“AYUSH therapies such as homeopathy is symptom based diagnosis while modern medicine is evidence based.” Dr. Hiten Kareliya
While speaking to Dr. Om Lakhani, an endocrinologist in Zydus hospital, Ahmedabad, he suggested how the government is trying to bandage the problem of shortage of rural doctors and not finding a solution to the problem. Moreover, he suggested how a democratic and equal representation of modern medicine doctors in the new medical association is required so such non-scientifically validated practices of ‘crosspathy’ are not actualised.
While, Dr. Anand Ahuja, a cardiovascular specialist perceived it as discriminatory towards those living in the rural areas, where to overcome the increased demand of doctors against its ameliorated supply, these anti-rural methods are being pushed. Moreover, Dr. Ahuja raised concerns about those seeking AYUSH treatments that may not be eligible for insurance claims. As discussed, medical insurance providers only provide claim to those seeking treatments from an evidence based practice. Even stem cell therapy, which is based on a scientific principle but not always a guaranteed success is excluded from such claims. Thirdly, Dr. Ahuja perceived that passing such bills can dilute the reputation of Indian doctors overseas. Since a large majority of doctors practicing modern medicine are based in the western countries, diluting the standard of medical practitioners by introducing a crossover of AYUSH and modern medicines can be detrimental for Indian doctors in the West and also for those seeking overseas medical experience.
While Dr. Ahuja didn’t comment on the extent of competency of homeopathic or Ayurveda principles of treatment, he stated, “The bridge course won’t be good enough to bridge the gap between the principles of modern medicine and other therapies, which is so wide apart. No course can possibly be sufficient to make anyone trained in one stream good enough to practise the other.” Furthermore, he claimed that the AYUSH practitioners are trained completely differently when it comes to pharmacology and can make life threatening mistakes if allowed to prescribe medications. Certain health risks highlighted during our conversation were the prescription of Beta blockers and ACE inhibitors, some of the most common prescription in the cardiovascular area- overdose or underdose of which, can cause serious problems affecting blood pressure and heart health.
As infectious diseases such as TB are one of the major causes of mortality in India, we discussed with Dr. Hiten Kareliya, an infectious disease specialist at Prime Infection Care, Vadodara, to discuss the implications of these practitioners prescribing anti-biotics. He raised concerns about over or under treatment with antibiotics that can introduce anti-biotic resistant strains of bacteria in the communities and hospital settings that will then fail to respond of other forms of antibiotic treatments. He also raised similar issues around training of AYUSH practitioners and modern doctors that apply completely different methods to check, diagnose and investigate patients.
Important issues can arise especially during infectious complications such as cerebral malaria, meningitis, HIV, pneumonia and sepsis where doctors decide on which tertiary care is required at its earliest- something that the AYUSH practitioners would not be able to refer to.
Also, Dr. Kareliya was concerned about their lack of knowledge in modern pharmacology and its implications on dosage and side effects. “AYUSH therapies such as homeopathy is symptom based diagnosis while modern medicine is evidence based”. If poorly treated, such patients could be carriers of diseases such as typhoid and ameobiosis that could infect the larger population.
Lastly, in cases such as TB, HIV and malignant tumours, prognosis and counselling is crucial. If these practitioners are not aware of drug pharmacodynamics and drug adherence, they will not be able to provide proper prognosis. In his opinion, Dr. Kareliya suggested the bridge course should be 2-3 years with internship in a public or corporate hospital to be eligible for prescribing modern medicine.