Dr M C Gupta, a doctor turned lawyer, provides medico-legal opinion on the legal aspects of modern medicine / allopathic hospitals employing AYUSH (Ayurveda, Yoga, Unani, Siddha and Homeopathy) practitioners.
Dr M C Gupta
Dr Gupta holds an MD (Medicine) from All India Institute of Medical Sciences (AIIMS), an LLB from Delhi University and LLM from Kurukshetra University. He has served as a faculty member at AIIMS for 18 years and as professor and dean at the National Institute of Health and Family Welfare. Currently, Dr Gupta is a practising advocate with health and medical law as the area of special interest. He is a member of the Supreme Court Bar Association and Indian Law Institute.
You Ask:
Are there any laws or guidelines with respect to the role of practitioners of Indian systems of medicine employed as medical officers in hospitals which deal only and solely with allopathic medicine? What is the status in the event of an error? — Dr Gladstone D’Costa, Voluntary Health Association of Goa
Dr Gupta Comments:
1) The practice of employing AYUSH practitioners in hospitals is common in many private hospitals. This is illegal and has been commented as follows by the National Consumer Commission:
“When a patient is admitted in a hospital, it is done with the belief that the treatment given in the hospital is being given by qualified doctors under the Indian Medical Council Act, 1956. It is not within the knowledge of the relatives of the patient that the patient is being treated by a Unani specialist. We hold that it is clear deficiency in service and negligence by the hospital for leaving the patient in the hands of a Unani doctor…
As laid down by the Apex Court in the above case (Jacob Mathew Vs. State of Punjab), we feel it is high time that hospital authorities realize that the practice of employing non-medical practitioners such as Doctors specialized in Unani system and who do not possess the required skill and competence to give allopathic treatment and to let an emergency patient be treated in their hands is a gross negligence.”
In Prof P N Thakur Vs. Hans Charitable Hospital, NC, 16 August 2007
2) This practice is employed by private hospitals to cut down costs because AYUSH graduates are available at a much less salary than MBBS graduates. The hospital owners naturally want to cut down expenses and that is the right of anyone who owns a business. However, no one is allowed to break law to maximise business returns.
As is clear from the NC decision quoted above, it is illegal on the part of hospital owners to employ AYUSH graduates under the guise of modern medicine graduates. Public needs to be cautious and vigilant against such hospitals. All concerned should complain against such hospitals in the interest of cleaning the medical profession. This is a material issue in a writ petition currently pending before the Delhi High Court against a corporate hospital owned by a senior IMA official.
3) While the fault lies with the owners of the hospital, blame must also be shared by the government which licenses and controls private hospitals and collects taxes from them and grants various favours to them or imposes sanctions upon them as it pleases but never bothers to check the malpractice of employing AYUSH practitioners in a clandestine manner.
Such malpractice is a clear reason in support of the Clinical Establishments Act, 2010, which aims at regulating clinical establishments. However, the government and the parliament made a mockery of this Act by imposing upon all private clinics and nursing homes a statutory duty to treat all emergency patients free of cost in contravention of the report of the Law Commission submitted as ‘201st Report On Emergency Medical Care To Victims Of Accidents And During Emergency Medical Condition And Women Under Labour (Draft Model Law Annexed), August 2006,” which contained detailed provisions for creating a state funded compensatory mechanism for compensating the medical profession for providing such statutorily mandated services.
The Health Minister Shri Ghulam Nabi Azad tried to be smarter by half and tried to hoodwink the medical profession, forcing them to file a writ petition against the Act in Madras High Court, which admitted the petition. In this way, the government itself botched its own potentially sensible efforts.
4) The following actions can be taken against private hospitals employing AYUSH doctors:
a) When patients choose a hospital, they should choose the one, which gives a written guarantee that it does not employ any AYUSH graduate. They should also prefer a hospital where all doctors carry a name badge showing in brief the academic qualifications like MBBS, MD or DM etc.
b) Complaint against the erring hospital can be made to the consumer courts and the state health department. If the state has a CEA, complaint can be made to the CEA authorities also. In an appropriate situation, a PIL may also be filed.
