Explained: What do the National Medical Commission’s new guidelines say about advertising in medicine?

The story so far:

On October 6, the National Medical Commission (NMC) issued guidelines on advertising and public communication by doctors and hospitals. Intended to prevent the “commercialisation of health care”, they cover hospital hoardings, social media and artificial intelligence (AI). Beyond curbing deception, they raise another question regarding how much can doctors and hospitals say to the public about their work and achievements?

What is prohibited?

Claims of “guaranteed cures”, “100% success” or being the “best” are barred. Similarly, fake reviews, manipulated online rankings, misleading celebrity or influencer endorsements, and offers encouraging unnecessary treatment are deemed unethical practices. The guidelines rightfully prohibit AI-generated or manipulated patient images, voices and testimonials. But section 8.1(i) prohibits advertisements that create “unnecessary demand” for medical procedures or promote “fear-based marketing”. Without objective criteria, such expressions leave considerable room for subjective interpretation and inconsistent enforcement.

Hospitals may publish factual details of services, charges, accreditation and doctors’ credentials. Yet Section 8.1(iii) restricts advertising professional achievements and success rates, and Section 8.1(v) prohibits promotional “before and after” surgical photographs, except for specified scientific or educational purposes. Such blanket restrictions risk regulatory overreach, particularly when authentic, appropriately contextualised images could help patients understand surgical outcomes. Section 9.2 also restricts the use of doctors’ photographs for self-promotion, including on letterheads and signboards. These restrictions apply only to registered medical practitioners under the NMC’s jurisdiction.

Why the information asymmetry?

Patients rarely possess the same medical knowledge as those treating them. Even amid an abundance of AI-enabled health information, choosing a surgeon or assessing a hospital’s safety record remains difficult. Verifiable professional achievements, including the number of surgeries performed, years of experience and treatment outcomes, could help patients make informed choices. While such figures can be misleading without context, they are fundamentally different from unsubstantiated claims to be the “best” or to guarantee success, which the guidelines already prohibit. Rather than restricting genuine professional accomplishments, requiring their accurate and transparent disclosure could better serve patients’ right to informed choice. The answer may lie in better disclosure, rather than less information.

Is commercialisation unethical?

The guidelines seek to prevent the “commercialisation of health care”, while Clause 8.1(ii) restricts promotion, suggesting commercialisation of medical practice. But in India, profit-making healthcare is lawful, as section 2(c) of the Clinical Establishments Act, 2010, recognises privately operated hospitals, and section 3(1) of the Companies Act, 2013, enables lawful commercial enterprises, including hospitals. Government policy also permits 100% FDI in hospitals.

Article 19(1)(g) protects citizens’ freedom to practise a profession or conduct business, subject to reasonable restrictions. In the case Tata Press v. MTNL (1995), the Supreme Court recognised commercial speech under Article 19(1)(a), including the public’s right to receive information, while permitting restrictions on misleading advertisements. The current guidelines appear to treat commercialisation itself as a problem, without clearly distinguishing legitimate business interests from practices that mislead or exploit patients.

Are government schemes exempt?

Central and State government schemes undertaken in the larger public interest are exempted, and can advertise. Flexibility for vaccination drives and other health programmes is understandable. But the exemption is broad. Safeguards should remain equally important whether a campaign is run by the government or a private hospital. Patients seeking private healthcare may independently praise or criticise doctors. But the guidelines remain silent on hospitals and practitioners using unsolicited patient testimonials for promotion. What if a patient voluntarily posts an account and a hospital subsequently shares it? The distinction remains unresolved.

Other unclear aspects

Graded penalties are intended for violators, starting with a warning and mandatory ethics training for the first violation, and increasing to a 6- to 12-month suspension for subsequent violations. At the same time, repeated offences could lead to removal from the register for one to three years. State Medical Councils will enforce these provisions after issuing show-cause notices and considering doctors’ explanations. Appeals can be made to the NMC’s Ethics and Medical Registration Board.

The guidelines remain unclear about who can initiate complaints and the evidence required. It addresses genuine concerns, but its broad and ambiguous provisions may create confusion over compliance and leave considerable room for subjective enforcement, particularly affecting smaller hospitals. Protecting patients from misleading advertisements and commercial exploitation is necessary. However, treating commercial intent itself as inherently suspect serves little purpose. Clearer distinctions between legitimate professional communication and unethical promotion would better serve both patients and healthcare providers.

(Dr. C. Aravinda is an academic and public health physician. The views expressed are personal. aravindaaiimsjr10@hotmail.com)