Introduction:
In a significant judgment redefining professional identity within India’s evolving healthcare ecosystem, the Kerala High Court held that the title “Doctor” is not the exclusive preserve of medical practitioners holding MBBS or equivalent qualifications and that physiotherapists and occupational therapists are legally entitled to use the prefix “Dr.” along with professional suffixes such as “PT” and “OT.” The judgment was delivered by Justice V.G. Arun while dismissing a batch of writ petitions filed by medical associations and individual doctors, including the Indian Medical Association and the Indian Association of Physical Medicine and Rehabilitation and its Secretary, who challenged the legality of physiotherapists and occupational therapists using the “Dr.” prefix. These petitions arose in the context of the National Commission for Allied and Healthcare Professions Act, 2021 (NCAHP Act) and the Competency-Based Curriculum framed for physiotherapy and occupational therapy, which permit professionals in these disciplines to use the “Dr.” prefix with appropriate professional identifiers. Earlier, the High Court had passed an interim order restraining the use of the “Dr.” prefix by such professionals who did not possess recognised medical qualifications. However, upon final adjudication, the Court lifted that restraint and held that neither the National Medical Commission Act (NMC Act) nor allied statutes confer any exclusive statutory right upon medical practitioners to use the title “Doctor.” The Court further clarified that historically and academically, the term “doctor” refers to persons who have attained the highest level of learning in their respective fields and is not confined to practitioners of modern medicine. The dispute also raised broader issues regarding professional autonomy, legislative policy, public perception, and the structure of multidisciplinary healthcare delivery, particularly in light of changing statutory frameworks that now recognize allied and healthcare professionals as independent contributors to patient care within their respective domains. Against this backdrop, the Court examined not only the legal entitlement to use the title but also the institutional balance between medical and allied health professions in a patient-centric healthcare system.
Arguments:
The petitioners, comprising medical associations and qualified medical professionals, argued that the use of the “Dr.” prefix by physiotherapists and occupational therapists would mislead the general public into believing that such professionals were qualified allopathic doctors, thereby creating serious risks to patient safety and informed consent. They contended that physiotherapists and occupational therapists essentially provide supportive or rehabilitative services and that first-contact diagnosis, prescription, and comprehensive medical management must remain the exclusive domain of medical practitioners trained in modern medicine. According to the petitioners, permitting allied health professionals to use the same prefix as medical doctors would blur critical distinctions in qualifications and scope of practice, potentially resulting in disastrous medical consequences if patients relied on such professionals for treatment beyond their competence.
The petitioners further argued that Section 40 of the Kerala State Medical Practitioners Act uses the word “title” in reference to medical practitioners and that this should be interpreted as a statutory recognition of the right of qualified doctors to exclusively use the prefix “Dr.” They also contended that the provisions of the NCAHP Act and the Competency-Based Curriculum, which recognize physiotherapists and occupational therapists as first-contact practitioners within their domain and allow the use of the “Dr.” prefix with suffixes, were contrary to the scheme of the NMC Act and therefore required to be read down. According to them, permitting such equivalence diluted the regulatory authority of the medical profession and undermined the central role of doctors in the healthcare hierarchy.
Reliance was placed on various judicial precedents to argue that misleading use of professional titles could amount to deception of the public and that courts have a duty to protect patients from confusion regarding professional competence. It was also argued that the legislature could not have intended to equate allied healthcare professionals with medical practitioners trained under the NMC framework and that any interpretation allowing such equivalence would be inconsistent with legislative intent.
On the other hand, the respondents, including physiotherapy and occupational therapy associations and government authorities, raised a preliminary objection regarding maintainability, arguing that the petitions were initiated by a limited group of doctors and not by statutory regulatory bodies such as the National Medical Commission, which had not objected to either the curriculum or the usage of the “Dr.” prefix. It was submitted that the petitioners were essentially seeking to protect professional turf rather than public interest.
Substantively, the respondents argued that physiotherapy and occupational therapy are independent branches of health science falling within Allied Health and Rehabilitation Services and that these disciplines involve extensive academic training, clinical exposure, and professional accountability. They emphasized that under the NCAHP Act, healthcare professionals are defined as those entitled to provide preventive, curative, rehabilitative, therapeutic, and promotional health services, and that physiotherapists and occupational therapists clearly fall within this statutory definition.
