Doctors Can Refuse To Treat "Abusive" Patient: Medical Body

In a significant move to address the escalating incidents of violence against medical practitioners, the National Medical Commission (NMC) Registered Medical Practitioner (RMP) has introduced regulations allowing doctors to decline treatment to "abusive, unruly, and violent patients or relatives." This step aims to ensure the safety and well-being of medical professionals while discouraging acts of aggression.

The notification stipulates that the attending RMP will assume full responsibility for their actions and is entitled to appropriate fees for their services. In cases involving disruptive or aggressive behavior from patients or their relatives, the RMP is empowered to document and report the misconduct, ultimately having the discretion to refuse treatment. Such cases are recommended to be referred for alternative medical care.

"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 from 2002. This marks the first instance where doctors will have the prerogative to refuse treatment to unruly or violent patients, marking a significant step towards safeguarding the medical fraternity, as per a report in NDTV.

The notification emphasizes that an RMP is entitled to choose whom they will serve, with the exception of life-threatening emergencies. Once a case is accepted, the RMP is expected to fulfill their obligations to the patient, providing adequate notice before withdrawing from the case or transferring the patient's care to another practitioner. The accountability for their actions rests squarely with the attending RMP, who is also entitled to the appropriate fees for their services.

Furthermore, the regulations emphasize the ethical responsibilities of RMPs towards the public and other healthcare professionals. The directive explicitly prohibits doctors from accepting gifts, travel benefits, or other forms of hospitality from pharmaceutical companies or corporate healthcare entities. However, the prohibition does not extend to salaries and legitimate employment benefits received from these organizations.

Moreover, the regulations discourage RMPs from participating in third-party educational activities, such as seminars, workshops, or conferences, if they are sponsored directly or indirectly by pharmaceutical companies or the allied health sector.

The regulations also address the financial aspects of patient care. RMPs are required to disclose consultation fees prior to examination or treatment. They are encouraged to provide an estimated cost of surgery or treatment to enable patients to make informed decisions. The notification also underscores that RMPs have the right to refuse or discontinue treatment if the indicated fees are not paid.

These comprehensive regulations aim to promote a secure environment for medical professionals while upholding the principles of ethical medical practice. The regulations reflect a holistic approach to patient care, financial transparency, and the cultivation of a professional relationship built on mutual respect and responsibility.

Patient-Doctor Ratio In India

According to Union Minister of Health and Family Welfare Mansukh Mandaviya's statement in the Rajya Sabha on April 5, 2022, India's doctor-population ratio stands at 1:834, taking into account an assumed 80 percent availability of registered allopathic doctors and 565,000 Ayurvedic, Unani, Siddha, and homeopathic doctors.

As of November 2021, there are 1,301,319 registered allopathic doctors with state medical councils and the National Medical Commission. The country also has 289,000 registered dentists and approximately 1.3 million allied and healthcare professionals.

The Indian Nursing Council records indicate that there are 3.3 million registered nursing personnel, encompassing 2,340,501 registered nurses and midwives, as well as 1,000,805 nurse associates. Currently, the nurse-population ratio in India stands at 1.96 nurses per 1,000 population.

The Department of Health and Family Welfare has been consistently striving to augment public health spending. According to Minister of State Bharati Pravin Pawar, the budget allocation for the Department has escalated by 50.5 percent to Rs 71,269 crore in the fiscal year 2021-22, compared to Rs 47,353 crore in 2017-18. The budget estimate for the upcoming fiscal year, 2022-23, is Rs 83,000 crore.

Addressing the issue of tuberculosis (TB), Pawar disclosed that 4,320 deaths were attributed to TB in India in the previous year, a decrease from 5,417 deaths recorded in 2020. Notably, reported TB-related fatalities have remained relatively stable at around four percent over the last two years. These statistics highlight the ongoing efforts and challenges in India's healthcare sector, as the nation strives to enhance healthcare accessibility, provider availability, and disease management.

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