Calcutta, July 8: Some private hospitals and nursing homes in Calcutta are increasingly hiring homoeopaths and ayurveda practitioners as residential medical officers (RMOs) who have to deal with life-threatening crises because Bengal doesn’t produce enough MBBS graduates.
A lacuna in the West Bengal Clinical Establishment Act allows hospitals to do so and the state health department is planning an amendment to plug the loophole, though the answer possibly lies in producing more MBBS doctors.
The act defines a residential medical officer (RMO) as one “who will be engaged for a particular discipline like allopathic, homoeopathic and ayurvedic or unani system of medicine, with requisite qualifications and registrationů for the particular discipline for which the clinical establishment is set up”.
When the act was passed in 1950, it was presumed that the “particular discipline” clause would ensure that a health care unit would hire doctors only from the discipline for which it has been set up. However, when a hospital gets a licence, it is not required to mention that it is an allopathic establishment, which allows it to hire doctors from any discipline.
But although it may not be illegal to hire doctors from non-MBBS disciplines, it is illegal for these doctors to prescribe allopathic medicines and “unethical” for a hospital to keep patients in the dark about their qualifications.
“Several private health care institutes are hiring Ayush (ayurvedic, yoga, unani, siddha, homoeopathy) practitioners who are illegally prescribing allopathic medicines and handling critical-care patients,” a health department official said.
In the proposed amendment, the definition of an RMO would stress “specialised knowledge and skill” to provide “adequate care”. The draft, to be prepared in six months, will need Mamata Banerjee’s nod before it can be tabled in the Assembly.
“We must totally avoid keeping non-MBBS doctors as RMOs because they have to deal with critical situations in an emergency,” said Pradip Tondon, president of the Association of Hospitals of Eastern India. “We have discussed this problem at our meetings.”
An RMO is usually the first available doctor at night. “If a patient appears in trouble, the RMO must immediately attend to him and consult the admitting doctor. If the latter is not immediately available, the RMO has to make decisions critical to the patient’s life,” the medical superintendent of a private hospital said.
The rules bar non-MBBS doctors from prescribing life-saving allopathic drugs, administering injections or making interventions such as using a defibrillator to stabilise a patient’s heart.
“Homoeopathy and ayurveda students are taught anatomy, surgery, medicine and gynaecology but not pharmacology, which is concerned with the uses, modes of action, and adverse effects of allopathic drugs,” the principal of a homoeopathy college said.
“We don’t produce enough MBBS graduates,” state director of medical education Sushanta Banerjee admitted. Bengal produces 1,350 MBBS graduates every year — an extra 600 seats will be added this year — compared with 5,500 in Karnataka. If the amendment is passed, private hospitals may have to hire outstation doctors at higher pay.
State-run hospitals too face a shortage but it’s easier for them to recruit RMOs. An RMO’s starting salary at a government hospital is around Rs 30,000 — virtually the same as at a private hospital — but the work hours are shorter.
Besides, hiring non-MBBS graduates is advantageous for private hospitals. First, they come cheaper by at least Rs 10,000. Second, their slimmer career options keep them from quitting suddenly, as MBBS doctors often tend to do in the run-up to their postgraduate entrance tests, or after cracking the exam.