5) If the court awards compensation on a complaint where it has been alleged and proven that the treatment was given by an AYUSH doctor, it is likely that the award will be payable, fully or mainly, by the hospital and not the AYUSH practitioner concerned.
The article/reply by Dr.Gupta is very good. The comments given in the case “Prof P N Thakur Vs. Hans Charitable Hospital, NC, 16 August 2007″ by the National Consumer Commission are note worthy.
Apart from the comments made by Dr.Gupta the following points have to be kept in mind:
1.Most of the students becoming AYUSH graduates would have earlier failed to get a seat in MBBS.They have a desire to become a ‘doctor’ at any cost.They always prefer to practice Allopathic medicine, but not Unani,Homeo or Ayurveda.This craze to become a private allopathic practitioner has to be curbed.
2. With the aim of promoting Indigenous systems of medicine, AYUSH graduates are given government posts in some rural areas.This will encourage them to have private allopathic clinics in their free time.
3.Various state governments have made it mandatory for the AYUSH graduates to have postings during their studentship or Internship at Government Allopathic hospitals.This is giving them confidence to practice allopathy in future.
4.Some practitioners are completing M.D. in the respective AYUSH subjects.Later they are keeping the suffix of M.D. after their names (removing BAMS,BUMS or BHMS) and practising as physicians/specialists in allopathy medicine.Even educated patients are going to these doctors.In fact a comment heard from a highly educated patient was “Doctor! you are only an M.B.B.S doctor, but that doctor is an M.D. As he is not available today,I have come to you for a consultation”
5.Public have to be aware of this.But many patients go to private AYUSH practitioners who practice allopathy with the belief that the doctor’s “hand” is good and my disease will be cured quickly.
t.i.i= this is india. plenty of laws , when it comes to implementation , no body is sure whom to approach . even among qualified doctors with degree in physiology , pathology , & other pre & para clinical degrees . they write only md with out mentioning the subject. even those with md in gen medicine write before their name cardiologist ( with out d m) , weather it is ayush or modern medicine , most of the doctors love to write all sorts funny & fancy titles in big bold letters. one more fancy thing about the doctors with diplomas – dgo | d ortho dvd working as resident doctors in medical colleges put huge boards i n front my their clinics as consultants , super specialists in joint replacement , spine etc. there no body check the abilities , skills , or the infrastructure & facilities . in small place i recently saw an add saying 150 beaded hospitals …….. promising all kinds treatments , that too with a borrowed names . any way we have to blame no body than our self for being born in this over crowed , greedy country . where the violation of law is a rule.dr.ramesh vardhan.
It is true that pvt hospitals are employing Ayush graduates but it is not due to financial reasons but due to unavailability of mbbs doctors specialy in non metropolitan cities.the Rmo are only supervising the treatment.
G
if govt control sale of bullet(life saving drugs) no one shoot on pt
Yes, We have to blame ourselves.
kya sare MBBS doc qabil Hote hain , Reservassion aur paise ke dum par pvt college se MBBS karne wale doc BAMS ke aadha aur Chauthai bhi nahi jante hain
Practicing of allopathic medicin by BAMS/BHMS doctors is not today’s problem but it is problem from since last 50 yrs for this nature. BAMS/BHMS/paramedicals are not solely responsible,so many factors are there like policies by govt,.no clear cut practising guidelines for BHMS/BAMS/BUMS given by the institute who run such courses at the time of admission and no such bonding & this is the first step where these graduates turned to allopathic practice, another reason is that after passing BAMS/BHMS/BUMS these graduates join private hospital which is run by modern medicine practitioner for gaining experience or most of the time employed by these hospitals & last reason is that indian population,economical standards & literacy,Sudden stoppage or banning these practices is not ideal solution as per some thinkers it”s ok but this like a ” bigde hue bachhe ko ghar se bahar kar dena”
I think few following suggestions for said problem to solve it
1) trained these existing practising graduates for three years in modern medicine(as per BRMS course) with their own expenses & making compulsion to 50 to 70 % practice of own system.
2)Give instruction to all institute who run BAMS/BHMS/BUMS/paramedical courses regarding practising guidelines for student at time of admission & write a bond regarding the same.
