The Medical Council of Hong Kong (the Medical Council) introduced a number of amendments to the Code of Professional Conduct published in January 2016 (the Code) with regard to doctors’ dissemination of professional service information (Relevant Information) to the public and patients, as well as unsolicited promotion of services. Such amendments recently came into effect in October 2022.
These amendments potentially increase the methods of disseminating Relevant Information (such as in social media) and unsolicited promotion of services, that will be subject to the Medical Council’s scrutiny. The amendments are likely to impact how doctors and medical practice groups communicate and the type of information they decide to communicate to the public and their patients. Awareness of these developments is therefore important for both doctors and insurers.
What are the major changes?
Announcements about doctors’ practice in social media and other media
In addition to announcements of the commencement or altered conditions of practice in mass media, section 188.8.131.52 has been updated to also provide for such announcements in social media. By way of example, doctors may now announce information relating to change of address and change of partnership in a non-exhaustive list of social media. However, except for announcements by a doctor to patients, such announcements to the public via means such as printing, mailing, and broadcasting are prohibited.
Announcements must be made bona fide
Under section 184.108.40.206, the previous requirement that such announcements must be completed within two weeks of the commencement or alteration taking place is now abolished. The new requirement reads that the announcements must be “bona fide”, which is not defined in the Code. However, the Medical Council, has given guidance to the extent that if an announcement is made repeatedly or well after the commencement of practice or alteration, it will not be treated as “bona fide”.
Letters of gratitude, etc, must not be published by any means
Under the same section of the Code, the prohibition on publishing letters of gratitude and announcements of appreciation from grateful patients or related persons identifying the doctor concerned in mass media, now extends to such publications in social media and any other means which make the publications available to the public.
Particulars in announcements must conform with Appendix H
Under section 5.2.3 of the Code, any Relevant Information disseminated by a doctor must conform with Appendix H, a new addition to the Code setting out particulars of Relevant Information which may be published with respect to each of the permitted ways of dissemination. It must be noted that different restrictions are imposed on different ways of dissemination, depending on whether the Medical Council view them as “active” or “passive” forms of dissemination. One example is that more stringent restrictions are imposed on announcements made in social media as opposed to service information notices posted within a clinic.
Pre-approval for dissemination by unspecified ways
If a doctor wishes to disseminate Relevant Information through ways different to those set out under section 5.2.3, pre-approval from the Medical Council must be obtained. However, where a doctor applies to disseminate Relevant Information containing details prohibited in Appendix H or through a method that is in conflict with section 5.2 in general, such application would unlikely be approved. The Medical Council particularly stress under section 220.127.116.11 that a doctor who provides information for publication (or permits the same) in a doctors directory is personally responsible for ensuring that the directory complies with the specific requirements in Appendix H.
Section 5.2.4 mirrors section 5.2.3
Section 5.2.4 on dissemination of Relevant Information to the public has been amended to mirror section 5.2.3 on dissemination in relation to patients. However, under section 18.104.22.168, the Medical Council reinforces the overarching principle that a doctor’s right to provide information about his or her service to patients is subject to provisions under section 5.2.
Unsolicited promotion of doctors’ services by other means
Under section 5.2.5, prohibition against doctors’ unsolicited promotion of services by means of visits, telephone calls, fax, emails and leaflets now extends to unsolicited promotion by any other means.
Our observations on the revised Code
Overall, the Code’s requirements regarding doctors’ dissemination of Relevant Information and unsolicited promotion of services have not been relaxed. Doctors are now expressly permitted to make announcements about their practice via a greater variety of ways and to make such announcements at a time beyond the two-week timeframe, provided that they are made bona fide.
However, the Medical Council indicated in its Newsletter Issue No.29 (September 2022) that an announcement made repeatedly and well after the commencement of practice or a clinic’s relocation would not be regarded as bona fide for the purpose of section 22.214.171.124. Despite the removal of the previous time restriction, doctors should refrain from delaying any such announcements following the actual date of the commencement or relocation, to avoid issues of non-compliance with the Code. While doctors are welcome to contact their patients to follow up on their clinical progress and remind them of upcoming appointments, uninvited private contact with members of the public for practice promotion by any means, should be avoided.
The amendments to the Code have strengthened the existing regime governing doctors’ dissemination of Relevant Information and unsolicited practice of services, by capturing more forms of communication. Doctors are recommended to review their current means of communication with reference to sections 5.2.3 and 5.2.4 as amended, and put in place necessary adjustments. If a doctor wishes to communicate Relevant Information to the public or patients via newer forms of communication unspecified in the Code, they must seek prior approval from the Medical Council, so that their applications can be assessed on a case-by-case basis. Before making the application, doctors should check what particulars may or may not be contained within the communication as Relevant Information as set out in Appendix H, as well as the general principles applicable to information provided by doctors to patients and the public under section 5.2.1 and practice promotion under section 5.2.2. Ultimately, doctors will have to ensure that the proposed form of communication and nature of the information to be conveyed complies with these provisions.