A Significant Judgment on the Use of the ‘Dr.’ Prefix
In an important judgment with wide implications for India’s healthcare ecosystem, the Kerala High Court has held that the title “Doctor” does not belong exclusively to medical practitioners holding MBBS or higher medical degrees. The Court ruled that physiotherapists and occupational therapists are also entitled to use the “Dr.” prefix, provided they are qualified in their respective disciplines.
The judgment was delivered by Justice V.G. Arun while dismissing petitions filed by the Indian Medical Association, the Indian Association of Physical Medicine and Rehabilitation (IAPMR), and its Secretary. These petitions had challenged the use of the “Dr.” prefix by physiotherapists and occupational therapists, especially those who do not possess a recognized medical qualification under the National Medical Commission framework.
Background: Earlier Interim Ban and the Core Dispute
Earlier, the Kerala High Court had passed an interim order restraining physiotherapists and occupational therapists from using the “Dr.” prefix. This interim relief was granted on the ground that such usage could mislead the public into assuming that they were allopathic medical doctors.
The petitioners, who were qualified medical professionals, were aggrieved not only by the use of the “Dr.” prefix but also by the status and powers conferred on physiotherapists and occupational therapists under the National Commission for Allied and Healthcare Profession Act, 2021 (NCAHP Act) and the newly introduced competency based curriculum for these professions.
They argued that physiotherapists and occupational therapists merely provide supportive services and that only specialist medical professionals are competent to deliver first contact medical care. They also objected to the curriculum permitting the use of “Dr.” as a prefix along with “PT” and “OT” as suffixes, claiming that this equated them with modern medical practitioners and could mislead the public.
Court’s Key Observation: NMC Act Does Not Grant the Title “Doctor”
While dismissing the petitions, the Court made a crucial observation that the National Medical Commission Act does not contain any provision that confers the title “Doctor” on medical professionals. The Court noted that the word “doctor” traditionally refers to a person who has achieved a high level of learning and is not limited to practitioners of modern medicine.
The Court observed that even in the present day, persons holding PhD degrees and other doctoral qualifications are entitled to use the title “Doctor”. Therefore, the belief that the title belongs exclusively to medical practitioners was described as a misconception.
The Court clearly stated that the challenge against physiotherapists using the “Dr.” prefix cannot be sustained because neither the NMC Act nor allied statutes grant any exclusive statutory right to medical doctors to use that prefix.
Interpretation of the Kerala State Medical Practitioners Act
One of the key arguments of the petitioners was based on Section 40 of the Kerala State Medical Practitioners Act, where the word “title” is used. They contended that this provision statutorily entitled only qualified medical professionals to use the “Dr.” prefix.
The Court rejected this argument and held that the word “title” in that section cannot be interpreted as granting exclusive statutory rights to medical professionals to use the prefix “Dr.”. In the absence of any explicit legal provision conferring such exclusivity, medical practitioners cannot claim a monopoly over the title.
The Court specifically observed that since the NMC Act itself does not provide for conferring the title “Doctor”, such a right cannot be implied or imported through indirect interpretation.
Fear of Public Misleading and Reliance on Past Judgments
The petitioners relied on various decisions of the Supreme Court and High Courts to argue that the use of the “Dr.” prefix by physiotherapists and occupational therapists could mislead the general public into assuming that they are qualified allopathic doctors. According to them, this confusion could have serious and even disastrous consequences for patient safety.
However, the Court did not find this argument sufficient to impose a blanket prohibition, especially in the absence of any specific statutory bar on the usage of the prefix.
Defence by Physiotherapists and Occupational Therapists
On behalf of the respondents, a preliminary objection was raised regarding the maintainability of the petitions, pointing out that they were filed at the instance of only a few doctors and not by any statutory regulator. It was also highlighted that the National Medical Commission itself had not raised any objection to either the curriculum or the use of the “Dr.” prefix.
Physiotherapists argued that their profession is an independent and distinct branch of health science under Allied Health and Rehabilitation Services. They also pointed out that the new curriculum recognizes them as first contact healthcare providers within their domain of expertise.
It was further argued that courts cannot use writ jurisdiction to read down provisions of law merely because one group of professionals disagrees with legislative policy.
Overriding Effect of the NCAHP Act
On behalf of occupational therapists, it was argued that the NCAHP Act has an overriding effect and would prevail over the NMC Act since it is a subsequent enactment. The Court took note of this submission and also noted that the National Medical Commission had been heard before the Parliamentary Committee when the law was being framed.
This indicated that the legislative intent was clear and that the regulatory framework for allied and healthcare professionals was created after due consideration.
Court’s View on the Changing Healthcare System
The Court also examined the broader policy background that led to the enactment of the NCAHP Act. It observed that for a long time, India’s healthcare system focused mainly on doctors, nurses, and frontline workers, while other professionals were loosely grouped as paramedical staff.
With the advancement of healthcare and the shift towards multidisciplinary, patient centric team based care, a new legal and institutional framework became necessary. The Court noted that under the Act, a “healthcare professional” is entitled to provide preventive, curative, rehabilitative, therapeutic, and promotional health services within their domain.
Why the Court Refused to Interfere
The Bench observed that in the absence of a direct and specific challenge to the statutory provisions themselves, it would not normally read them down. It also found no compelling reason to interfere with government policy, especially at the instance of only a limited group of medical professionals.
The Court felt that rewriting or diluting the law through judicial intervention would be inappropriate in a matter that clearly falls within legislative policy and regulatory design.
Final Outcome: Petitions Dismissed
After considering all these aspects, including the overriding effect of the NCAHP Act and the policy framework behind it, the Kerala High Court dismissed all the petitions. With this, the earlier interim restriction also stands effectively nullified.
Why This Judgment Matters
This judgment is likely to have a significant impact on how professional identity, titles, and roles are perceived in India’s evolving healthcare system. It reinforces the idea that healthcare today is no longer a doctor centric monopoly but a multidisciplinary ecosystem, where multiple qualified professionals play legally recognized and independent roles.
At the same time, it also reopens an important debate on patient awareness, clarity of professional roles, and the need for transparent disclosure of qualifications in clinical settings.
