July 4, 2019 0 By FM

A ction by the Indian Medical Association ‘s (IMA) Kerala Branch against advertisement by some corporate hospitals featuring doctors has once again brought the issue of violations of certain sections of the Code of Ethics to the fore.

The development comes after a hospital in Kerala published advertisements in newspapers featuring doctors who are practicing in the hospital along with their photographs and qualifications among others.

“We have received several complaints and there are mainly some complaints about a couple of hospitals,” said Dr N Sulphi, State Secretary, IMA Kerala State Branch. There are certain norms that are applicable to advertisements featuring doctors. The doctor on his/her own or through others cannot advertise with their photograph and professional qualifications and other details, which is a violation of the norms.

“There are several unhealthy trends that are going on and we have received complaints of such advertisements being published. We have issued a direction to our members that they should not participate in such advertisements,” he added.

Such violations of ethical code, reported in the past from various parts of the country, has to be addressed mainly through bringing awareness and follow-ups through the doctor community said experts.

There are instances where the doctor can advertise in such a way, especially when he or she starts to practice, shifts practice to another or going for leave, etc. Hospitals can advertise, but such advertisements should not display the photograph of the doctor and their claims or accolades.

As a preliminary step, the association will warn the doctors not to do such advertisements. It will take the next step after examining these issues in the IMA’s ethics committee for disciplinary action.


Code of ethics and violations

Section 6.1 of Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002 provides that soliciting of patients directly or indirectly, by a physician, by a group of physicians or by institutions or organizations is unethical.

The violation of the section was brought to the notice of the authorities a few years back by a medical practitioner, Dr K V Babu from Kannur, Kerala, who fought for years to make the authorities act against such violations. Later, action was taken against a group of doctors for the violation and their names were removed from the State Medical Register for 15 days as a punishment.

Earlier in December 2014, the Ministry of Health and Family Welfare has said that the Medical Council of India has also received two complaints with regard to advertisement of medical professionals in the year 2013-2014. These complaints were considered by the Ethics Committee of the MCI and were followed with strict action.

As per the announcement, the Ethics Committee (EC) considered a complaint letter dated May 17, 2013 received from Prof. Sri Ram Khanna, Department of Commerce, Delhi School of Economics, and the University of Delhi against advertisement given by doctors of Nova Orthopaedics & Spine Hospital, Nehru Enclave. On the directions of MCI, Chairman and Medical Superintendent of Nova Orthopaedic& Spine Hospital, Nehru Enclave appeared before the EC. He accepted responsibility for the release of the advertisement and expressed the view that it was ethically wrong. He tendered an unconditional apology and stated before the committee that they will be putting an advertisement to the newspaper for withdrawal of the advertisement. On submission of proof of withdrawal of advertisement published in the newspaper, the apology of the hospital was accepted by the EC. Accordingly, the matter was disposed of by MCI.

In another instance, the EC considered a newspaper clipping published in August, 2013 with regard to Saket City Hospital, New Delhi. The Medical Director of Saket City Hospital, Saket, New Delhi appeared before the Ethics Committee on behalf of Chairman. He apologized for the advertisement given in the newspaper and stated before the committee that they will be putting an advertisement to the newspaper for withdrawal of the advertisement. On submission of proof of withdrawal of advertisement published in the newspaper, the apology of the hospital was accepted by the EC. The matter was disposed of by MCI.

MCI has informed the Ministry that its EC considered a letter on May, 2014 from Secretary General, the Advertising Standards Council of India and decided that wherever possible the registration details of the doctors shown in the advertisement shall be obtained from the Indian Medical Register and the respective state medical councils to be asked to investigate and take necessary action in pursuance of the Medical Council (Professional Conduct, Etiquette & Ethics) Regulations, 2002 within a period of six months under intimation to the council.

The Advertising Standards Council of India (ASCI), Mumbai also had to be asked to send to MCI the state-wise list of doctors (only allopathic) registered with MCI/State Medical Councils to take necessary action in accordance with the Code of Medical Ethics. ASCI was to be advised to write to appropriate Law Enforcing Authorities of the Country to take suitable action against the fake doctors and their advertisements which is maligning the image of medical professionals. The decisions were also communicated to the ASCI through a letter in the same year, according to Union Health Minister J P Nadda.


Need to comply with regulation

Dr Sulphi said that as an association, IMA is communicating with its members on the need to comply with the regulation, as a matter of ethics.

Sources say that similar efforts are being taken by the other branches of the association. For instance, in 2016, the IMA has conducted a campaign to spread awareness among its 2.5 lakh members on the ethics to be maintained during advertising. Certain aspects have to be kept in mind while issuing an announcement, for instance about setting up of practice or shifting their practice. The advertisements, however, should not carry any claims or other elements that could potentially solicit a patient to them.

However, IMA is a professional organisation, and it can only take actions at its level. The regulatory actions have to come from the relevant medical councils and the Medical Council of India. If such practices are continued, the association will take action on the organisational level, removing their privileges and it will report to the councils about the violation, said Sulphi.