Maharashtra government decision to allow homeopathy graduates to register with Maharashtra Medical Council (MMC) after completing a one-year certificate course has raised the temperature of the state's medical community in opposition. Doctors in Maharashtra are strongly opposed to the move as it is antithetical to medical education, professional standards and patient safety. Doctors agree with Bombay High Court decision for the removal of strike after only one year but the main issues of the proposal are still in dispute.
Dr. Dilip Bhanushali, former president of the Indian Medical Association (IMA) and even the chief executive of the Indian Medical Association (IMA) has become one of the most vocal critics of the government’s decision. The proposal is not scientifically and legally sound, he said, and there should be no reason for them to allow doctors who have been trained in one system of medicine to practice in another system after short certification course.
Dr Bhanushali dismissed the government’s argument that the move is intended to address a shortage of doctors. India’s healthcare education system has flourished considerably in the past decade, he said. He added that the country has now almost 835 medical colleges that produce nearly 35,000 new doctors a year, and that the shortage argument is not convincing.
He also noted that the Supreme Court has consistently held that medical practitioners should practice only the system of medicine in which they have received formal education and qualifications. The proposed policy is inconsistent with this long-standing legal principle, he said.
Dr. Bhanushali said the IMA's opposition is not to homeopathy or other traditional medicine. He said every recognized medical system should retain its own identity and that practitioners should remain within the scope of their professional training.
At the same time, patients should have freedom to choose homeopathy, Ayurveda or modern medicine based on their habits, he said. But this choice only matters for practitioners who are well-schooled in the discipline in which they work. If crossover is allowed without education, he said, patients could be confused and professional responsibility diminished.
One of the strongest objections from the medical community is that a one-year bridge course is not sufficient. Dr. Bhanushali argued that to become a good modern medical professional, one needs to have years of study, clinical experience and supervised training.
He noted that an MBBS degree itself is five years of intensive education followed by several years of postgraduate specialization for those who wish to become surgeons or specialists. Suggesting that a one-year certificate course could provide comparable expertise, he said, undermines the rigorous standards that define modern medical education.
His remarks are representative of a wider concern among doctors that shortening the path into modern medicine could potentially affect the quality of patient care. Medical associations say to diagnose diseases, prescribe contemporary medicines, and perform medical procedures requires a lot of knowledge that can be acquired only through a short certification program.
The controversy also led to a statewide doctors' strike but health professionals have since complied with the Bombay High Court's order to resume services. Dr. Bhanushali said the protest was not the first course of action but rather the result of long-drawn out efforts to interact with the government.
He said representatives of the medical fraternity had met ministers many times, wrote memoranda and participated in discussions at the state and central level. Despite many rounds of dialogue, there was less progress and doctors felt that they were not being heard, he said.
Although he acknowledged the court’s concern that patients should not suffer from disruptions in healthcare services, he also said medical practitioners’ concerns regarding education standards and patient safety also should be taken seriously.
Dr Bhanushali also questioned the intention behind the government's proposal. Private homeopathy colleges have been dropping in admissions over the past few years, he said, and, therefore, a pathway to modern medicine would be more attractive to prospective students. He also claimed that some of these institutions are political. These allegations, however, he refused to provide any evidence.
The Maharashtra government’s proposal continues to stir debate in the healthcare sector. Supporters say that it will help to expand access to healthcare in areas of need and in underdeveloped areas of the country and opponents say that the policy risks mixing the different systems of medicine and the quality of training is going to be less obvious.
As the debate continues, medical associations are calling for healthcare experts, regulatory bodies, and politicians to engage in broader discussions with healthcare experts, regulators and policymakers for further discussions with professionals before any changes are to be made to the way healthcare providers and policymakers before any reforms can be considered and any new professional qualifications are considered to be very different. The debate underscores the delicate balance in healthcare accessibility and patient safety, medical ethics and the integrity of medical education is what must be balanced with the safety of the health care system and the ethics of the profession is at stake from the perspective of the professionals in the United States of medicine: as the health system and the profession is the only way to ensure the safety of healthcare accessibility and the quality of health care professionals.
