Medicine
"For the medical community it may not mean much. But I think it would be unfair on patients and customers," says one doctor.
A team of doctors check a child admitted at the Baba Raghav Das Medical College Hospital in Gorakhpur.

Persons practicing Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy (Ayush) could be allowed to practice allopathy or modern medicine on clearing a bridge course, a contentious provision in a Bill that was recently introduced in the Lok Sabha states.

The National Medical Commission Bill 2017, introduced in the Lower House of the Parliament last week, seeks to replace the Medical Council of India and also revamp medical education in India.

Clause 49 of the Bill states that a joint meeting of the National Medical Commission, the Central Council of Homoeopathy and the Central Council of Indian Medicine should be held at least once a year "to enhance the interface between homoeopathy, Indian Systems of Medicine and modern systems of medicine".

"The joint sitting, may, by an affirmative vote of all members present and voting, decide on approving specific bridge course that may be introduced for the practitioners of Homeopathy and of Indian Systems of Medicine to enable them to prescribe such modern medicine at such level as may be prescribed," it reads.

Experts across the field feel that such a provision, if passed, could do more harm than good.

"They are different systems of medicine altogether. So there is no way they can clear a bridge course and then start practicing allopathy. Somebody who's done MSc in Zoology can then say I'll do a bridge course and become a doctor, isn't it? It will just not work," says Chennai-based senior gynaecologist Jaishree Gajaraj.

"For the medical community it may not mean much. But I think it would be unfair on patients and customers," she adds.

Attempt to increase strength of doctors in rural India

The reasoning behind the provision could be an attempt to increase the availability of doctors in rural India. But modern medicine is much more complex and a bridge course is more like a short-cut.

Dr Oommen George, a public health specialist and a TB expert, calls it a Catch 22 situation.

"We have doctors who are trained in modern medicine and there's lots of them. But unfortunately, most of them don't work for the vast majority in the country which is both the rural and the urban poor. That's one side of the story. There's also a decline in the quality of medical education even in modern medicine. And on the other side you have a huge number of people who are working currently as family physicians and trusted practitioners, who are affordable and accessible to the majority. And they are practicing modern medicine whether it is legal or not," he explains.

Such a measure, he said, can be good from a political perspective since it is dealing with something that is already happening and is making it legal. But the "facade" is likely to blow up sooner or later.

"Modern medicine is something that is quite complex. There is scope for someone like a physician assistant who can deal with primary care. For people who are dealing with general physicians who work in primary care, 90% of them are dealing with problems that don't require complex knowledge. There is a scope for that group of people. But we don't have a very successful physician assistant programme in India," he says.

India has nearly 8 lakh Ayush practitioners, a number which is likely to increase. And a clause such as the one in the Bill could affect in more ways than one.

Dr Sampath Kumar, Senior Assistant Professor, Institute of General Surgery, Madras Medical College, is totally opposed to the idea of a bridge course as he believes that it will be harmful to society.

"They also are planning for a diploma for class 12 students so that they can study a MBBS like course for 1-2 years and serve rural people. The lives of rural people are not lives?" he asks.

If the government wants more trained and registered doctors to serve in rural areas, then it should also be willing to compensate professionals fairly.

"The government thinks it will be helpful to the society, especially poor people. But it can recruit allopathy doctors. We are already working in a government hospital for meagre salaries. We state government doctors get one-fourth of what private practitioners and central government make. So, if the government increases our salaries, we will even go to rural areas and serve," he says.

What is also of concern is that it is not clear to what extent will Ayush practitioners be allowed to practice allopathy on clearing the bridge course. For instance, will they be allowed to treat basic health issues like a common cold or can they all perform procedures such as surgery?

Health professionals, however, agree that there is a need for an overhaul of medical education in the country and this could perhaps answer the acute shortage of qualified doctors in the longer run.

"The ideal situation would be to standardize medical education in the country. In a way that there is only one course of medicine. At the same time, you are also taught all kinds of medicine, including homeopathy and ayurvedic medicine," Dr Oommen says.