Mumbai: Hospitals face tighter advertising rules as NMC guidelines take effect

A week after the National Medical Commission NMC barred ldquoNo 1 specialistrdquo posts beforeandafter photos and AImade testimonials medical experts are weighing in on what the new advertising code means for patients and for the profession Many welcome the move Some are still reading the fine printThe guidelines in force since October 6 follow Writ Petition Civil No 11602023 in the Supreme Court and the 2002 Indian Medical Council ethics regulations They aim to make sure patients choose their doctors and hospitals on facts not on promises of miraclesLevel playing fieldFor Dr Santosh Kadam member of the Maharashtra State Medical Council Mumbai and past president of the Indian Medical Association Maharashtra the biggest change is who is coveredNow they have brought corporate hospitals also under the gambit and this is a level playing field for doctors small nursing homes and corporate hospitals he said noting that the rules apply across print broadcast websites social media influencers online platforms and AIgenerated or AIassisted content almost covering every sort of advertisementHospitals he pointed out can still share objective verifiable information Location and contact details Departments and facilities Emergency services and accreditation Lawful feesHe added that publichealth education and researchbased communication remain permitted but must stay nonpromotional Doctors may also make limited announcements such as starting or changing practice a change of address temporary absence resumption of practice or consultation chargesConsent extentDr Kadam said the rules draw a clear line on patient material Patient information and images cannot be used for advertising and consent does not legalise otherwise prohibited promotion The ban covers referral fees discounts meant to drive unnecessary care paid rankings fake reviews testimonials beforeandafter images celebrity promotion and manipulation of online engagement or search visibilityDr Indrajit Khandekar professor of forensic medicine at MGIMS Sevagram Wardha said the test is the patientrsquos interest ldquoPatients need reliable information not promises of miraclesrdquo he saidHe stressed that the guidelines allow factual communication while restricting misleading cure claims promotional testimonials and patient solicitation Doctors he said must protect patient privacy and remain responsible for authorised publicity even when an agency or influencer publishes it ldquoThe real test is whether communication helps patients make informed choices or exploits their vulnerability to generate more businessrdquoDr Khandekar has already initiated a training programme for doctors through various private practitioner associations and forums to familiarise them with the new guidelines and ensure complianceDr Santosh Kadam member of the Maharashtra State Medical Council Mumbai Mohini Priya advocate Dr Indrajit Khandekar professor of forensic medicine at MGIMS Sevagram WardhaThe cautious voiceDr Aruna Vanikar immediate past president of the UnderGraduate Medical Education Board UGMEB NMC said ldquoI am yet to go through the guidelines but I am of the view that there should be some ethics in medical practicerdquo she saidPatients should look forhellipCredentials Doctorsrsquo online posts must show name qualifications registration status and registration numberSuperlatives ldquoBestrdquo or ldquoleadingrdquo claims must be verifiable with any awardrsquos methodology date and awarding body disclosedReviews Doctors cannot seek or share patient testimonials and fake or paid reviews are barredBeforeandafter pictures Banned in promotion even with consent allowed only for scientific or educational use with anonymised consentDiscounts Coupons cashbacks and free procedures are barred if they could prompt unnecessary treatmentAI content Must carry a source mark and AI cannot create a patientrsquos image voice or outcomeWhere the guidelines are silentExperts say several questions remain openEnforcement Action ldquomay be contemplatedrdquo by State Medical Councils and the penalty amount is not specifiedExisting posts No word on whether current content must be removed or if there is a grace periodHospitals They fall under Clinical Establishments or state laws not the doctorsrsquo penalty ladder which runs from warning and ethics training to removal from the register for one to three yearsComplaints No patient complaint channel is set out though action rests with State Medical CouncilsPlatforms and agencies Healthcare platforms must avoid paid ranking of doctors but monitoring is unclear Doctors remain responsible for content they authorised or knowingly permittedPenalties and due processState Medical Councils may impose graded action on doctors a warning and ethics training for a first violation censure and a fine for a second and three to six monthsrsquo suspension for a third Serious violations such as misleading cure claims or mass digital solicitation can mean six to twelve monthsrsquo suspension repeat offences removal from the register for one to three yearsPenalties require a showcause notice and a reasoned order Doctors can appeal to the NMCrsquos Ethics and Medical Registration Board within 60 daysPetitioner speaksMohini Priya advocate on record Supreme Court for petitioner Dr Aniruddha Malpani who filed the 2023 PIL said ldquoWe welcome these guidelines Individual doctors faced strict advertising limits while corporate hospitals marketed identical services without equivalent accountability But the biggest limitation is enforceability The NMC Act regulates practitioners and guidelines cannot create powers the parent law does not confer These standards must be built into the Clinical Establishments Act and state laws or they remain advisoryrdquoDr Malpani said ldquoUnregulated advertising by commercial corporate hospitals has made life very difficult for patients because these hospitals can claim what they like and the worst thing is they can get away with it Even worse itrsquos created an uneven playing field these corporate hospitals which charge a lot of money are free to advertise whereas individual doctors who are in private practice who run small nursing homes or clinics and who provide far better compassionate communitybased healthcare do not have that same opportunity As a result wersquore seeing healthcare becoming increasingly corporatised impersonal and uncaring This is a step in the right direction but therersquos clearly a lot more work which needs to be donerdquopopcorn numberOct 6 descDay guidelines came into force classDefault