The proliferation of websites and mobile apps that connect patients with doctors has yet again raised questions about the ethics of the practice.
In August last year, the Indian Medical Association had sought clear-cut guidelines from the Medical Council of India (MCI) on the issue of telephonic medication and online consultations, while observing that the practice is illegal and unethical.
Now, the Karnataka Medical Council (KMC) has advised doctors against engaging in online consultations stating that it runs contrary to the regulatory body’s code of ethics. “Such consultations are detrimental to both patients as well as the doctor and may lead to many complications, which is nothing but playing with the life of a patient. The KMC can even go to the extent of initiating action (including cancellation of registration) against doctors who take up online consultations,” Veerabhadrappa H., KMC president, told The Hindu .
According to the 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.
The KMC’s opinion comes in the wake of a compliant filed by the Bangalore Dermatological Society (BDS) on an advertisement published in a newspaper by a tech health services company inviting doctors to join their panel of online consultants.
Cautioning doctors of legal consequences in the consumer fora too if the treatment goes wrong, Mr. Veerabhadrappa said: “Our opinion on online consultations holds good for all specialities and not just dermatology.”
Long-term effects
Taking strong exception to such advertisements and open invitations to doctors, the society wrote to the KMC in June, 2018, asking its opinion on the legality of online consultations. “We are also concerned about its long-term effects on the profession of doctors as a whole. We hope the KMC will guide us, with clear guidelines, with respect to the legal aspects of such online forums and companies,” stated the complaint.'
“Companies are approaching doctors to join their panel for a fee. The more a doctor pays, the bigger he is projected as the best doctor. In fact, many young doctors who are working in corporate hospitals, are being asked to provide online consultations. Some of them may not be able to withstand pressure by their seniors and hence, may suffer consequences,” said R. Raghunatha Reddy, president of BDS.
“A history of the ailment and clinical examination is needed to prescribe any medication. Ethically, a doctor can prescribe medicine or advise treatment only upon physically seeing a patient and so, telephonic and online consultation is unethical,” he said.
‘Wrong diagnosis’
BDS secretary Jagadish P. said there is always a possibility of allegations and finding negligence on the part of the doctor by the legal fora. “At the same time, it is detrimental for patients too as online consultation may end up with a wrong diagnosis. They can also develop complications as many medicines may have side effects,” he said.
Pointing out that marketing on the internet and advertising is not permitted in the medical profession, Mr. Jagadish said there cannot be a substitute for face-to-face consultation and physical examination of the patient.
