Introduction:

In Indian Medical Association v. Union of India and connected cases, WA 437 of 2026 and connected matters, a Division Bench of the Kerala High Court comprising Justice Sushrut Arvind Dharmadhikari and Justice P V Balakrishnan considered appeals filed by the Indian Medical Association and the Indian Association of Physical Medicine and Rehabilitation challenging a Single Bench decision that had permitted physiotherapists and certain allied health professionals to use the prefix ‘Dr.’ before their names. The controversy touches upon a sensitive and evolving issue in professional regulation namely whether physiotherapists and occupational therapists who are governed under the National Commission for Allied and Healthcare Profession Act 2021 can legally prefix ‘Dr.’ to their names and whether medical doctors possess a statutory entitlement to the same. During the hearing on February 23, the Division Bench made significant oral observations indicating that the Court cannot legislate from the Bench and that the determination of such a policy matter squarely lies within the domain of the government or the legislature.

Arguments on Behalf of the Appellants:

Senior Advocate Mayankutty Mather appearing for the appellants contended that the Single Bench had erred in permitting physiotherapists and occupational therapists to use the prefix ‘Dr.’ without any statutory backing. It was submitted that neither the National Commission for Allied and Healthcare Profession Act 2021 nor its Schedule confers any right upon physiotherapists or occupational therapists to use the prefix ‘Dr.’. According to the appellants the only basis relied upon by those professionals was a curriculum document which cannot override or supplement statutory provisions. Counsel argued that professional titles must flow from legislative sanction and not from academic course structures. It was further contended that allowing physiotherapists who act on the advice of medical doctors to use the prefix would create confusion in the healthcare system and potentially mislead patients. The appellants highlighted that physiotherapists and occupational therapists function as allied healthcare professionals and not as primary diagnosing physicians. The senior counsel pointed out an anomaly that under the current statutory framework even MBBS and MD qualified medical practitioners do not find explicit statutory language authorising the prefix ‘Dr.’ yet by long standing convention and recognition they use it. If physiotherapists are permitted to use the same prefix without clear legislative backing it may dilute professional distinctions and create far reaching implications in medical regulation. The appellants also brought to the notice of the Court a notification dated September 9, 2025 issued by the Director General of Health Services under the Ministry of Health and Family Welfare stating that physiotherapists cannot use the prefix ‘Dr.’. However that notification was withdrawn the very next day on the ground that further deliberations were required. According to the appellants this sequence demonstrated that even the executive branch had recognised the complexity and sensitivity of the issue. The senior counsel emphasised that unless the statute specifically authorises the use of the prefix the Court ought not to permit it through judicial interpretation. The appellants therefore sought interference with the Single Bench decision and prayed that the Court restrain physiotherapists from using the prefix until the legislature clarifies the position.

Observations and Response from the Bench:

During the course of hearing Justice Dharmadhikari orally questioned the appellants to point out any enabling statutory provision that permits even medical doctors to prefix ‘Dr.’ before their names. The Bench observed that there must be some legal basis authorising the usage and asked counsel to identify such a provision. The Court reflected historically that in earlier times the term doctor was associated primarily with scholars and teachers and that physicians gradually came to be known as doctors through convention. The Bench expressed that the issue involves broader questions of professional recognition and legislative policy. The judges repeatedly remarked that the Court cannot legislate and cannot declare that a particular category of professionals can or cannot use the prefix when the statute itself is silent. The Bench stated that if the appellants believe there is a lacuna in the law they must seek amendment of the Act or make appropriate representations to the competent authority namely the Ministry of Health and Family Welfare. The Court emphasised that legislative power lies with the legislature and policy determinations must be undertaken by the executive in consultation with stakeholders. It observed that courts cannot create rights or prohibitions not expressly provided in the statute. The Bench suggested that the government can invite objections and suggestions and after due deliberation take a considered decision. Once such a decision is taken it would be open to any aggrieved party to challenge it in accordance with law. The Court also indicated that it would be appropriate to dispose of the appeals with a direction to the government to take a decision in a time bound manner rather than adjudicate the substantive issue in the absence of a clear statutory framework.

Court’s Approach and Interim Outcome:

The Division Bench made it clear through its oral observations that it does not consider it appropriate to assume the role of the legislature in deciding whether physiotherapists or medical professionals can prefix ‘Dr.’ to their names. The Court observed that without a definitive governmental or legislative determination it cannot meaningfully resolve the controversy. It underscored that competent authority lies with the Ministry of Health and Family Welfare which can examine the matter comprehensively and if necessary place proposals before the legislature. The Bench indicated that courts are constrained by the statutory text and cannot declare what is not provided in the Act. In view of these observations the Court asked whether the matters could be disposed of with a direction to the government to take a decision. However the senior counsel for the appellants sought time to obtain instructions from the parties. Consequently the matter was posted to March 3 for further consideration. Although no final judgment was delivered at this stage the oral remarks of the Bench reflect a clear judicial philosophy of restraint in matters involving professional regulation and legislative policy.