Registered medical practitioners of allopathy under the Indian Medical Council Act, 1956, are eligible to practice telemedicine from any location in India – Paromita Sengupta
The Coronavirus pandemic — which has strained public and private health systems, infected over 35 million people and caused 1 million fatalities worldwide — has generated a huge demand surge for telemedicine (aka remote consultation) services. With fear spreading of contracting the lethal virus in crowded hospitals and doctors’ waiting rooms, telemedicine, which enables medical practitioners to diagnose and monitor patients with suspected Covid-19 infection as well as other ailments remotely, is becoming increasingly popular. However, there’s more to the practice of telemedicine than switching from conventional doctor-patient interaction to remote location digital consultation.
In March last year, the Union ministry of health and family welfare issued guidelines authored by the Medical Council of India in consultation with government think tank NITI Aayog. The guidelines require all medical practitioners to observe several protocols and processes to practice telemedicine. Among them: explicit identification of doctor and patient and consent for examination, maintenance of records of the consultation and complete confidentiality.
Registered medical practitioners (RMPs) of allopathy enrolled in the registers of medical practitioners maintained by the state and Central governments under the Indian Medical Council Act, 1956, are eligible to practice telemedicine from any location in India. In the interests of improving their practice and safeguarding themselves against liability suits, RMPs will be required to complete a mandatory online course — currently being developed in association with NIMHANS (National Institute of Mental Health and Neuro-Sciences), Bangalore — within three years of its notification.
The guidelines offer practical advice to doctors to provide telemedicine services. They also stipulate norms and protocols relating to the doctor-patient relationship; issues of liability and negligence; evaluation, management and treatment; informed consent; prescription and reimbursement; health education and counseling.
The Basel (Switzerland)-based International Society for Telemedicine and e-health (ISfTeH) also offers training modules covering communication tools, ethics and legal aspects of telemedicine.
Pay and perks
Telemedicine provides medical practitioners (MBBS and above) with part-time/full-time work opportunities in India and abroad. Moreover, they have the opportunity to work for transnational tele-health corporates ready and willing to pay an average $216,958 (Rs.1.5 crore) annual salary. Other tele-health companies pay $100-150 per hour while some offer $15-30 per video consultation.
In India, medical professionals are beginning to integrate telemedicine into their regular practice. An opportunity for solo practitioners to grow their practice can also be availed by registering with e-health platforms (Practo, Onco.com, mfine, CallHealthetc) unlinked to hospitals/clinics (Rs.600-1,200 per consultation).
“I believe the MCI/NIMHANS guidelines will enable provision of medical aid and advice to a much larger number of people, and will compensate for India’s adverse doctor-people ratio deficit (0.62:1,000) against the WHO-recommended 1:1,000.
Although admittedly, telemedicine cannot replace the physical doctor-patient interaction and examination, it can do wonders to supplement it. Given that the traditional Indian patient values a doctor’s ‘healing touch’, a workable solution post-pandemic could be an in-person first examination followed by remote review of investigation reports and writing of further prescriptions,” says Dr. Roshmi Gupta, an ophthalmology postgrad of Calcutta Medical College and the B.R. Ambedkar University, Agra. After graduation, Gupta acquired 14 years of rich experience (LV Prasad Eye Institute, Narayana Nethralaya and Vasan Eye Care) prior to her second stint as head of the department of Oculoplasty, Orbital Surgery and Ocular Oncology at Narayana Nethralaya, Bengaluru in 2014.
Gupta believes that in the post-pandemic era, well-qualified telemedicine practitioners have excellent opportunities in medical fields such as radiology, orthopaedics and ophthalmology, which involve extensive sharing of images and scans. According to her, it is essential for all medical professionals to develop telemedicine practice skills. “Standard clinical skills apart, mindful listening, technical know-how and perseverance are critical attributes for practicing telemedicine. Moreover developing virtues of patience, empathy and good manners will help patients in distress to manage illness, anxiety and stress,” she adds.