Hiring a locum doctor for your clinic in India Registration checks, the prescription, records, TDS and a short written agreement.

A locum is a registered doctor who runs your OPD while you are away, for a week of leave, a conference or an illness. Engaging one properly comes down to five things: confirm the doctor's registration, make sure every prescription and certificate carries the locum's own name and registration number, keep the consultation records in the clinic, deduct TDS on the fee if your clinic is required to, and write the terms down. The 2002 regulations of the erstwhile Medical Council of India, which the NMC's 2026 advertising guidelines still say are to be read alongside them, have a regulation on exactly this arrangement.

What do the NMC rules say about a substitute doctor?

Regulation 4.4 of the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002 is headed "Appointment of Substitute". It reads: "Whenever a physician requests another physician to attend his patients during his temporary absence from his practice, professional courtesy requires the acceptance of such appointment only when he has the capacity to discharge the additional responsibility along with his / her other duties. The physician acting under such an appointment should give the utmost consideration to the interests and reputation of the absent physician and all such patients should be restored to the care of the latter upon his/her return."

Three practical points follow. Ask a locum who already has a full practice whether they can genuinely cover your hours. Agree in writing that the locum will not take your patients with them. And arrange the handover back, since the regulation expects the patients to return to your care.

You may also tell patients you are away. Regulation 6.1.1 lists "On temporary absence from duty" among the formal announcements a doctor is allowed to make, and section 9.3 of the NMC's guidelines of 6 October 2026 repeats that a doctor may issue a factual, non-promotional announcement about temporary absence. A notice at the counter and on your Google listing naming the locum, with qualifications and registration number, is within those words.

Who can work as a locum in my clinic?

Only a doctor enrolled in a State Medical Register or the National Medical Register. Section 34(1) of the National Medical Commission Act, 2019 says no one else shall "be allowed to practice medicine as a qualified medical practitioner" or "be entitled to sign or authenticate a medical or fitness certificate or any other certificate required by any law to be signed or authenticated by a duly qualified medical practitioner". Section 34(2) sets a punishment of up to one year in prison, a fine of up to ₹5 lakh, or both. Regulation 1.6 adds a duty on you as the clinic doctor: a physician "shall not employ in connection with his professional practice any attendant who is neither registered nor enlisted under the Medical Acts in force".

1. Take a copy of the locum's registration certificate and the current renewal, and the degree certificates for any qualification that will appear on the prescription.
2. Check the registration yourself on the Indian Medical Register or National Medical Register, both linked from the NMC website, and with the state council where the locum is registered.
3. If the locum is registered in another state, ask your own state council whether they must also register with it before practising in your clinic. Karnataka, for example, says doctors from other states registering with it now do so on self certification, without an NOC from their earlier council.
4. Match the speciality to your OPD. Regulation 7.20 says a physician "shall not claim to be specialist unless he has a special qualification in that branch", so a locum covering a paediatric OPD should not be presented as a paediatrician without that qualification.
5. Ask for the locum's professional indemnity policy and note its expiry date; see our post on professional indemnity insurance.

Whose name goes on the prescription during locum cover?

The locum's. Regulation 1.4.1 says: "Every physician shall display the registration number accorded to him by the State Medical Council / Medical Council of India in his clinic and in all his prescriptions, certificates, money receipts given to his patients." Your pre-printed pad carries your name and number; the locum must not sign under it. Either print a pad or letterhead with the locum's name, recognised qualifications and registration number, or have the locum strike out and write in their own details on each sheet. The same applies to medical certificates and receipts. Our post on what a prescription must contain lists the other fields.

Who keeps the records the locum creates?

The clinic, in the same OPD register or software it always uses. Regulation 1.3.2 says a request for records from the patient, an authorised attendant or legal authorities must be acknowledged and the documents issued "within the period of 72 hours", and that request will come to the clinic, not to a locum who has left. Agree that the locum will write every consultation into the clinic's system, will have access to those records later if a question or complaint arises, and will not keep separate patient lists. Regulation 2.4 also says a physician should not "withdraw from the case without giving adequate notice to the patient and his family", which is one more reason for a written handover note on patients still under follow-up when you return.

Do I deduct TDS from a locum's fee?

Yes, if your clinic is a "specified person" and the year's payments to that locum cross ₹50,000. From 1 April 2026 the rule is in section 393(1) of the Income-tax Act, 2025. Table serial 6(iii) covers "fees for professional services" paid by a specified person, at 10% (2% applies only to technical services and two other narrow cases), with a threshold of ₹50,000. Section 402(28) defines professional services to include services rendered in the course of carrying on the "medical" profession.

Section 393(1)(a) applies the rate "on the entire amount" once the aggregate exceeds the threshold, so a locum paid across several stints in a year can cross it without anyone noticing. Keep a running total per locum. Deposit dates, returns and the certificate are in our post on TDS when a clinic pays a visiting consultant. If the locum is on monthly salary under your control rather than a fee, salary rules apply instead; ask your CA which it is before the first payment.

What should a locum agreement say?

One page is enough if it settles these points:

1. Dates and OPD hours covered, and the emergency arrangement outside them.
2. The fee, per day or per session, paid for the locum's work. Regulation 6.4.1 bars "division, transference, assignment, subordination, rebating, splitting or refunding of any fee" and any commission for "referring, recommending or procuring" patients, so the fee must not depend on referrals. Our visiting consultant agreement post covers fee structures in detail.
3. TDS: fees paid net of tax where the clinic must deduct, and the certificate the clinic will issue.
4. Prescriptions, certificates and receipts signed under the locum's own name and registration number.
5. Records kept in the clinic's system; the locum's access to them afterwards; no separate patient lists.
6. Patients return to the clinic doctor at the end of the cover, as regulation 4.4 expects, and the locum will not solicit them.
7. Confidentiality of patient data, and indemnity cover in force for the period.