Maharashtra’s prescription for doctor shortage creates flutter

Can homeopaths be allowed to prescribe allopathic medicines?

The Maharashtra Cabinet has triggered a fresh debate on the subject, having recently approved a decision allowing homeopaths prescribe allopathic medicines, provided they clear a year-long course on the same.

The decision is to plug the shortage of regular doctors in rural areas, where people are more likely to run into a practitioner of traditional medicinerather than an allopath.

Tug-of-war As anticipated, the decision has allopathic doctors sore and the Indian Medical Association (IMA) has said it will contest the decision.

But traditional medicine practitioners point out that it is a progressive step towards integrated medicine, especially when the shortage of healthcare professionals looms in the Indian healthcare sector.

The homeopath-allopath tug-of-war is not a new one; it hit headlines over a year agowhen chemists in Maharashtra were caught in the cross-fire. Chemists had threatened to go on strike in the State, after they were raided by the State Food and Drug Administration (FDA) for honouring prescriptions from “cross-party” practitioners. Operating in areas where doctors are few, chemists had dispensed medicines to patients based on prescriptions given by traditional doctors —homeopaths and ayurvedic doctors. And this ran foul of the FDA.

The Supreme Court, too, had earlier debarred cross-prescriptions. But the issue got cloudedwhen Maharashtra paved the way by allowing ayurvedic practitioners to prescribe allopathic medicines. And the latest Cabinet decision seeks to bring into circulation about 50,000-odd homeopaths.

IMA’s S. K. Joshi told Business Line that they would oppose the Maharashtra Cabinet’s decision. “You cannot learn in one yearwhat others have taken five years to digest,” he said.

The move will not bridge the shortfall of doctors as traditional practitioners too hover around cities, he added. If the Government is serious about getting doctors to rural areas, they must improve the primary healthcare infrastructure and incentives to doctors, he suggested.

According to a healthcare report by Technopak in 2012, India needs an additional 8 lakh-plus doctors and 18 lakh-plus nurses. Technopak Chairman Arvind Singhal says the Maharashtra decision is but a “short-cut.”

There is a reason why allopaths are put through seven to nine years of training, including in hospital environments, he said, adding that otherwise, it could lead to quackery.

Maharashtra Council of Homeopathy’s B.H. Shah points out that a Central Government directive already exists allowing States to rope in traditional Ayush (Ayurveda, Unani, Siddha and Homeopathy) practitioners to bridge the human resource shortfall.

About 90 per cent of the homeopathy syllabus is similar to allopathy, in terms of anatomy, surgery and so on, and the pharmacological details will be taught at a regularised course, he said.

Ranjit Puranik of the Ayurveda Drug Manufacturers Association, also linked with a Mumbai-based Ayurveda college, said the latest decision is a step towards integrated or holistic treatment where the best of both streams can be used to benefit the patient.

Quackery is a different issue, and needs to be monitored, irrespective of the latest decision, he added.

new appointments India’s healthcare is sitting on a time-bomb, says Technopak’s Singhal, as the Government’s move to create 10,000 fresh doctors will take time.

At present, India reportedly has one doctor for 2,000 people, short of the developing country average of two per 1,000 people. In developed countries, it is four doctors per 1000 people, points out Singhal.

> jyothi.datta@thehindu.co.in