How would you feel if you came to know that your cardiologist, who you trust your life with, was not a qualified doctor? A far-fetched idea? Not quite. It has now come to light that a number of doctors in India are actually not allopathic medical practitioners. They have degrees in alternative medicine and yet they practise allopathic medicine, duping patients and putting them at inordinate risk.
Take Jayesh Hari (name changed), once known as a top-notch cardiologist in Chennai. He ran a thriving practice in the city and was a regular on the cardiologist conference circuit, recalls Ravi Shankar, former president, Tamil Nadu chapter of the Indian Medical Association (IMA).
When Hari botched up a case of a heart problem in a 50-year-old patient, and a police case was filed against him, the citys medical community was shocked. We felt he was being victimised, says Shankar. But when the cops asked Hari to produce his medical degrees, he couldnt. It was found that Hari was, in fact, an ayurveda doctor.
Shankar calls this qualified quackery. Doctors earn degrees in alternative medicine — like ayurveda, homoeopathy and unani medicine — and then practise allopathy. This trend first appeared in rural areas. But its now become common in the cities, says Shankar. Earlier this year, the Tamil Nadu IMA made a list of 2,500 non-qualified doctors practising allopathic medicine in Chennai, and handed it to the police. About 200 doctors were arrested, says the former president.
When P.A. Balaji, professor at the department of physiology, Dr B.R. Ambedkar Medical College, Bangalore, was approached by a city nursing home to work as a consultant doctor two years ago, he agreed to take the job because the 60-bed hospital boasted of quality infrastructure. But once I started working there, I found that a majority of the junior doctors did not have an MBBS degree. Instead, they had graduated in ayurveda and homoeopathic medicine, he says.
In May this year, Balaji conducted a study to find out if the trend of hiring non-qualified doctors was common. He surveyed 20 private nursing homes in Bangalore — of capacities ranging from 10 to 60 beds — and found that only 12 per cent of the duty doctors in each hospital ward and casualty department held MBBS degrees. About 87 per cent of the doctors were ayurveda, homoeopathic and unani degree holders. The survey was published in the International Multidisciplinary Research Journal and the Journal of South India Medico Legal Association earlier this year.
The Medical Council of India specifies that a doctor trained and registered under a particular system of medicine can only practise what he is qualified in — and not in any other system. This rule was also upheld by the Supreme Court a few years ago. The law remains only on paper, says Balaji.
Currently, seven lakh doctors are registered with the Medical Council — to which 30,000 MBBS graduates are added every year. There are as many non-allopath medical practitioners in the country — five lakh ayurveda and one lakh homoeopath doctors. We have conducted several random surveys in the last five years and these reveal that 90 per cent of non-allopath doctors regularly prescribe allopathic medicine, says Anil Bansal, secretary, anti-quackery cell, IMA.
Some even start calling themselves allopathic doctors. A Delhi-based ayurveda professional who claimed to have an MD (doctor of medicine), had managed to fool the entire medical community. It was only when he prescribed incorrect antibiotics and a heavy dose of steroids to a patient last year that his false credentials became known.
The main reason cross-practice is thriving in urban India is because the demand for doctors has out-stripped their supply, says Bansal. Cities are growing rapidly and the supply of qualified doctors isnt keeping up with it, he says. Ideally, there should be one doctor available for every 1,000 persons. In India, this ratio is 1:1,700, he adds.
Also, MBBS degree holders dont want to become general practitioners (GPs) anymore. GPs earn poor salaries. All medical graduates want to become specialists, says Bansal, adding that only two per cent of MBBS graduates become GPs every year. The rest drop out to study postgraduate courses.
Another reason doctors of alternative medicine start prescribing allopathic drugs to patients is that in India, a paracetamol tablet carries more mass appeal than a homoeopathic ferrum phos tablet. People have more faith in allopathic medicine. Also, steroids and antibiotics provide quick relief for any illness. So ayurveda and homoeopath doctors have taken to prescribing these drugs, says V.N. Sharma, chairman, anti-quackery cell, IMA.
When the IMA organised an anti-quackery week in Delhi last month, it didnt have to look hard to find non-qualified doctors practising allopathic medicine. We randomly picked 15 nursing homes across the city. Each hospital had hired ayurveda and homoeopath degree holders as junior doctors, says Sharma. In one week, the anti-quackery cell shot videos and took pictures of 150 non-qualified doctors and handed them over to the police. Every nursing home in the city hires junior doctors who are not qualified for the job, adds Sharma.
The result is often mistreatment, or even medical negligence. R.K. Sharma, a retired doctor from the All India Institute of Medical Sciences (AIIMS), Delhi, recalls receiving a 16-year-old patient with a perforated vagina a few years ago. The girl had a vaginal infection and was being treated by an ayurveda doctor. He attempted to perform surgery on her, which punctured her vagina and resulted in the infection spreading in the abdomen, recalls Sharma. Although the patient was rushed to AIIMS by her parents, she died a few days later.
Sharma says this was one of the five or six serious cases of malpractice that he treated in his career. I often received patients whose diseases got complicated because they were pumped with unnecessary steroids and antibiotics, he adds.
But ask the doctors of alternative medicine why they prescribe allopathic medicines and they will tell you its all for a good cause. In rural India, homoeopaths and doctors of other disciplines are often the only medical practitioners available. So such a move is necessary to make up for the shortage of doctors and medical facilities, says Paresh Navalkar, spokesperson, Homeopathic Integrated Medical Practitioners Association.
But the medical community is not convinced. In the last two years, medical bodies across India have tried to build public awareness about unqualified doctors. The IMA announced that the first week of October would be anti-quackery week. We conducted dharnas and awareness programmes. We also conducted random raids at nursing homes across Delhi and drew up a list of 150 non-qualified doctors, says Bansal.
The Tamil Nadu chapter of the IMA is trying to bring the focus back on the concept of family doctors in Chennai. The idea is to add some prestige to the job of a general practitioner. It will encourage MBBS graduates to work as junior doctors for a few years before they head for higher studies, says Jayalal, president, IMA, Tamil Nadu.
But for now, it may be advisable to check a doctors medical degrees before you submit yourself to him.