Doctors can now refuse treatment to abusive, violent patients: NMC

New Delhi [India]: Taking a major step toward curbing the ongoing instances of violence against doctors, the National Medical Commission Registered Medical Practioner (RMP) (Professional Conduct) Regulations, 2023 official notification said that the doctors can now refuse to treat “abusive, unruly, and violent patients or relatives”.

“The RMP who attends to the patient will be fully accountable for his actions and entitled to the appropriate fees. In case of abusive, unruly, and violent patients or relatives, the RMP can document and report the behavior and refuse to treat the patient.

Such patients should be referred for further treatment elsewhere,” the notification mentioned under the duties of RMPs towards their patients said.

These new regulations will replace the Medical Council of India’s (MCI) Code of Medical Ethics 2002. This is for the first time when doctors will have the right of refusal of patient treatment to the unruly and violent patients. The move is aimed at discouraging violence against doctors.

“RMP is free to choose whom he will serve, except in case of a life-threatening emergency. Having accepted a case, the RMP should neither neglect the patient nor withdraw from the case without giving adequate notice to the patient and his family.

If a change of RMP is needed (for example, the patient needs a procedure done by another RMP), consent should be obtained from the patient himself or the guardian.

The RMP who attends to the patient will be fully accountable for his actions and entitled to the appropriate fees,” the notification stated.

It’s also mentioned in the notification under duties of RMPs towards the public and allied healthcare professionals that doctors can’t receive any gifts, travel facilities etc from pharmaceutical companies.

“RMPs and their families must not receive any gifts, travel facilities, hospitality, cash or monetary grants, consultancy fee or honorariums, or access to entertainment or recreation from pharmaceutical companies or their representatives, commercial healthcare establishments, medical device companies, or corporate hospitals under any pretext,” it said.

However, this does not include salaries and benefits that RMPs may receive as employees of these organisations, the regulations stated.

Further, the regulations said, RMPs should not be involved in any third-party educational activity like CPD, seminar, workshop, symposia, conference, etc., which involves direct or indirect sponsorships from pharmaceutical companies or the allied health sector.

Under Right to remuneration of RMP it’s mentioned in the notification that the consultation fees should be made known to the patient before examination or treatment of the patient.
“A reasonable estimation of the cost of surgery or treatment should be provided to the patient

to enable an informed decision. RMP can refuse to treat or to continue to treat a patient if the fees, as indicated, are not paid,” it said.