a surgical strike, literally

The Indian Medical Association has opposed the government’s move authorising post-graduate ayurvedic doctors to perform *58 types of surgical procedures. The government notification says they must be “practically trained to be acquainted with, as well as to independently perform” surgical procedures.

Ayurvedic doctors say, “Ayurvedic medical students are well-trained and have been performing surgeries since decades.” Well, we didn’t know.

In India, ayurveda is an accepted system of Medicine and comes under AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy). Even now there are people who prefer Puttur bone-setters to orthopaedic surgeons, and there are people who prefer ghee treatment for unclogging coronary arteries to angioplasty. It has always been this way.

From the viewpoint of allopathic surgeons, this authorisation has breached an invisible boundary wall that set apart and gave the right to operate only to experts with an MS in Surgery and a number of years of experience. With this notification, these criteria no longer have to be met! For surgeons, there’s a sense of devaluation of something hard-won, of evidence-based science being tainted with the unproven empirical, of dilution of scientific principles that are the cornerstone of modern Medicine . . .

What was the use of all those teenage years spent preparing for entrance exams, then four gruelling years of medical college, three more years of post-graduation in General Surgery and some more years in super-specialisation? What about all the sleepless duty nights over years and years, when all other things that go to make a life were shoved onto the back burner? The workdays spent scrubbing up and standing hunched over OT tables, with aching neck and knees? The list of *58 procedures doesn’t cover much, but it might well be a foot in the door, which is how the IMA is treating it.

The question is, will this list be adhered to and not treated as carte blanche to perform any surgery? People always find loopholes. It won’t be hard to, since allopathic-trained anaesthesiologists and gynaecologists are reportedly already working with ayurvedic surgeons in ayurvedic hospitals.

When the AYUSH ministry was formed in November 2014 it was obvious that it was an attempt to integrate all of alternative Medicine. We were given to understand that we were outside its ambit. Its objectives did not mention Surgery, hence this announcement came as a surprise to us last month. We didn’t even know there was an Indian system of surgery after Sushruta’s time, i.e. 6th century BCE!

A few years ago, a cardiologist friend of mine briefly worked at a small hospital owned by an allopathic doctor. The young duty doctor was unable to interpret a patient’s ECG when it was crucial, and my friend was shocked to know that both he and the duty doctor who worked the night shift were ayurvedic doctors. He resigned post-haste – handed in his notice – not waiting to find out what ayurvedic doctors would do with a patient in atrial fibrillation. Is the IMA aware that ayurvedic doctors are employed in hospitals owned and run by their fraternity?

Can allopathy and AYUSH be integrated? Is there enough overlap between them? The fact that anesthesiologists and other allopaths have been working with ayurvedic surgeons for years shows that some allopaths think so! This is the chink in the IMA’s armour, and the government is bound to wedge its new notification into that fortuitous gap!

So, now that the government has legitimised Fusion Medicine – not unlike Fusion Food or Fusion Music – it’s unlikely that ayurvedic doctors will only operate on their patients in ayurvedic hospitals using procedures based on ayurvedic principles. Now that the edifice of modern surgery has been dealt a body blow, I wonder what new system will evolve, and how it will affect different interest groups.

During internship, after graduating from college, I was posted to the Plastic Surgery Unit for a fortnight. A teenager with a 4-inch-long slash right across his face was brought to Emergency and I stitched it up. When he returned for suture removal the senior plastic surgeon was surprised at the neat scar and laughed when I said I was handy with a needle and thread much before I became a doctor.

So I was just thinking, some day tailors might be employed and authorized to suture small cuts and lacerations in hospital ERs! Why have boundaries? Let’s abolish them all!

* According to the notification, the procedures listed include removal of metallic and non-metallic foreign bodies from non-vital organs, excision of simple cyst or benign tumours (lipoma, fibroma, schwanoma etc) of non-vital organs, amputation of gangrene, traumatic wound management, foreign body removal from stomach, squint surgery, cataract surgery and functional endoscopic sinus surgery

(Taken from The Print, dt 12th December 2020)

One thought on “a surgical strike, literally

  1. This is scary. Big time. The common man is being taken for a ride. By no means is this a positive step. There are quacks in every field and this will increase and kind of legitamise it. Patients go with huge trust to a doctor. Imagine being treated by someone whose not really trained nor has the expertise. Like crash courses and crash diets.

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