Be fair and open, NMC tells doctors in conduct review

The National Medical Commission (NMC) has undertaken a detailed set of professional conduct reviews for medical professionals, advising them to have “fair and open” communication with patients.

NMC said most complaints against doctors can be put down to communication gaps. In the case of alleged medical negligence, doctors have been advised to prepare proper documentation of all medical records of the patient.

Physicians have also been restricted from using titles such as ‘specialists’ if they don’t have a proper degree or skills.

Dr Yogender Malik, a member of the ethics and medical registration board said, “We have reviewed real life case studies of patient-doctor relationship and issues pertaining to it, professional errors and their consequences.

NMC has been hearing cases of misconduct and passing judgments and the need was felt to disseminate the learning from the complaints against doctors. We have tried to collate valuable lessons to both the stakeholders, particularly medical practitioners. The aim is to create awareness, mitigate professional faults, safeguard patients from potential ethical lapses.”

For most patients it is difficult to distinguish between ethics, conduct and negligence.

“Patients expect the same doctor to be available in the hospital 24x7, especially in a corporate set-up. They don’t understand duty shifts of the doctors and a new problem is fixing responsibility when a patient is treated by a team of doctors. Patients think that a doctor may attend only for consultation and will not take the responsibility for the rest of the treatment protocol. So, we have tried to address all these issues,” said Dr Malik.

A medical practitioner would be liable only when his conduct falls below that of the standards of a reasonably competent practitioner in his field, NMC in its directions to doctors and advised them to avoid making negative statements to patients about clinical judgments and procedures performed by professional colleagues.

Additionally, while transferring emergency patients, NMC has said that it is the duty of treating doctor to ensure that the referral hospital is informed, and the patient is received at the referral hospital with proper documentation.

In the case, Medical Termination of Pregnancy Act 1971, there should be compliance with the law even in emergency situations. Hospitals are required to be registered under the MTP Act, procedures to be done by a qualified specialist and requisite signed consent should be taken from the patient or her husband or next of kin in case the woman is unable to give consent.

In a surgery like Hysterotomy, there should be a separate general anesthesia consent form that ensures the patient understands the risks and type of anesthesia planned and should carry the name and signature of the anesthetist, in addition to the name and signature of the patient.

To address the issue of overcharging by hospitals, the NMC has said that allegations of financial irregularities are outside its jurisdiction regulator, however overcharging is unethical, and doctors should avoid such practice.