Summary: The NMC has issued Ethical Advertising Guidelines with immediate effect, but since the NMC Act only empowers the NMC and State Medical Councils to regulate doctors, hospital liability is routed through clinical establishments laws that vary by State and often lack any advertising-specific penalty framework. The Guidelines practically make treating doctors’ de-facto institutional marketing proxies, creating attribution issues and potentially requiring hospitals to revise arrangements with doctors on image use, content approval and indemnity.
On October 6, 2026, the National Medical Commission (“NMC”) issued its Guidelines on Ethical Advertising and Public Communication by Hospitals, Medical Institutions and Registered Medical Practitioners (“RMPs”), which were made applicable with immediate effect. The Guidelines define “advertisement” broadly enough to cover influencer content, search-engine promotion, sponsored posts, AI-generated material and news features “intended for promotion”. They bar RMPs from solicitation, superlatives, success-rate claims, before-and-after imagery and referral-linked payments.
Hospitals and clinical establishments may only publish factual, verifiable information. State Medical Councils (“SMCs”) can penalise RMPs with a warning or even remove them from the register for up to three years, after issuing a show-cause notice and a reasoned order, with two tiers of appeal. In essence, the Guidelines largely reinforce restrictions and prohibitions cited in the 2002 Ethics Regulations. The harder question is whether the Guidelines can bind hospitals, which are the principal advertisers.
A Regulator Without Jurisdiction
The NMC Act, 2019, gives the NMC and SMCs power over RMPs, not medical institutions. The Guidelines concede this and route hospital liability through the Clinical Establishments Act or the relevant State legislations and give those laws priority in case of conflict. This deference exposes a structural problem. The Clinical Establishments (Registration and Regulation) Act, 2010, is applicable to States that have adopted it. Other States run on their own statutes. These laws are built around registration, minimum standards and display rates, and generally do not contain any specific advertising code or advertisement related penalty framework.
The Uniform Code for Pharmaceutical Marketing Practices, 2024, prohibits gifting and/ or any other forms of inducements to healthcare professionals and direct-to-consumer promotion of prescription drugs. Yet enforcement depends heavily on the company’s own ethical standards, submission of compliance affidavits and complaint-led processes, with limited deterrence. The new NMC Guidelines may replicate the same pattern: instructive norms and a slow, complaint-driven enforcement process.
The more useful tools for hospital advertising lie elsewhere. The Drugs and Magic Remedies (Objectionable Advertisements) Act, 1954, applies to “any person”, including a hospital, and prohibits advertisements claiming to cure specified conditions, with criminal consequences. The Consumer Protection Act, 2019, empowers the Central Consumer Protection Authority (“CCPA”) to act against misleading advertisements, impose penalties on advertisers and endorsers, and bar endorsers from future endorsements. Neither depends on NMC’s jurisdiction and in practice, the NMC Guidelines add an additional layer of exposure without any mechanism to coordinate it with the other available enforcement mechanisms. Hospitals and healthcare institutions may end up facing parallel proceedings before an SMC, a State health authority, and the CCPA, each applying a different standard of “misleading”. Further, RMP is defined by reference to registration under the NMC Act, 2019 which covers allopathic practitioners alone, leaving AYUSH practitioners and dentists, registered under their own statutory boards, outside the scope of Guidelines entirely.
The Attribution Problem
Due to lack of authority over clinical establishments and hospitals, the Guidelines target doctors. The Guidelines state that using an agency, influencer or intermediary does not absolve an RMP or an institution of the content it “authorised, commissioned, sponsored, adopted or knowingly permitted”. Further, the SMC is empowered to examine an RMP who personally authorised or participated in prohibited communication.
This makes the practicing doctor the regulatory proxy for institutional marketing, with predictable difficulties. A consultant whose photograph appears on a hoarding may have signed a standard-form agreement, granting the hospital image rights, with no control over content. Whether such a doctor “knowingly permitted” the promotional campaign is a fact-intensive question that every proceeding must resolve. Disciplinary risks will sit with the individual, while commercial benefit sits with the institution. Hospitals must rewrite consultant agreements to cover name and image usage, content approval, takedown and indemnity, and the RMP’s compliance with the NMC Guidelines. The Guidelines are also intended to restrain pharma-linked promotion and prohibit an RMP’s endorsement of drugs and devices. Co-branded disease-awareness camps and sponsored “patient education” content, which are common in hospital-pharma industry tie-ups, will now need careful review against the Guidelines, and will hinge on whether the activity is monetised or promotional.
Practical Hurdles
Volume and speed of enforcement of the Guidelines may comprise of the first layer of difficulty. Hospitals, agencies, influencers and patients generate content daily, and SMCs, already burdened with their disciplinary caseload, may not be able to effectively monitor the content being published in their jurisdiction. The process mechanism further compounds the problem. A show-cause notice, a speaking order and appeals imply that the campaign may have already ended before any final order has been issued, and the penalty framework is only indicative of what the SMC “may” contemplate.
Interpretation is the second issue. The Guidelines permit information about equipment but not claims of superiority, which is hard to apply in novel and advanced technology. Claims of “leading” or “top” are permissible only if objectively verifiable, with methodology disclosure and ranking/ award date, a standard many current hospital campaigns would not meet. Whether a thought-leadership piece or a health camp is “promotional” is also a subjective test.
Platforms are the third hurdle. The Guidelines require healthcare platforms to follow NMC norms and avoid paid doctor rankings, but contain no enforcement route against them, so takedown still depends on other regulatory frameworks.
Data is the fourth. The Guidelines also bring in the Digital Personal Data Protection Act, 2023, so misuse of patient images or testimonials may attract a separate regulator and separate penalties.
The Way Forward
Until States across India adopt the spirit and essence of the Guidelines through their own rules or legislative amendments, enforcement may be uneven. A hospital’s real exposure will depend on the respective State and adverse actions taken against its doctors. Hospitals, moving forward, need to consider the Guidelines as a compliance baseline, with consistent review of external communication, revised agency and influencer contracts, updated consultant agreements, an audit of existing claims and awards, and implementation of protocols for AI content and patient data. The Guidelines in their current form set a clear ethical benchmark on an uneven legal foundation. Closing that gap will require State-level adoption and coordinated action across health and consumer regulators.
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