New Delhi: With a number of websites and mobile apps coming up to connect patients with doctors, the question of ethics has risen up since such online/mobile programmes may divert patients from one doctor to another and charge a fee from doctors for providing their services, which is unethical.
According to the Medical Council of India (MCI) Code of Ethics Regulations, 2002, soliciting of patients directly or indirectly, by a physician, by a group of physicians or by institutions or organisations is unethical.
Dr K K Aggarwal, honorary secretary general, Indian Medical Association (IMA), told India Medical Times, “The real world rules also apply to the digital world. For example, I cannot be paid for referring a patient, as it is not allowed. If anybody sends me a patient for money, that is not allowed. Marketing on the internet as well as advertising is not permitted in the medical profession.”
Saurabh Arora, CEO of Lybrate, believes health portals empower patients to get the right advice at the right time and allow doctors to touch more lives and help them with their extensive knowledge. Lybrate runs a mobile-based healthcare platform that connects doctors and patients through its health app.
“We don’t charge any fee to doctors when patients view doctors and book appointment with them. Neither there’s any fee charged to doctors to list their credentials on the site,” Arora told IMT. “Doctors cannot pay to promote themselves. In fact, we exist to ensure patients get unbiased healthcare information.”
“The smartphone based services like Lybrate do have a certain utility but the company and the doctors must make sure to proceed in such a manner as to avoid legal liability,” New Delhi based Medico-Legal consultant Dr M C Gupta told IMT.
Dr Gupta said, “A single death or mishap, allegedly due to negligence attributed by the court to the service providing company and the doctor concerned can be sufficient to cause devastating damages to both. The example of Uber, where rape by a taxi driver of Uber in India led to severe penal action against Uber, should not be forgotten.”
In a recent communication with doctors, Lybrate said: “Your patients personally cannot visit you but send you medical questions, diagnostic reports and their current status and you could counsel them instantly with the same accuracy as you do face to face. The open question services are free of cost while there is a subscription charge for private question services.”
“Such a claim made by a doctor or by the company with which the doctor associates itself is a false claim because there cannot be a substitute for actual face to face consultation and actual physical examination of the patient. Anybody who says that these can be dispensed with and induces patients to pay fee for such consultation is acting knowingly falsely and fraudulently and may be liable in law, including the Consumer Protection Act (CPA) – 1986 and the MCI Regulations – 2002,” said Dr Gupta.
According to Dr Aggarwal, IMA is preparing a code of ethics for doctors that would define the profession’s ethics on online activities. Under the code, soliciting patients through websites, paying fees to agents that host such portals and doctors boasting of achievements in the social media would be dubbed unethical. “Some of the digital code of conduct has already been passed,” he said.
As per Arora, patients should have easy access to relevant and timely healthcare information so that they could take an informed decision about their health. Health portals which seek to connect patients with doctors online and through mobile only help facilitate this.
“Any ethics framework to govern online activities of doctors should ultimately help people with increased access to healthcare, and with providing information for better decisions,” concluded Arora.
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