It is disconcerting when doctors need to protest to draw attention to issues affecting their community. But as the National Medical Commission (NMC) Bill gets discussed in Parliament, there is a silver lining in that concerns on medical education and doctor shortages are getting catapulted onto centre stage.

On Tuesday, doctors across the country protested the NMC Bill on grounds that it was “non-democratic” as it would replace an elected body (Medical Council of India, MCI) with one where representatives are “nominated”. Their other key concern was that the Bill paved the way for a back door entry of practitioners of traditional medicine into the domain of allopathic doctors.

The MCI has seen its share of controversy in the past. But the Indian Medical Association may not be entirely off the mark in calling for the NMC to be more democratic and representative of needs from across the country. Also unhappy with the Bill in its present avatar, public health workers too are are also concerned that the cost of medical education may increase if Government has a limited control on the fees colleges can charge medical students, among other things.

Shortage concerns vs turf wars

While these may be valid concerns, the protest against the “back door” entry of traditional medicine practitioners is an area where the argument gets shrill. Which is why this tectonic decision merits a deeper and more scientific discussion, away from the danger of spiralling into a mere turf war.

In 2014, when Maharashtra took a similar approach to allow traditional practitioners to prescribe allopathic medicines, a chemist operating in rural areas of the State explained the rationale to Business Line . Allopathic doctors are not available in remote areas, he said. And if the chemist did not honour a simple, non-critical prescription from a homeopath or an ayurved, the shop ran the risk of being attacked by restive patient families.

This a reality the country faces, where there are huge shortages of allopathic doctors, nurses, para-medical staff etc. It needs redressal at the medical education stage, but even that takes time because it takes years before a full fledged doctor is turned out into the community.

Bridge course

On the other side, staunch and trained homeopaths and traditional practitioners also are unhappy with the Bill that proposes a “bridge course” for their community to practice allopathy. This is like “lighting a fire in our own homes”, said a homeopath unwilling to be named. Instead of popularising traditional medicines, this move encourages traditional practitioners to gravitate towards allopathy, he said.

A regulatory expert and seasoned hand in traditional medicine Dr DB Anantha Narayana says the NMC Bill is the right step towards integrated medicine, though it needs fine-tuning. As more countries look to traditional practices, India with its natural advantage should frame rules to ensure that benefits on both sides of medicine are not lost or misused. Maharashtra and Punjab are moving in this direction, he said.

Clear guidelines are required indicating the circumstances and diseases where traditional practitioners can prescribe allopathic medicines, he says. In fact, they can even be told to clearly display signboards indicating that they are trained homeopaths with permission to dispense a limited range of allopathic medicines. Homeopath and ayurveds are also trained in physiology, disease patterns and so on, he points out. But as is the case with all things in the country, the success of this move lies heavily on stringent enforcement to prevent abuse and quacks, he says.

With this being the backdrop, clearly the NMC Bill needs a more open and scientific discussion keeping patient interest at the heart of it all.

jyothi.datta@thehindu.co.in

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