3) start employment drive for these graduates in the respective field
4) If above suggestions are not sufficient then say to govt.that please introduce these ayurveda/homeopathy/unani at PG level after passing MBBS degree or to stop courses
& finally if all measure fail then took a gun & fire all bullets on these existing practioner & their families,so extra burden from the earth will be reduced.
Think from both side,not from one side.
Thank U
Think from both side not from one side
Dear All. Kind attention plz!!!
These is no Ayurvedic/ homeopathic/ Unani hospital of Govt. from where the students of these pathies get the training. They have to join hospital which practice allopathy after passing out. Govt. Gives permission to open colleges but point to note is that these is no single govt homeopathic medical colleges at least in other stated homeopaths have govt jobs and also they have govt homeopathic medical colleges but not in maharashtra. Today the scene is that after passing MBBS hardly any student go fot general practice other wise maximum students goes fot post-graduations and want to become specialist. If we become so strict about practicing own pathy in smaller villages and smaller towns you wont get MBBS doctors because they dont go to villages. You visit any small village you will find only DHMS/ BAMS/BHMS drs practicing there. And even they are many a time doing a good job for society. Even an uneducated people can directly ask for paracetamol/febrex/ crocin then why cant medical practitioner prescribe it because he has already learned it in hospitals when he was working there as rmo even if he has not studies it in his course.In old days people who used to work as compounder with any doctor for 5-10 yrs were allowed to have there clinics and they used to practice as RMP ( registered medical practitioner ). Then why there people are not allowed to practice as they have studies the same anatomy/physiology/pathology/surgery/toxicology/biochemistry/medicine which is studies by MBBS student. Only the medicines are different.
how many practitioners of allopathic system have gone through history of medicines? do you know, who is the father of surgery in the world? Dear, once you go through Sushruta samhita, you will find no modern surgical procedure beyond Sushruta’s Shastrakarmas. Even all the surgical instruments are mentioned there in Sanskrita terminology. Indian system of medicine was ruined by British, and you people, even government is nourishing that Lord Mackale’s aim. Ayurveda is very potent and we request you all to first go through Ayurvedic books and syllabus of AYUSH doctors before passing such disgusting comments. Of course, each system has its limitations, as allopaths can’t rejuvenate nervous system, liver and kidney. They have no medication for menstrual problems than to severely complicate the condition with hormones. Same as them we dont have antibiotics and emergency medicine. This is the natural law of symbiosis.
Ham kuch bhi kahne se pahle modern anatomy, physiology, clinical & pharmacology padhte hain. Aap ham par comment karne ke pahle hamari books padha karen….. samjhe you all one eyed desi angrejo
Then Why dont you practice Ayurveda only. Why You want to jump to use these Allopathy drugs with side effects and injections?The question is just practice the system you are trained in.
What about the allopathic doctors practising homoepathy??? What about the MBBS GP’S prescribing the ayurvedic, unani or homoe formulations taught to them thru the medical rep’s glib talk?? Dr Gupta, please wake up. Unfortunately, we have never tried to assimiliate what is best for us. Howver, we like to ape our ex Brtish rulers and believe that the system left behind by them is the best. Look at China, acupuncture has been assimiliated in their medical practise and surgeon perform surgeries using acupuncture anaesthesia.. Why is it that we have to have a separate deartment as AYUSH for our ayurveds, unanis, and homoepaths. Why can’t we have one medical umbrella for evevrybody. Why can’t we teach the basics of these sciences to all our undergraduate medicos and then let them decide where they want to go? Why can’t we have The AYUSH courses at the post graduate levels? Well, Ileave it to your conscience to decide what is right and best for our country.
