Month: July 2022

Proposed guidelines for Registered Medical Practitioners (2022) by the National Medical Council

Author – Dr Nalanda Singh (Medical Consultant, Intelehealth)

The draft document has been released in the public domain recently by National Medical Commission (NMC) regarding Professional Conduct Regulations (2022) which includes Telemedicine Practice Guidelines for Registered Medical Practitioners (RMP). This will serve as a set of self-regulatory guidelines for the RMP to practice medicine both physical and remote teleconsultations, and commitment to patients, society, and professional colleagues.


Prefix, Suffix, and Modern Medicine:

  • Only those RMPs who are registered under NMC Act, 2019, can use Medical

Doctor (Med Dr.) as a prefix before their names

  • Only NMC recognized medical degree/ diploma as a suffix

  • All RMPs, employed or self-employed should display the unique registration number below the RMPs’ signatures

  • RMPs are allowed to practice only one system of medicine.

  • RMPs need to be involved in public education & awareness activities without involving advertisement.


Prescribing Generic Medicine:

  • Every RMP is expected to prescribe drugs using “generic”/“non-proprietary”/“pharmacological” names only.

  • Encourage patients to purchase drugs from Jan Aushadhi Kendras.

  • To avoid misinterpretation prescriptions should preferably be written in capital/ typed and printed.


Continuing Professional Development (CPD):

  • 30 credit hours required every 5 years, to be updated online regularly by

receiving training from recognized medical colleges, health institutions or medical societies.




  • Guidelines reflect relevant professional as well as social expectations from


  • Must not refuse to treat a patient in case of a medical emergency, nor

discriminate based on gender, religion, caste, or economic grounds.

  • In case of abusive, unruly violent patients or relatives, the RMP can document, report, and refer the patient.

  • When an epidemic occurs, an RMP with all necessary medical protection and his own health permitting should not abandon his/her duty for the fear of contracting the disease him/herself.

  • Should not engage in endorsement or promotion of any drug, or medical product.

  • RMP & their families must not receive any gifts/travel facilities/ hospitality /cash/ monetary grants.

  • Inclusion of Declaration of Geneva 2017 called ‘The Physician’s Pledge’.




  • Strict and detailed penalties have been enumerated for uniformity across the country in the assessment of liabilities and award of disciplinary actions in case of professional misconduct.

  • The disciplinary actions mentioned are – Reformation, Temporary suspension of license to practice, which can range from 1 month to 3 years.
    Debarring the RMP will depend on the level (severity) of misconduct proved.

Digitization of Medical Records:


  • Every self-employed RMP shall maintain medical records of all patients for 3 years from the date of the last contact with the patient. This should be done within 3 years of publication of the official gazette.


  • Before performing any clinical procedure, or operation, the RMP should obtain the documented informed consent of the patient. In case the patient is unable to give consent, the consent of the legal guardian or family member must be taken.

  • In an operation that may result in sterility, the consent of both husband and wife is required.

  • In-vitro fertilization or artificial insemination shall be undertaken only after informed written consent from the female patient, spouse, and the donor.

  • A RMP shall not publish photographs or case reports of patients without their permission in a manner by which their identity could be revealed.

  • For the use of patient data in academic teaching or clinical case discussions, patient consent is required. Under no circumstances will the patient’s data be posted on social media.

Social media conduct:

  • RMP can provide factually verified information/ announcements on social media.

  • Should avoid discussing treatment or prescribing medicines and soliciting patients on social media




  • Principles of medical ethics that are mandatory for the profession must also be respected in the practice of telemedicine.

  • A RMP is eligible to provide telemedicine consultations from any part of India and should be familiar with guidelines, processes, and limitations of telemedicine practice, hence they need to undergo CPD training on the same.

  • Teleconsultations should not be anonymous, the patient and RMP should know each other’s identities.

  • In the case of a minor patient, teleconsultation should proceed only in the presence of a parent/legal guardian.

  • Patient confidentiality, privacy, and data integrity should not be compromised.

  • Mandatory consent.

  • Telemedicine Application types-


  1. Mode of communication – video, audio, text

  2. Timing of the information transmitted – real-time, asynchronous

  3. Purpose of the consultation – nonemergency (first consultation & follow up), emergency (first aid, counseling, referral)

  4. Interaction between individuals involved – patient to RMP, caregiver to RMP, RMP to RMP, health worker to RMP.

  • Patient management-

  1. Health education- related to health promotion & prevention

  2. Counseling- specific advice related to underlying condition

  3. Medicines- can prescribe any drug except schedule X drugs

Guidelines for technology platforms enabling telemedicine:

  • RMPs must not participate in telemedicine platforms that provide ratings by the patient or others including reviews, advertisements, and promotions of RMPs by any means (manipulation of algorithms/search engines).

