not give to any person, whether for compensation or otherwise, any approval...for use in connection with his name, signature, or photograph in any form or manner of advertising through any mode nor shall he boast of cases, operations, cures or remedies or permit the publication of report thereof through any mode.&rdquo;&nbsp;</p><h2 style="text-align: justify;"><span style="font-size: 12pt;">3. What are the principle objectives of the Code Of Medical Ethics Regulations, 2002?&nbsp;</span></h2><p style="text-align: justify;">Autonomy, non-maleficence, beneficence and justice - have been extremely influential in the field of medical ethics and are fundamental for understanding the current approach to ethical assessment in health care. This study tests whether these principles can be quantitatively measured on an individual level, and then subsequently if they are used in the decision-making process when individuals are faced with ethical dilemmas.</p><p style="text-align: justify;">&nbsp;</p>