we were caught napping

We were caught napping. And now the Indian Medical Association is scrambling to reverse the notification that ayurvedic doctors are authorised to perform 58 types of surgeries listed by the government.

Here are some reactions:

 “The government’s decision to bring in a rule that allows practitioners in specified streams of Ayurveda to be trained to perform surgical procedures trivialises the medical profession,” Reuters quoted Rajan Sharma, the head of IMA, as saying.

(We mean it makes our entrance exams, MBBS degree, MS degree, our career goals, all totally irrelevant!)

“Let every system grow on its own strength and purity,” the doctors’ body said in a statement earlier.

(We mean, let us retain our purity because our system is evidence-based, let other systems follow their teachings, we will not judge)

In a statement last month, the IMA said, “The purity and identity of Ayurveda stand equally challenged. That the council prescribed modern medicine textbooks and Ayurveda institutions practised surgery with the assistance of modern medical doctors cannot be reason enough to legitimise encroachment into the jurisdiction and competencies of modern medicine.”

(We mean that it ceases to be Ayurveda once their students use textbooks meant for MBBS students, therefore have them write entrance exams meant for our students and get admission to our colleges on merit rather than sneak in like infiltrators across the LOC)

Reacting to the strike, IMA national president Dr R Sharma said: “Modern medicine is controlled and research-oriented, we are proud of the heritage and richness of Ayurveda but the two shouldn’t be mixed”.

(We mean we are proud of our heritage in general, we are fine with ayurveda aficionados going to vaidyas for treatment, but we would rather they didn’t pass off allopathic procedures as ayurvedic)

The Resident Doctors’ Association of AIIMS-Delhi, in a statement, said, “This step will not only encourage already rampant quackery, but also undermine the safety of the public. We request the government of India to retract this notification immediately”.

(We mean we consider other systems of medicine unscientific by the current scientific standards of the world, and we don’t want any sort of cross practice with them)

“It is obvious that Ayush is dependent on modern medicine, doctors, anaesthesia, antibiotics and equipment to perform modern surgical procedures. It fails the test of logic, this irresponsible initiative, placing thousands of gullible patients at risk”, the doctors’ body said in a statement.

(We mean we always knew that Ayush vaidyas were illegally using our methods and materials but we turned a blind eye because, until now, we were too indifferent to be bothered about the ‘gullible patients at risk’)

The Ayush ministry issued a clarification claiming that the technical terms and modern developments are a common heritage of mankind. The IMA rejected their clarification as being ‘deceptive camouflage of mixing the systems of medicine’.

(We know that nobody in India is concerned about intellectual property, plagiarism, ethics, fairness and things like that, so we don’t buy the ‘common heritage of mankind’ argument)

Dr R V Asokan, secretary general, said, “At any point of time, there are about 1.5 lakh unemployed young MBBS graduates. They do not have a place in the system. And these unemployed doctors can be captured for gainful employment wherever the government wants”.

(Do we mean we have been remiss in supporting our youngsters, employing Ayush vaidyas in their place, claiming we have no place for them in our system?!)

According to an article in The Times of India dt 15th Nov 2020, many hospitals, including large corporate ones and mostly in big cities, are employing Ayush doctors as RMOs, Emergency Casualty Officers and even to manage ICUs at night. Ayush doctors can be hired for as little as Rs 20,000 per month while MBBS doctors might have to be paid Rs 40,000.

(That means we took a short cut for monetary gains and the chickens have come home to roost, because the whole country now knows that vaidyas are being substituted for MBBS doctors!)

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This notification is unprecedented, but not surprising. It’s part of the general quest for reliance on all things indigenous, and seems part of a universal zeitgeist. Fortunately, patients use all systems – allopathy, ayurveda and homeopathy – and know which works for them for what ailment.

Nothing ought to change for allopathic surgeons because most surgeries need expertise that one acquires with years of experience, which our surgeons have.

ENT and ophthalmic surgeries are particularly complex because of the sensitive and extremely small structures packed into tiny spaces. One wrong snip could leave a patient with a huge deficit for the rest of his life. This is significant because ENT and ophthalmic surgeries are on the government’s list of permitted surgeries for ayurvedic doctors.

As a surgeon pointed out at a meeting recently, the challenge lies not in performing a routine surgery as much as it does in dealing with unexpected complications you find after opening up a patient, or unexpected events in the course of surgery. For this you need a large amount of experience that is only possible to garner through MBBS and MS courses because of the sheer volume of work.

Laws are one thing, reality something else. In this case, something wrong that was happening has been legitimised instead of being corrected. This is exactly the way our government regularises illegally-constructed buildings through akrama-sakrama, safety and fairness be damned.

While it is necessary to highlight this for the government, we also need to look inward and see where we are going wrong in the way we practice Medicine. We might need to revisit the Hippocratic oath to get our bearings again.

2 thoughts on “we were caught napping

  1. Shyamala, this is similar to the situation in the usa, where the para professionals are invading our turf, have a fraction of our training and expect same payment but pass liabilities to true doctors! am so glad to be not devoting my days to this anymore! Amita

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  2. While i was studying dentistry i used to see people in city market area of Bangalore trying to treat dental problems on the roadside and was shocked and surprised. Imagine the harm being caused to the people going to them! Then we would frequently get these cases in the opd in those years. Used to empathize with them about their damage.
    And now with all these new changes there are going to be huge scale losses to people and correcting some defects may not be possible. Years of expertise has no value it seems. Would the people trying to make this change get surgeries done from the ayurvedic doctors themselves? A trained mbbs or ms doctor can’t do what a bds or mds can and vice versa. Why this experiment when there are so many mbbs doctors who can be trained for postgraduation and efforts and revenue put in that direction?

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