Thank you so much for understanding this problem.You r absolutely right.AYUSH doctors doing allopathic practise only because of lack of govt jobs.govt has estblished the AYUSH courses but have not established right way to brighten their future.Either the courses should be stopped or should create opportunities for them
About 30 % of Patient Ayurvedic Medicines used by MBBS Allopathic doctors,but they don’t know the pharmacology of ayurvedic drugs,and don’t know how they work in the body.My suggestions are, The study of Theory and practice of Ayurveda must teach for about 1 year should be compulsary in syballus for MBBS Graduates.More over, some body has comment that Ayurveda has no Anti-biotics. Its wrong, so many ayurvedic drugs like Sukshma Triphla, Trikatu, Gandhak rasayan,Haridra, Spthika ,Rashmanikya etc etc worked as Antibiotics.Thousands of herbal drugs can be used in place of Antibiotics and gets the better results in comparisation to Allopathic medicines.Also,I will explain you that Old BAMS(Bachelor of Ayurveda with MODERN MEDICINE AND SURGERY. The degree self evediently proved that they have sufficient knowledge of Allopathic also. Moreover most of the integrated BAMS doctor as declared superior in the practical fields in comparisation to MBBS.On the above facts came to the conclusion that complaxicity made by the govt.and the policy of the Govt.is defective.It must be corrected.Here the question is,practising, working as RMO,Medical officer in Allopathic nursing homes etc, In my openion Its not a defame or wrong. They know well all basic fundamentals,and having sufficient knowledge of medicines also.can successfully performing there duties in nursing homes.
Ekbar silybus to dekho sir ji mbbs or bams ka….aap jaise bol rahe hai ki bams doctr dont knw anytn…mujhe lakta hay aap najanke ye sab ulta palta bams doc ke bare may bol rahe hay…aap jaise logo ke karan hamare des ka science kharap ho raha hay…one tin m teln u jst go nd c d sylibs of bams…ek patient thik karne ke liye diagnose ke jarurat hota hay aur medicine wo to koi ascha pharmacist v dey sakta ha diagnose ke baad….samja mr.lawyer cum md…
Dear Sudhanshu,
U were very soft on allopaths by saying that they dont have any medicines for menstrual problems.
But the fact actually is that allopathy has no “curative” medicine right from a normal general cough cold to cancer and AIDS .
They have just two types of medicines ,first is “palliative” and second is “suppressive”.
1)Palliative means – which gives temporary relief .
eg. Pain killers -The biggest misnomer.Actually its name should be nerve paralyser ‘coz it just blocks the nerve from sending the signals to the brain which inform’s the brain about the pain. And the poor patient feel’s that he is relieved of the pain , but the pain again starts as the medicines power is used up . Then again the patient opts for the same thing . People are also so ignorant and uninterospective about themselves that they dont even think that inspite of repeatedly ressorting to the pain killer why does this pain reappear ?? .
They will never ask this question to themselves.
2) Suppressive means – These medicines suppress the disease which is, according to the nature, the worst thing that is done to the body .U are actually playing with the harmony and systemacy of the body .
These people forget the basic law of energy that is applicable in the universe and thus to us that “ENERGY CAN NEITHER BE CREATED NOR CAN BE DESTROYED,IT JUST CHANGES FROM ONE FORM TO ANOTHER” .
Now disease is also a form of energy (-ve enegy) ,if it is suppressed ,it does’nt get destroyed, it will just change its form from one disease to another and re-appear in some other forms .
Now here the patient thinks that he has been out of the previous disease and the new thing that has appeared has nothing to do with the previous disease .This is altogether a new thing and again ressorts in the cluthes of the sophisticated butchers.
By the grace of ALMIGHTY and my FATHER, our family has never been to an allopath for last 25 years and have not consumed even a single pain killer .
We take only HOMEOPATHY medicine. My father has not taken any medical insurance cover as our FAMILY’S MEDICAL EXPENSE has never exceeded 1000 rupees .
The great thing is that he has cured my asthama ,now it has been 14 years i dont have any problem regarding breathing .If i would have been on the mercy of allopaths ,i would have still be taking the inhalers and would never be able to play football,badminton,cricket .I also won district badminton championship ,when i was 15. now my age is 24 .
Hope this would be an eyeopener for the people.
dear sir,
mr gupta as you know that all the pathy has made for curing the ill patient . if any medico who belongs from any pathy if they treat the pt using the allopathy and they are not duly follow the syllabus of allopathy
Thank you Dr.Shrikant Thakre.Your suggestion is unbioused,true,and non jelous.Your solution will be suitable for whole nation and poor people and the whole practitioners who are earning for their bread and butter. I want to add further that ,there should be scrutiny and evaluation of each practioners MBBS,BAMS,BUMS,BHMS,BDS etc.every year by Govt.about the effect of their treatment on patients,wheather their tratment( Medical or surgical and investigations) were ethical or non ethical.Is it not true that many surgeries are done without indication.Many drugs which are prescribed unnecessary.Many investigations are done unnecessarily.
