NMC brings doctors’ digital patient acquisition under ethics rules

The National Medical Commission (NMC) has brought the promotion of doctors and hospitals and how they attract patients online under the ambit of medical ethics, prohibiting paid rankings, fake reviews, referral fees, misleading claims and the use of artificial intelligence (AI) to create or manipulate patient testimonials.The Ethics and Medical Registration Board’s Guidelines on Ethical Advertising and Public Communication by Hospitals/Medical Institutions and Registered Medical Practitioners, issued on October 6, apply to communication through websites, social media, messaging platforms, podcasts, sponsored content, influencers and online platforms. The guidelines have come into effect immediately.The guidelines prohibit registered medical practitioners (RMPs) and hospitals from making claims such as “best”, “No. 1”, “leading”, “most trusted”, “top” or “unmatched”, unless these can be objectively verified through a transparent and independently ascertainable methodology. Any ranking or award used in advertising must also be independently verifiable, with relevant details disclosed where necessary to prevent the public from being misled.Online promotion targetedThe NMC has specifically addressed online promotion. RMPs and hospitals cannot procure or manipulate fake followers, likes, reviews, ratings, testimonials, comments, views or other digital engagement. They cannot manipulate search rankings, visibility or algorithms to create a misleading impression of their professional standing.The guidelines also target financial incentives for bringing in patients. An RMP cannot offer, pay, solicit or receive a commission, rebate, bonus, gift, gratuity, referral fee, lead-generation fee or other consideration connected with the referral, recommendation or procurement of patients, specimens or materials for diagnosis or treatment.Advertising agencies, digital marketing agencies, influencers and online platforms cannot be engaged in a manner in which payment is linked to the procurement or referral of individual patients.On patient testimonialsPatient testimonials have also come under specific restrictions. An RMP cannot use or permit a celebrity, influencer, patient, employee or other third party to promote professional services through prohibited testimonials, endorsements or recommendations. The guidelines also prohibit RMPs from requesting or sharing patient testimonials, recommendations, endorsements or reviews for professional promotion on social media.The guidelines prohibit the use of AI to create or manipulate patient testimonials and other promotional material in a manner that misrepresents treatment, outcomes or professional standing. The provisions also cover manipulation of patient images or voices and synthetic endorsements presented as though they came from actual patients or professionals.The NMC has also specified what doctors and hospitals can communicate. “Hospitals can provide factual information about their location, departments, facilities, equipment, emergency services, accreditation, services and fees. Doctors can provide factual professional information and participate in public-health and educational communication, provided it does not become prohibited promotion,” it said.Discounts, limited-period offers, contests, coupons, gifts, cashbacks, referral benefits and free procedures are also prohibited where they are likely to encourage unnecessary consultation, diagnostic investigation or treatment. Lawful disclosure of fees and packages can be made if it is factual, transparent and not misleading.The guidelines prescribe graded disciplinary action against RMPs. A first violation can attract a warning and mandatory ethics training; a second can result in censure and a monetary penalty; and a third can lead to suspension of registration for three to six months. Serious violations can attract suspension for six to 12 months, while repeated violations can result in removal from the medical register for one to three years.For hospitals and medical institutions, the applicable penalty and appellate mechanism under the Clinical Establishments Act or the relevant State law will apply. Where an RMP has authorised, participated in or endorsed prohibited communication, the doctor’s professional conduct can separately be examined by the appropriate medical regulatory authority.The guidelines have been issued in the context of a writ petition before the Supreme Court and the existing framework governing professional conduct.