The Maharashtra State cabinet recently gave its nod to a bill that allows homeopaths to practise allopathy after completing a one-year bridge course in pharmacology. The State government also amended the Maharashtra Medical Practitioner’s Act to allow ayurveda practitioners to practise allopathy.
The medical fraternity was shocked and the India Medical Association said they would be taking legal recourse. The State government’s move came in the wake of homeopaths going on hunger strikes, pressurising the government to allow them to prescribe allopathic drugs. It emerged then that of the 62,000 registered homeopaths in the State of Maharashtra a mere 10,000 were practising homeopathy. The rest were involved in mixed practice. In Goa too a large number of homeopath and ayurvedic doctors are involved in mixed practice. These doctors are the first preference for hospitals and nursing homes who can employ them for a paltry Rs 10,000 a month.
After struggling to obtain their medical degree no MBBS doctor is willing to work for one fourth the salary that
government hospitals pay them.
It is therefore common to find homeopath
and ayurvedic doctors employed
as RMOs (Resident Medical Officers),
casualty medical officers and general
duty medical officers in hospitals
throughout the State. Some hospitals
realizing they can get into trouble for
this have begun calling them ‘clinical
assistants’ instead of RMOs.
Although they are employed to monitor
patients, there are those who sign
patients’ discharge letters and even
prescribe allopathic drugs, using an
allopath doctor’s prescription pad or
a blank piece of paper.
Allopath doctors insist that these
doctors who are qualified in one system
of medicine aren’t legally permitted
to practice another system. The systems
of treatment are vastly different. “All
allopath doctors study medical pharmacology
from the first year till their
last. The essence of medical treatment
is pharmacology and all subjects in
our course are taught in the context
of each other. Pharmacology is not a
standardized subject that one can study
by doing a one year’s crash course,”
one GMC doctor said.
Cross practice or cross pathy has
become rampant with hospitals exploiting
the system openly and taking
things for granted. Many a times ICUs
(Intensive Care Units) are left in the
hands of these doctors with no MBBS
doctors available round the clock. Hospitals
however don’t fail to bill their
patients the steep ICU charges. The
safety of patients are being compromised
and it is only time before a
patient goes to court and sues for medical
negligence. “Why should patients
pay Rs 10,000 as ICU charges unless
there is an anesthetist, an intensivist
and one specialised in internal medicine
present? It’s ultimately all about the
profits,” one doctor said. He pointed
out that reputed educational institutions
conduct short intensive care courses
open to homeopaths and ayurvedic
doctors too.
It is mandatory for allopath doctors
to register with the Goa Medical Council
before giving their first prescription.
MBBS doctors have to obtain credits
and every five years these credits are
renewed. “When it is so mandatory
for MBBS doctors how are these homeopathic
doctors able to prescribe medicines.
How does their council allow
it? The Health services should take action
as they are the ones giving licenses
as per the Goa Medical Practitioner’s
Act,” one doctor said.
Recently the Delhi Medical Council
issued an order warning doctors registered
under its council against cross
practice. It stated that no cross pathy
practice is allowed by any medical practitioner
unless such person is also registered
in that system in which he is
practising. The order states that drugs
commonly prescribed include LIV52,
Amlycure DS, Cystone, Septilin, M2
Tone, Neeri and Amycordial. Cross pathy
the order said can be punishable by
rigorous imprisonment up to three
years and a fine of up to Rs 50,000
under the Delhi Bhartiya Chikitsa
Parishad Act of 1998.
President of the Goa Medical Council
Dr Shekhar Salkar says the council
hasn’t received any complaints in the
past three years of cross practice. He
explains that the council has jurisdiction
over only allopath doctors and cannot
pull up or act against homeopath or
ayurvedic doctors. Aggrieved patients
needn’t come to the council and can
complain directly to the police he says.
Hospitals employ a large number of
homeopath and allopath doctors because
there are a shortage of MBBS
doctors he says. “There are hardly any
MBBS doctors available. They are either
absorbed by government hospitals or
pursue higher studies. Hospitals have
no choice. These doctors can’t write
prescriptions but they can monitor patients
in wards. Many homeopathy and
ayurvedic doctors rate higher than
MBBS doctors. Around 60 percent of
medicine is common sense and they
learn the required skills when practising
in hospitals,” he says.
Registrar and secretary of the Council
for Indian System of Medicine and homeopathy
Dr Dilip Vernekar says homeopaths
don’t have well equipped, full
fledged hospitals where they can train.
They need clinical exposure and experience
in general hospitals.
Further, when they graduate they
have no job opportunities. Many enter
the marketing field, do their MBA while
others join hospitals.
Majority of homeopathy and
ayurvedic colleges in the country are
run by politicians. They receive grants
and many aren’t able to fill up even
half their seats.
Pediatrician and vice president Goa
Medical Council, Dr Dyanesh Volvoikar
says a need based assessment needs
to be carried out as there are a large
number of homeopaths and ayurvedic
doctors unnecessarily being thrown
into the system with no jobs available
for them. He suggests that the government
employ them as health educators
and that their services be used
for health programs.
The solution to the problem of health
care not reaching rural India, he says
is to have more allopath doctors. He
suggests that district hospitals be converted
into medical colleges since they
are already equipped. Doctors can be
employed part time on honorary system
as their lecturers.
Dr Volvoikar points out, “Can an accountant
who is not a CA sign a company
statement? Can a notary ship be
awarded to a non advocate? Why the
different standards then for medical
practice?
