The national medical council (NMC) bill, has turned out to be a pandemonium for the centre. It has led to a disarray and confusion among the Professionals, in general, and the Medical fraternity in particular. The NMC bill, with a wide portfolio of recommendations was first proposed in 2016, aimed at overhauling the ‘corrupt’ Medical Council of India that re-gulates the medical ethics and education in the country. One of its goals was to curb the supposed corruption in MCI through a greater distribution of powers, by setting up an independent Medical Advisory Council to oversee the National Medical Commission, the proposed successor of the MCI. But, ironically, all the members of the NMC are the members of council, hence making the idea of ‘greater distribution of powers’ technically absurd. Most of these recommendations have to do with the general administration and working of the said bodies, and did not draw flak from the medical fraternity. Perhaps, the most controversial point in the NMC is the recommendation for allowing the practitioners of the alternative medicine (Ayurveda, Homeopathy), to practice allopathy, after a ‘condensed ‘bridge course’ for a duration of one year. With this recommendation, the government seems to have opened a pandora box, drawing castigations from all the professional corridors, including the practitioners of alternative medicine itself.
The reason for such recommendation is that the government thinks that allopathic doctors are not willing to work in rural and tribal areas after completing their graduation and are concentrating more on the exams for admission into specialty courses, which is a stark reality.
According to WHO, the recommended doctor-patient ratio should be around 1:1000, however India has an average ratio of 1-1700, which may worse in the rural areas of the order of 1:6000
According to Rural Health Statistics 2014-15 of the Ministry of Health & Family Welfare, there is huge scarcity of doctors and specialists in the rural healthcare system. The statistics and numbers, very vehemently vindicate the ‘concerns’ of the government. Indian rural areas suffer from an acute shortage of doctors, physician specialists, but the method to fulfill the dearth, by “back door” entry of traditional medicine practitioners into allopathy is of a greater concern as it can very conveniently tantamount to jeopardizing the hearth care and safety of the citizens.
On an average, a simple medical graduate has to undergo a strict training for a period of five and a half years followed by an internship of 1 year. The training starts from the very basics of medical science, which include subjects like basic anatomy of human body, Physiology and Biochemistry of various organic compounds. The MBBS course further consolidates and toughens with each passing year, with the student being taught more ad-vanced subjects like the pathology of various diseases, the mechanism, action, indications and side effects of various medications, community based medicine, immunization and medico legal aspects. Finally, the medical student is initiated into clinical subjects of surgery, medicine and gynecology. He/She is taught the theoretical part and side by side receives strict practical inception into treating and managing patients under the guidance and supervision of senior doctors. This is followed by one year internship, where he is partially allowed take decisions about rendition of his skills. Hence, medical graduation is one of the most systemic and organised training program which imparts scientific and evidence based knowledge to its student, very well, since they are to deal with human lives.
Alternative medicine or fringe medicine, even though largely followed in many parts of the developing world consist of practices ‘claimed to have the healing effects’ of medicine but which are disproven, unproven, impossible to prove. Alternative therapies or diagnoses are not part of medicine or science-based healthcare systems. Alternative medicine consists of a wide variety of practices, products, and therapies – ranging from those that are biologically plausible but not well tested, to those with known harmful and toxic effects. The alternative medicines famous in India include Ayurveda and Homeopathy. While Ayurveda refers to the traditional Indian system of medicine, homeopathy finds its root in ancient Greece; none of the two have scientifically approved or validated approaches into treating various diseases. Rather, both the systems rely upon the ‘assumed medicinal properties of herbs or techniques’ in Vedas and ancient Greek texts without a scientific verification, which can very conveniently be translated to ‘superstition’.
The brief introduction of the two, hence, very clearly shows that they stand on the two extreme sides of the number-line. In-fact, the allopathy and the alternative medicine have time and again, been, invalidating, opposing each other. The bill is anti patient as it allows the unscientific mixing of different thoughts. Allopathy is a wide field, which encompasses a hundred other branches. What are the branches that AYUSH practitioners would be allowed to dwell into? Would they work alongside a surgeon, a gynecologist, a cardiologist or would they help a general physician to decide if a particular chest disease should be diagnosed as swine/bird flu.
This is why this tectonic decision of allowing the AYUSH to practice, war-rants a more reasonable and scientific decision away from the perimeter of clash of egos, and war turf.
Can the practitioners of alternative medicine do justice to allopathy? Is one year of a condensed bridge course equal to 6 years of Spartan training? Are we willing to put the lives of our citizens in hands of quarks who will be allowed to practice medicine because of some bad decisions of a few unreasonable people with political undertones? The decision seems more of a hoodwink, with political background of appeasing the right wing otherwise the government could very well introduce better ways of strengthening the peripheral and rural health care system.
One of more plausible way, which has been repeatedly suggested and could have been thought over in the NMC was the placement of ‘category’ doctors in the areas of their origin. Every year hundreds of students, both at undergraduate level (MBBS) as well as postgraduate level (MD/MS) enter various prestigious institutes through reservation system. More than 50 percent seats are reserved at both levels for RBA, SC, ST students. Apart from this, posts as assistant professors and professors also have reservations based on the existent quota system. These categories are mostly based upon the areas, regions, ethnicities, tribes, recognized as ‘under developed’ ‘under privileged’ by the state/centre.
For such students, post graduates, lecturers, professors, who have reached their designations under any of these reservations, the servitude in the areas, or for the ethnicities of which they have availed, should be made mandatory. The specialists who are working in urban hospitals and have availed of the quota system should give a certain amount of time at the places of their origin, in rural areas. Such a decision would not only strengthen the rural healthcare but would also justify the system of reservations
There has been criticism of the bill, both by the allopathic doctors as well as the practitioners of AYUSH. Both have urged on maintaining the purity of each of the systems. Mixing of them will just increase the quackery; instead, the efforts should be made at strengthening each of the systems.
The decision makers need to realise that health care should be the most prioritised sector of national policy making. An emotionally or ideologically influenced decision can put thousands of lives at stake. Additionally, it reflects the unreasonable illogical decision making of a country. Hope the issue is resolved with utmost seriousness
The Author is a freelance journalist, author and PG-Scholar in GMC and Asso-ciated hospitals
