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The ‘hybrid doctor’ debate

Of 8,847 posts of doctor under the public health department, 1,983 are currently vacant.

Mumbai |
Updated: January 15, 2014 12:00:57 am

For a week, Maharashtra has been debating the implications of a cabinet decision that allows homoeopaths to prescribe allopathic drugs after taking a year-long pharmacology course. The cabinet itself was divided in its discussions leading to the decision, the medical fraternity is aghast, and even the homoeopathic fraternity is not unanimous in the conviction that it will work.

Put forward by the state’s medical education department, the proposal had been taken up by the cabinet as far back as in 1999 but the government then changed before it could be placed in the assembly. Following last week’s cabinet clearance, Maharashtra is set to become the first state to allow such a practice.

There are allegations about the objective being politically motivated. The state has 46 homoeopathy colleges, all private, and many of these are owned by current and former MLAs and ministers. Sources say an NCP minister’s family runs a college in Marathwada and a Congress minister of state’s family runs one in the Mumbai Metropolitan Region.

The state’s argument is that there is a large shortage of doctors, especially in rural areas. Of 8,847 posts of doctor under the public health department, 1,983 are currently vacant. The medical fraternity, however, has questioned if there is any guarantee that homoeopaths who complete the pharma course will go to rural areas.

In the cabinet meeting, Medical Education Minister Vijaykumar Gavit argued against opposition to say that rural areas were so short of doctors that  a number of homoeopaths are illegally prescribing allopathic drugs in any case.

Maharashtra has 62,000 registered homoeopaths.

The road ahead

The government will seek to amend the Bombay Homoeopathic Practitioners Act, 1959, and the Maharashtra Medical Council Act, 1965. The Central Council of Homoeopathy, however, is not convinced this will do. It says changes will first need to be made to two central laws, the Central Council of Homoeopathy Act, 1973, and the Indian Medical Council Act, 1956. Last June, the central council had rejected Maharshtra’s request for incorporation of modern pharmacology in the homoeopathy curriculum.

The government has now requested the Maharashtra University of Health Sciences to frame the syllabus for a certificate course in modern pharmacology. This will give registered homoeopaths the right to prescribe allopathic drugs to the extent learnt during the course, and only within Maharashtra.

“The methodology in the two courses is different,”  says Dr Shivkumar Utture, executive committee member in the Maharashtra Medical Council. “Homoeopathy cures slowly by treating symptoms, allopathy provides quick results. They cannot be merged.”

“Ninety-five per cent of the syllabus of MBBS and BHMS (Bachelor of Homeopathy, Medicine and Surgery) is the same,” counters Dr Bahubali Shah, administrator of the Maharashtra Council of Homeopathy. “Pharmacology is the only MBBS course that is not touched in BHMS. The one-year course will fill that gap.”

Both MBBS and BHMS are courses of four-and-a-half years, with some subjects common. “The pharmacology course will not be enough as it will compress all the information of four-and-a-half years into one year,” says Dr Santosh Wakchaure, president of the Medical Association of Resident Doctors.

The chief minister has directed the medical education department to ensure homoeopaths allowed allopathic prescriptions display their pharmacology certificates in their clinics.

Hybrid fears

The Indian Medical Association, the Maharashtra Medical Council, the Medical Association of Resident Doctors, the Association of Medical Consultants, the General Practitioner Association of Bombay, and the Maharashtra State Medical Teachers’ Association are moving court for a stay on the decision, which they say will end up creating a hybrid course.

The IMA and the state medical council have cited Dr Mukhtiar Chand vs State of Punjab and Poonam Verma vs Ashwin Patel, in which the Supreme Court had observed a person qualified in one system of medicine cannot practise in another. “The court also stated a medical practitioner registered with one council cannot be registered with another. If homoeopaths can prescribe allopathic medicines, then they will come under the purview of both their council and MMC,” says Dr Jayesh Lele, secretary of IMA, Maharashtra.

The other streams

“Once homoeopathic doctors are allowed, other branches will demand a similar course,” says Dr Kishor Taori, state medical council president.
Dr Bahubali Shah of the homoeopathy council stresses that many serving medical officers have been drawn from the directorate of AYUSH (ayurveda, unani, siddha and homoeopathy).

The government reserves 25 per cent such posts for Bachelor of Ayurveda, Medicine and Surgery graduates. Congress Minister for Minority Affairs Naseem Khan will submit a proposal seeking 10 per cent for unani practitioners, too.
As for homoeopaths, a number of organisations have been making representations for similar reservation, say health department officials.

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