The National Medical Commission (NMC) is a statutory body, established in 2019, which replaced the Medical Council of India (MCI). It operates under the National Medical Commission Act, 2019 and functions as the regulatory body for medical education in India. The NMC’s mission is to ensure ample supply of high-quality medical professionals across the country, promote equitable and universal healthcare and uphold high ethical standards in all medical services.
The NMC Guidelines
Recently, the NMC issued new professional conduct guidelines for doctors. Among them, guidelines on social media usage were outlined, dictating that doctors ensure the information they provide online is verifiable and not misleading.
Another major guideline pertained to the right to refuse treatment. Doctors can deny treatment to abusive, unruly, or violent patients and their relatives.
However, one of the most contentious guidelines was related to prescription and medication. This guideline requires doctors to prescribe generic medicines, barring certain specific cases. The guideline stressed on judicious use of fixed-dose combinations, prescribing only approved combinations.
The continuous professional development (CPD) guidelines require doctors to continue learning throughout their active years, compel them to earn 30 credit points every five years in their relevant fields, among other regulations.
The final set of guidelines centered around conference participation, indicating that educational sessions or conferences cannot be sponsored by pharmaceutical companies, among other restrictions.
Response to the NMC Guidelines
The Indian Medical Association (IMA), the largest body of doctors in India, has voiced its opposition to these guidelines, finding them “unscientific” and “impractical”. One of the primary concerns raised was about the quality and efficacy of generic drugs in India.
Doctors argue that many of these generic drugs are substandard, spurious, or counterfeit. With less than 0.1% of drugs manufactured in India tested for quality, doctors fear that prescribing such drugs without certainty of their quality could not only jeopardize patient care but also expose them to legal and ethical risks.
Some other issues brought up by the IMA are the additional burden on doctors to accumulate credit points through CPD sessions, reduced educational opportunities due to prohibition of pharmaceutical industry sponsorships, and the increased administrative burden from adherence to the extensive new guidelines.
The Way Forward
To address these concerns, a multi-faceted approach is needed. The quality and safety of generic drugs must be improved through the establishment of more testing labs, regular inspections, strict penalties, and a national database for drug quality.
Patients and doctors both need education about the pros and cons of generic drugs, using scientific evidence to dispel myths and promote rational medication practices.
Medical institutions and professional bodies should organize regular CPD sessions that cover a range of medical advancements. Furthermore, open conversations and consultations between the NMC, medical practitioners, pharmaceutical industry representatives, and patient advocacy groups are encouraged, to refine and adapt the guidelines to address emerging challenges and ensure ethical patient care.
