Maharashtra’s prescription on doctor shortage generates debate on integrated medicine

Can homeopaths be allowed to prescribe an allopathic medicine?

The Maharashtra cabinet has triggered a fresh debate on the subject, having recently approved a decision allowing homeopaths to 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 were more likely to run into a practitioner of traditional medicine, rather than an allopath.

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, it is a progressive step towards integrated medicine, especially when the shortage of healthcare professionals looms over Indian healthcare.

The homeopath-allopath tug-of-war is not a new one and in recent times, it had hit headlines over a year ago, when 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 were 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 clouded, when 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 year, what 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 consultants Technopak in 2012, India needed 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 resourse shortfall.

About 90 percent 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.

In fact, says Ranjit Puranik of the Ayurveda Drug Manufacturers Association, also linked with a Mumbai-based Ayurveda college – 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.

Shortages

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 its four doctors per 1,000 people, points out Singhal.

As the shortage of doctors, nurses and para-medics casts its shadow on Indian healthcare – it remains to be seen if Maharashtra’s prescription will be a progressive step towards integrated medicine, or will it in fact trace the traditional contours of suspicion and mistrust between the different systems of medicine.