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At its meeting this week, the Union Cabinet dropped a “bridge course” proposal between alternative systems of medicine and allopathy. And in doing so, it managed to avert for now a strike that was to start on Monday by medical students and professionals.
The “bridge” proposal of the National Medical Commission (NMC) Bill aims to train alternative practitioners in modern medicine, in a limited way. But the plan irked allopathic doctors, who saw it as a back-door entry for disgruntled practitioners of traditional medicine. The bridge course was envisaged to address doctor shortage concerns in rural areas.
As allopathic doctors under the Indian Medical Association opposed this move, even threatening a massive stir, a temporary truce was called as the IMA prepares to meet Health Minister JP Nadda next week.
The “contentious” issue though has thrown up some reasonable arguments from both allopathic and traditional medicine practitioners. Maybe even provoking early discussions for a pathway where multiple streams of medicine exist alongside one another, without diluting or disrespecting each stream.
As Monday's strike is replaced by a two-hour token protest, IMA President Ravi Wankhedkar seeks greater clarity on the NMC Bill. Different streams of medicine are based on different principles, he explains, and they should not be mixed. There is confusion still on whether the “bridge” was open to dentists and nurses. Besides, States have been advised by the Cabinet to take a call independently to address rural healthcare.
Rural incentives
Contesting the doctor shortage reason, Wankhedkar says a lakh-odd doctors enter the system annually and only about 27,000 get enrolled into PG Courses. Young doctors may not go to rural areas because they are not adequately compensated, there is no medical infrastructure or facilities for them or their families, he says. Maharashtra, for instance, pays a doctor ₹25,000 a month for a 11-month contract, he says, indicating that doctors are getting shortchanged.
Incentivise doctors to go rural areas by offering tax-breaks and other supports to make it attractive, he says. The profession is a major employer as even a small clinic employs at least two more people.
The Government can scale up district hospitals into medical colleges, he suggests and doctors emerging from them would be inclined to serve these areas, he adds.
A former IMA President, KK Aggarwal, points to countries that are addressing their rural healthcare needs by offering doctors two times their compensation package or giving tax breaks to set up in these regions.
Two-way bridge
Giving a different take, Global Homoeopathy Foundation's Dr Rajesh Shah calls for a bridge course for allopathy doctors on alternative medicine, instead of scrapping the present bridge proposal. This would empower the doctor and benefit the patient who would get holistic treatment, he says.
Asthma in children, for example, is well treated by homoeopathy. But an allopathic doctor needs to be aware of this to advice a patient to take long-term treatment from a homoeopath. Just as a general practitioner would refer to a specialist, the same can be done between different streams of medicine, but for that they need to be aware of the other's benefits, he says.
“The ignorance of a doctor cannot be a reason to deprive a patient of a genuine treatment that is available,” he adds.
The basic education on different medicine streams is common, he explains, adding that it changes in terms of treatment. There are genuine concerns, he agrees, in terms of quality education not being uniform across different colleges. But the aim should be to raise these standards, he says, adding that rigorous training and stringent parameters should be defined for candidates before they begin to practice.
Turf war
A regulatory expert on alternative medicine, Dr DBA Narayana, is not surprised by this “turf war”. Both streams of medicines have their benefits and shortcomings. For example, allopathy is good for acute illnesses and alternative medicines for chronic illnesses.
As patients question the cost of treatment and worry about side-effects, integrated medicine will find greater acceptance, he says, optimistic that the ongoing discussions will in a couple of years throw up a holistic model of healthcare.
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