The respondents further submitted that the curriculum recognizes physiotherapists and occupational therapists as first-contact health providers within their specific scope of practice, meaning that patients can directly consult them for issues falling within their professional competence without referral from a medical doctor. It was argued that this recognition is consistent with international healthcare models and modern multidisciplinary healthcare approaches.
It was also contended that courts cannot exercise writ jurisdiction to rewrite or read down statutory provisions merely because a professional group disagrees with legislative policy. The respondents argued that the NCAHP Act was enacted after due parliamentary deliberation, including consultation with the National Medical Commission, and therefore represented a conscious policy choice to strengthen allied healthcare professions as independent and regulated contributors to healthcare delivery.
Occupational therapists, in particular, emphasized the overriding clause in the NCAHP Act, arguing that as a later and special enactment dealing with allied and healthcare professions, it would prevail over earlier laws in case of any inconsistency. They asserted that the statutory framework now clearly recognizes their professional status and autonomy and that denial of the “Dr.” prefix would undermine legislative intent and professional dignity.
Judgment:
The Kerala High Court dismissed all the writ petitions, holding that the claim of medical professionals to an exclusive right over the title “Doctor” had no statutory foundation. Justice V.G. Arun began by examining the statutory framework governing medical and allied healthcare professions and observed that neither the NMC Act nor allied statutes contain any provision expressly conferring the title “Doctor” upon medical practitioners. The Court rejected the argument that the use of the word “title” in Section 40 of the Kerala State Medical Practitioners Act could be interpreted as granting an exclusive statutory right to use the prefix “Dr.”, holding that in the absence of an express provision, such an inference could not be drawn.
The Court observed that historically and academically, the term “doctor” is derived from the Latin word “docere,” meaning “to teach,” and has traditionally been used to denote persons who have achieved the highest level of learning in their field. It noted that even today, individuals holding PhD degrees are entitled to use the title “Doctor,” and therefore the claim that the prefix belongs exclusively to medical practitioners is fundamentally misconceived.
Addressing the challenge to the NCAHP Act and the Competency-Based Curriculum, the Court examined the legislative background and noted that the health workforce in India had long been centered around doctors, nurses, and frontline workers, while other healthcare professionals were loosely grouped as paramedical staff. With advancements in healthcare and changing service delivery models, the legislature adopted a fresh vision of patient-centric, multidisciplinary team-based care, leading to the enactment of the NCAHP Act.
The Court examined the definitions of “allied and healthcare professional” and “healthcare professional” under the Act and emphasized that healthcare professionals are statutorily recognized as providers of preventive, curative, rehabilitative, therapeutic, and promotional health services. It held that physiotherapists and occupational therapists clearly fall within this category and are not mere assistants to doctors but independent professionals within defined scopes of practice.
On the question of reading down statutory provisions, the Court held that in the absence of a direct constitutional or legal challenge to specific sections of the NCAHP Act, it could not rewrite legislation to suit the preferences of a particular professional group. It found no compelling legal or constitutional reason to interfere with legislative policy, particularly when the Act was enacted after parliamentary scrutiny and consultation with relevant regulatory bodies, including the National Medical Commission.
The Court also took note of the overriding effect clause in the NCAHP Act and observed that even if there were any perceived inconsistencies between the NCAHP Act and earlier medical legislation, the later enactment would prevail in respect of allied healthcare professions.
On the concern that public might be misled by the use of the “Dr.” prefix, the Court observed that the curriculum itself requires physiotherapists and occupational therapists to use professional suffixes such as “PT” and “OT,” which clearly indicate their field of specialization. It held that informed patients are capable of understanding professional distinctions, and that professional regulation, rather than title monopoly, is the appropriate mechanism to protect public interest.
Ultimately, the Court concluded that medical professionals do not possess an exclusive statutory or legal right to the prefix “Doctor” and that physiotherapists and occupational therapists, being recognized healthcare professionals under a valid parliamentary enactment, are legally entitled to use the “Dr.” prefix along with appropriate professional identifiers. Finding no merit in the petitions and no legal basis to interfere with legislative policy, the Court dismissed all the writ petitions and upheld the validity of the statutory and curricular provisions.