  • Technology platforms providing telemedicine services are obligated to ensure that consulting RMPs are duly registered.

  • The platform must provide the name, qualifications, registration number, and contact details of every RMP.

  • In case of non-compliance with guidelines/ existing laws applicable to the

provision of services, appropriate legal action can be initiated against the


  • Artificial intelligence/ machine learning is not allowed to counsel the patients or prescribe any drugs but can assist and support the RMP on

evaluation, diagnosis, or management.

  • Technology platforms must ensure a proper grievance redressal mechanism for end-users of their services.

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Quality Assurance Mechanism

Author : Dr. Shilpa Bhatte (Chief Program Officer – Global Lead, Intelehealth)

Telemedicine is the remote diagnosis and treatment of patients using telecommunications technology. 

It is a reasonably new medium for providing and seeking healthcare services due to its sudden thrust into the limelight during the COVID-19 pandemic. As healthcare providers, we are still in the process of understanding and exploring how these services can be optimized and made effective and efficient to suit patients’ needs while also inculcating a sense of trust in the medium through which the advice is provided. 

At Intelehealth, we believe that healthcare providers will need ongoing user support and troubleshooting with tech-related issues to adapt to a new medium and will require support to deliver healthcare advice effectively.


To support our healthcare providers and standardize their skills – we maintain a rigorous quality assurance mechanism for our helplines and telemedicine platforms. Specifically, with helplines, we do a thorough and ongoing medical audit of a few core areas, such as: 

  1. Communication skills 
  2. Quality of the advice/information provided 

The clinical team conducts the audit based on details recorded on the app and given to them. But they can contact the concerned backend doctor/s, frontline health worker/s, or patient/s for further understanding.

With communication skills, our focus is to emphasize the need to engage the patients with empathy and compassion, understand their symptoms and ask relevant questions to understand the morbidity better. 

  • Introduction: Stating who you are and the organization/government you are calling on behalf of is extremely important, along with the reason for the call – it can be disorienting to a person/patient if they do not understand who you are and the nature of the call
  • Using speech effectively: Speaking slowly is essential, and so is pronouncing words well. Maintaining a calm tone is important, and mumbling or speaking fast may have a counter-effect in the person not being interested in the consultation. One has to also quickly assess if they can hear your questions satisfactorily and can respond accordingly.
  • Language: It is essential to adjust the language according to the listener/patient, optimizing their engagement and responses. It is also vital to always be respectful and empathetic in your questions
  • Minimize use of medical language: Health providers assume that patients will understand the nature of the morbidity under question. This may not always be true. Hence use descriptive language to explain the color, shape, size, etc.
  • Script: Having a written down prompt sheet is extremely important to ensure all the points that need to be covered are completed. This ensures that the call was efficient in receiving information from the patient in case the conversation drifts and hence helps bring back focus to the subject under scrutiny.
  • Listen well: Communication is about speaking and active listening, which shows the person/patient that you are paying attention to what they are saying.
  • Summarizing: Repeating important information/instructions on prescription helps ensure that the advice provided was well received and understood. Note down a follow-up schedule if required or pertinent 

While assessing the quality of advice/information provided by the health provider, our focus is to evaluate: 

  • Ensure that evidence-based information is provided to the patients
  • Updated information based on local government guidelines is provided
  • Wherever possible – holistic information on preventative, curative, and/or treatment plans is shared with patients 
  • Treatment standards are applied to ensure that all patients receive appropriate care regardless of financial means

Overall the Medical audit includes the vetting of the following parameters: 

  • Registration: Process, Completeness, Closure of visit
  • Demographic details
  • Consent
  • Case history: Completeness of information by matching with an appropriate mind map and checking for ambiguity in the information given in the recording versus that registered on the app
  • Issues about past, family history, etc
  • Issues about measuring and registering vitals: Registering vitals, the correctness of values
  • Issues about physical examination including complete assessment: Diagnosis, investigations, prescription, follow-up, referral 
  • Turnaround time – TAT: time-lapse between upload of the case and a prescription issued
  • Time-lapse between consultation by backend doctors and patients receiving prescription
  • Patient outcome
  • Tech-related issues: app or user-related issues
  • Doctor patient communication 
  • Quality of advice and information provided

The quality assurance process is a fact-finding process rather than a fault-finding endeavor to provide regular feedback to the health providers to build their capacity to provide effective and efficient teleconsultations. This, in turn, has a virtuous effect on the trust-building process between patients and telehealth providers and increases the robustness of the telemedicine platform.  

Dr. Gulhan Abdullaevna at Razzakov city headquarters checking the doctors web page at Batken, Kyrgyzstan
Renu Kumari, Community Health Officer using eSanjeevani app at Dorma Health & Wellness Centre, Khunti district, Jharkhand
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