The National Medical Commission (NMC) underscores the attributes that distinguish a proficient Registered Medical Professional (RMP), emphasizing the important role of empathy, understanding, and compassion in their interactions with patients' families during critical incidents. Additionally, the Apex Medical Commission stressed the importance of maintaining an uninterrupted communication channel, particularly in emergency scenarios. NMC also advised the doctors to ensure proper documentation to avoid lawsuits in the future.

In its recently released e-book, "Professional Conduct Review: Lessons from Case Archives," these observations were made by the Commission, which was released on October 5, 2023, by the Ethics and Medical Registration Board (EMRB) of NMC. Referencing a previous case, the National Medical Commission (NMC) noted that a patient's condition might be subjectively interpreted by their family, potentially differing from scientific evidence. Despite the adherence of qualified Registered Medical Professionals (RMPs) and their teams to established protocols, a patient's condition may be perceived differently by their family.

The commission said in its e-book, "At times, it may be possible they are misinformed by the limited knowledge available on the internet and other resources." In one specific instance focusing on the treatment provided to a 58-year-old male patient who suffered from acute myocardial infarction despite undergoing angioplasty, the patient succumbed to the condition.

The patient was suffering from severe chest pain. The ECG revealed that it was a myocardial infarction. Therefore, thrombolysis was done, but the pain persisted. Thereafter, angiography and angioplasty were carried out by a qualified cardiologist in view of hemodynamic instability. Initially, the patient was recovering, and on the third day, he was shifted to a ward. Later that evening, he experienced a collapse while returning from the washroom. Immediate resuscitation efforts involving defibrillation and CPR were given. Subsequent angiography revealed the stent remained open without indications of clot formation or blockages. The NMC's inaugural e-book highlighted a case involving the unfortunate demise of a patient post-angioplasty despite intensive care. The patient managed with various medical interventions in the ICU, faced complications leading to multi-organ dysfunction and eventual death. The family, alleging negligence and overcharging by the hospital, filed a complaint. However, both the State Medical Council and the NMC's Ethics and Medical Registration Board (EMRB) exonerated the RMP after comprehensive evaluations, affirming that standard procedures were adhered to.

The NMC stressed the significance of meticulous documentation, empathetic communication, and informed care in catastrophic events like myocardial infarction. Despite adherence to standard procedures, the NMC noted that family perceptions might deviate from medical evidence due to potential misinformation sources. The Commission affirmed the appropriateness of the stent and the team's decisions, supported by expert opinions. This case underscored the vital role of established protocols and effective communication in patient care, as emphasized by the NMC.

The NMC highlighted essential takeaways:

• emphasizing continuous communication during emergencies,

• stressing documentation to prevent litigation, and

• underscoring the importance of qualities like compassion and empathy.

The Commission affirmed that, along with documentation, an RMP's understanding and empathetic approach toward families during catastrophic events define a "good doctor."

The NMC's Volume I E-book covered nine case archives, each exploring various topics like doctor-patient communication, delayed treatment due to a wrong diagnosis, and inadequate specialty practice. For every case, the book provided details including keywords, context, abstract, case summary, discussions, decisions by medical councils, lessons learned, and key takeaways.

(Rehash/Jeba Aslam Mulani)