'No more sponsored lavish dinners, cocktail parties for doctors': NMC lays down new guidelines

Medical conferences held at luxurious hotels with lavish dinners and cultural festivities might soon become a thing of the past due to new rules from the National Medical Commission. These regulations prohibit doctors from participating in any seminars, workshops, or conferences that receive sponsorships, either directly or indirectly, from pharmaceutical companies or the allied health sector. Breaching these regulations could result in the suspension of a doctor’s license for a period of three months. Section 35 of these fresh professional conduct guidelines also prevents doctors and their families from receiving consultancy fees or honorariums from pharmaceutical companies or their representatives. Additionally, these rules extend to encompass “commercial healthcare establishments, medical device companies, or corporate hospitals under any pretext,” prohibiting doctors from accepting fees or honorariums from such entities. In the past, during the era of the former Medical Council of India (MCI), a provision was in place that forbade doctors and their families from accepting gifts, travel arrangements, or hospitality from companies. However, companies found a workaround by forming contracts with doctors, compensating them for delivering lectures, conducting workshops, or being part of their boards. Doctors would then declare the income from these honorariums and consultancies. Corporate hospitals also engaged in similar practices, contracting doctors to attract patients and compensating them under the guise of ‘facilitation fees’. This allowed many doctors to earn more than their regular salaries through these consultancy deals with pharmaceutical and medical device companies, as well as through these ‘facilitation’ payments. The new regulations seem to have closed this loophole. According to the new rules, doctors can only receive remuneration from these commercial entities in the form of salaries and employment benefits. This tightens the grip on potential conflicts of interest. In January 2010, the MCI had similarly prohibited doctors from accepting gifts from pharmaceutical companies. However, facing strong opposition from doctors, the regulations were later softened to permit gifts valued up to Rs 1,000. Furthermore, restrictions on travel were relaxed by stating that doctors couldn’t accept travel support to conferences, seminars, or workshops “as attendees”. Consequently, many doctors were designated as faculty members rather than delegates to secure travel funding. It remains to be seen if these seemingly stringent regulations will be subject to future dilution, as was the case with previous rules. The new guidelines emphasize that doctors must be conscious of potential conflicts of interest, especially in situations like clinical drug trials. They stress that the nature of these relationships should be publicly disclosed, complying with existing laws and regulations. These revised regulations have been hailed as an improvement over the previous MCI guidelines in deterring doctors from receiving improper incentives or bribes from pharmaceutical and commercial entities. The rules aim to address a loophole that allowed doctors to receive questionable payments via consultancy or honorarium channels. However, some critics find the regulations too concise, urging for more comprehensive provisions. Malini Aisola from the All-India Drug Action Network was quoted in a report saying, “The regulations should have offered more detailed insights into how various aspects would be handled. The section regarding disclosure of relationships lacks strength. Ideally, the regulations should outline how doctors are required to divulge details about their funding sources, the intent behind the funding, and the platforms where this information will be publicly accessible, preferably on a dedicated website or portal.