Please file a PIL to stop these type of course after completing those student future is not secure due to underdevelopment of Technology and Ayurvedic science.
this is really very bad that ayush doctors practice allopath. being a ayush (ayurvedic doctor) i prescribe modern medicine too. there are many views and laws ..but i want to make it very clear that there is acute shortage of MBBS(talented) doctors in rural as well as urban India. are they(MBBS) ready to serve poor people. i know many MBBS doctors who do not know correct spelling of many medicines like azithromycin. many MBBS doctors prescribe useless recipe of medicine which are interacting each other. ..many are prescribing medicines which are giving large earning at the compromise of quality…why not MBBS dcotors discuss all these. i admit ayush doctors should prescribe…their system of medicine…but what is wrong if he prescribes PPI (proton pump inhibitor) for hyperacidity and related disorders. i have read and it is fact that.. prolonged use of PPI may cause achlorhydria that may lead to other complications.MBBS doctors donot pay attention to real quakes that practice medicine without any knowledge in urban and rural India… because these quakes refer patients to MBBS doctors .on the other hand AYUSH doctors are competitors and real threat to MBBS doctors not patients.this is fact. on more thing any doctor whether ayush or allopath should be punished if he does wrong treatment. thank you…..
I think following points should be considered.
1. BAMS is 100% integrated course to pass. if not prove it. consider question paper or syllabus to oral exam.
2. If there is a problem about Prescribing medicine then consider this.
a. say ayurvedic practitioner to go without antibiotic in emergency.
b. say Allopathic practitioner to practice without serpentina in HTN.
More than 87% of modern drugs are modified stage of traditional medicine only considered antibiotics are new drugs not mentioned by any means in tradition system. And More than 94% of Traditional medicine practitioner are using simply modified old drugs.
see what is basic these people are using resources to treat people for better life. but the people related with this decision can not be considered human, because they are challenging the basics of life that if you become one degree holder you could not have another. it doesn’t matter you have better skill than previous. does it means ones you are Idiot always Idiot. Really these are not human being to consider just kept away these people from govt. system, otherwise next day they will say the Law graduate could not be considered for MLA and if it is so and previously listened then think how many parliamentary member will go home. and still if you don’t get it consider you are proving rejection of science. and humanity of your. As I believe every human Being could be act as Doctor if Knowledge with appropriate training is given by a body approved by law. MBBS is not actually that. frankly it is pressure of world bank with WHO to fund India passed in Govt. misused by MBBS or supporter. So it is not the war of knowledge or actual relief to the patient. it is the war of Pharmacy preparing products issuing knowledge and not taking responsibilities of safety to keep their brand safe.
so in my opinion professional of health care should not allow to make private practice. He must be bound to follow govt. service.
otherwise the Indians will go without health care. china will have more than 3/4 share (WHO 2012 report) for his traditional medicine. and you will see Chinese medical practitioner and Indian will attain it. As well as Chinese Pharmacy making drugs in India.
I hope you can understand if you are a Indian.
and not MBBS/BAMS/BHMS/BUMS.
Majority of those having ayurvedic or homeopathic degrees do not have opportunity to work in hospitals because the number of hospitals offering inpatient services are very few in our country. The fact that employing ayurvedic or homeopatic doctors is illegal is known to owners of nursing homes or hospitals. But they are simply not ready to give proper salary to MBBS doctors and so they are not joining.These hospital owners are busy in spending money on advertisements and quacks in villages who refer seriously ill cases to them.Now public should know that most of the RMP or LMP doctors other than the patient who had practical experience is referring to a particular hospital is doing it for commission only.Most of the hospitals do not display the names of MBBS doctors for public and this is done to cover up.For permissions,MBBS doctors nanes appear on paper but in reality the patient may not find any MBBS doctor in casuality or ward other than the specialist who admit him and see him once or twice per day.Many doctors employing these non-MBBS doctors are active Indian Medical Association(IMA) members.Unless there are fulltime MBBS doctors with competence,the patient’s life is at great risk.Somebody should file PIL against this type of practice because court only made the government agencies work in the past.I do not know any instance where the patient had gone to court for not getting the treament from MBBS doctors in allopathic hospitals.
