Pathology practice

Dear friends,
In today’s day and age, all of us want to have a safe and trouble free practice. It is the duty of the IMA to present before you certain ethical and legal points about running of pathology laboratories in private practice.
The Medical Council of India has clearly stated that Pathology, being a part of modern scientific medicine, the practice of the same is permissible only to registered medical practitioners with post graduate qualifications in pathology.
Many members of IMA are either running in house Pathology Laboratories in their hospitals with the help of technicians or referring their patients to the laboratories independently run by technicians. Reports not certified by Pathologist (doctor with postgraduate qualification in Pathology) are not authentic. The Hon. High court of Mumbai has passed an interim order in PIL No. 28/2005 on 10/10/2007, which clearly states that only a qualified pathologist recognized by Maharashtra Medical Council & Medical Council of India (MD Pathology & DCP) can certify pathology laboratory reports. No person with any other qualification is entitled to practice Pathology.
Recently, Hon. Supreme court of India has passed verdict on 12.12.2017, stating that Laboratory Report can be countersigned only by a registered medical practitioner with a post graduate qualification in Pathology.
Similarly, according to Medical council of India, Code of medical ethics, the physician (registered practitioner) should not associate professionally with person violating code of ethics. (Ref: Code of ethics Regulations
2002: Published in Part III, Section 4 of the Gazette of India,
dated 6th April 2002, para 1.2.1). If the Doctor refers patients to an illegal laboratory and treats the patients relying on those reports, it is breach of Code of Medical Ethics. In such cases, MMC can deregister the respective doctor for a specific period or permanently.
In case of any complications during treatment, the court may find doctors ‘illegal ab initio’ guilty of negligence, if reports from illegal laboratories have been accepted and the doctors may be prosecuted under appropriate sections of Indian Penal Code for medical criminal negligience. What this means is that if the first act itself is illegal, all other subsequent acts need not be taken into consideration.
Reports from illegal labs are not admissible for medical insurance claims. If patient goes to consumer forum, both technician who runs illegal lab and the doctor referring patient to such a lab or accepting report from such a lab are liable for payment of compensation. There are cases where doctors had to pay compensation and MMC has taken action against these doctors for breach of medical code of ethics. (Ref. Nagpur HIV case, Washim consumer forum).
The Maharashtra Medical Council has received complaints about such unethical practices and patronage of such illegal laboratories by IMA members. The Council has taken a dim view of the same and as of now has issued strict warnings to the offending parties. However, in the future, the Council may not take such a lenient view if the practice continues despite warnings and reminders. Criminal procedures have also been initiated against such complaints and the court has given imprisonment for running such in
house laboratories without requisite post graduate pathology qualifications. This was most recently seen in a judgement delivered in Parbhani where an MBBS doctor was convicted and sentenced to 6 months imprisonment for running an in- house illegal laboratory with help of technician and issuing the reports.
It is the duty of the pathologist to personally supervise the process of testing and then authenticate the reports after critical appreciation / assessment of findings of the examinations / test. Pathologists cannot offer their names to multiple laboratories without spending adequate time in these laboratories and authenticating pathology reports with due diligence (as mentioned above).
The Maharashtra Medical Council has handed orders of suspension for various periods ranging from a week to 6 months to four pathologists. The Council has made it very clear that such grossly unethical and dangerous practices will not be tolerated and suitable punishment will be meted out to the guilty parties. The Indian Medical Association also reiterates that it will not support any members who indulge or support such activities.
The Indian Medical Association has always strived to uphold the highest ethical standards of the medical profession. We hope every member understands the above mentioned points and implements the same in their practice. The Association will not be in a position to help members in any way if they are found guilty of supporting and associating themselves with illegal laboratories.

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