The doctors with MBBS or MD degrees are taking 10th class failed girls as nurses and private medical college is taking ANMs.There are examples of unable to read the spellings properly and giving wrong medicines. I am sure that most of the hospitals in any other small cities are following this practice.The government is framing many rules but their implementation is very bad.The hospital should have employees as per government rules.They should make available the list of employees to the local police or recognised voluntary organizations or patients on demand.
BAMS, BUMS and BHMS doctors claim to eliminate the diseases from the root and always say that Allopathy is bad so they must never use it.
I am n0t agree with supreme court decision. . Its totly a wr0ng thng. Ayush doctors are totly equal to alopathc. . .
I m nt agree wid dis dcisi0n. . Totly wr0ng. . It means al india hospitals are doing ilegal practice. .ayurveda is d orign of mdicl science. . . .
It is interesting to read the article.In most of the Govt Hospitls there are seperate wings for treatment of Ayurved aand Homeo system of medicines.It is open for the patients to choose which pathy of treatment they want.This problem as cited may not applicable in all hospitals but the Hospital using the services of BHMS and BAMS doctors for Allopathic tratment should be prosecuted as patients will not be able to know who is treating them.I find in most of the private hopitals located in Visakhapatnam city areas are engaging BHMS and BAMS qualified doctors for treating the patients in Allopathic medicines.These hospitals shoulde be raided by the Drug inspectors and should be prosecuted for cheating the public.Similarly the BHMS and BAMS qualified practioners should not be allowed to practice Allopathy in the interests of Homeo & Ayurvedic system of medicines.The purpose of their studying such courses becomes meaningless.They can atleast be given additional one year training and allowed to have registration in Medical council of India to practice in Allopathic medicines.
dear friends i read the views of mbbs and ayush doctor i just want to say that many people says many things please dont play with the life of any patient because pt come to you with faith and belive if you dont know the proper action and side effect of any pathy but in other hand it will life saving or fatal thanks for your views irealy enjoy the reading
what is this we as a country are producing quacks it is no doubt thjat many ministers in maharashtra are having many ayurvedic , homeopatic colleges if this graduates want to practise let them practise ayurvedic or hoeopatic. unani medicine only not allopathic they dont have the right no wher in world they practise this thing even in germany where homeopathic medicine was discovered they dont do this things that is why many foreigners coming to india are telling that india is land of quacks the supreme court judgement is right , even this doctors are not allowed to write doctors in front of their names they have to write vaidya which is indian the hospitals employing this doctors their registration has to be cancelled and their accrediation has to be cancelled they are putting patients life at risk do you want to kill your people
Before coming to any conclusion Dr. Gupta please have a look on the SYLLABUS of B.A.M.S students concerning Modern Medicine And Surgery so called quacks in your terms
http://www.ccimindia.org/draft_syllabus-ks.html
The supreme court judgement says a quack is a person who lacks knowledge of a particular system of a medicine but practises in that system. So to all mbbs fellows plz go and check the new syllabus of BUMS . In our syllabus we study all the subject that you study with additional subjects of our pathy. We have total allopathic pharmacology to study and during one year internship we do duty in an allopathic and in our own hospital. So in a way we emerge more organise than you mbbs as far as general practice is concern. And remember in the eye of law , an ayush and a mbbs is totally epuivalent.
Doctor hoke treatment karna sikho,naki me mbbs hu wo bams hai ye pata karo.pehle logoke najarme ao,unka problem samjho,unko cure karke apna dharm nibhao,uske bad fakra se kehna me doctor hu(cahe tu jo bhi ho),ghar beth ke,MR aur Company se pesa leke galat prescribe karna kahaki insaniyat hai.hum logoga Aim yahi rehna cahie ki duniya se disease kese dur kiya jaye,pehle wo karo badme jhagda karna.