Should Ayurvedic Physicians be Conducting Surgeries? | UPSC

Should Ayurvedic Physicians be Conducting Surgeries? | UPSC

      HEADLINES:

Ayurvedic doctors and sanction for surgeries

      WHY IN NEWS:

What are the issues around allowing non-allopathic surgeons to receive training for various procedures?

MINISTRY? :- Ministry of AYUSH
SYLLABUS COVERED: GS 3: Medicine

      LEARNING: 

For PRELIMS go through the types of surgeries in AYURVEDIC System of medicines.

For MAINS it is important to understand the bills and relevant acts. Let us dive in !

      ISSUE: 

Recent notification from GOI allowed; Ayurvedic doctors to training practise general surgery, ENT, ophthalmology and dental procedures.

  • The Central Council of Indian Medicine (CCIM) , a statutory body set up under the AYUSH Ministry to regulate Indian systems of medicine.
  • It issued a gazette notification allowing postgraduate (PG) Ayurvedic practitioners to receive formal training .
  • The training will be for a variety of general surgery, ENT, ophthalmology and dental procedures.

The decision follows the amendment to the Indian Medicine Central Council (Post Graduate Ayurveda Education) Regulations, 2016.

  • This will allow PG students of Ayurveda to practise general surgery.

LEGALITY CHECK

  • The National Medical Commission Act in 2019 allowed induction of mid-level care providersCommunity Health Providers — in primary healthcare in India.
  • Community Health Providers would serve at health and wellness centres across the country.
  • The focus was on primary healthcare provision, with a limited range of medicines allowed for them to use for treatment of patients.

This move had also attracted strong opposition from modern medicine practitioners, who branded this as a form of quackery through half-baked doctors.

  • Several countries have been using mid-level care providers, such as nurse practitioners.

This is to enhance the access to healthcare, though with strict safeguards around training, certification, and standards.

  • The current debate revolves around the CCIM issuing amendments to the Indian Medicine Central Council Regulations, 2016.

WHAT IS THE AMENDMENT?

The amendment allows PG students in Ayurveda to undergoing :

(i) ‘Shalya’ (general surgery) and

(ii) ‘Shalakya’ (dealing with eye, ear, nose, throat, head and neck, oro-dentistry) to perform 58 specified surgical procedures.

CONFLICT OF INTEREST

  • This was immediately opposed by many allopathic professionals.

The Indian Medical Association (IMA) decrying it as a mode of allowing mixing of systems of medicine by using terms from allopathy. 

  • The AYUSH Ministry subsequently clarified that the ‘Shalya’ and ‘Shalakya’ postgraduates were already learning these procedures.
  • The procedures in their (surgical) departments in Ayurvedic medical colleges as per their training curriculum.
  • The amendment merely added clarity and definitions to the 2016 regulations concerning post-graduate Ayurveda education.

CAN SHORT-TERM TRAINING EQUIP THEM TO CONDUCT SURGERIES?

The postgraduate Ayurvedic surgical training is not short-term but a formal three-year course.

  • Whether the surgeries conducted in Ayurvedic medical colleges and hospitals have the same standards.
  • The outcomes as allopathic institutions requires explication and detailed formal enquiry, in the interest of patient safety.

Should Ayurvedic Physicians be Conducting Surgeries? | UPSC

DOCTOR-PATIENT RATIOS

  • As of now, no such restriction exists that limits non-allopathic doctors, including those doing Ayurvedic surgical post graduation, to rural areas.

They have the same rights as allopathic graduates and postgraduates to practise in any setting of their choice. 

ALLOPATHIC SURGEONS IN RURAL AREAS 

  • The shortage and unwillingness of allopathic doctors, including surgeons, to serve in rural areas is now a chronic issue.
  • The government has tried to address this by mechanisms such as rural bonds, a quota for those who have served in rural service in postgraduate seats.
  • More recently, there was  a plan to work on increasing the number of medical colleges and postgraduate seats.
  • However, we would probably still continue to fall short of enough trained specialists in rural areas.
  • We need to explore creative ways of addressing this gap by evidence-based approaches.

 Task-sharing, supported by efficient and quality referral mechanisms. 
 

  • The advent of Community Health Providers in many States, is also an opportunity to improve some elements of healthcare (preventive, promotive, and limited curative).
  • This will also ensure clarity of role and career progression.

PATIENT’S SAFETY AND ETHICS

  • The AYUSH streams are recognised systems of medicine, and as such are allowed to independently practise medicine.
  • They have medical colleges with both undergraduate and postgraduate training, which include surgical disciplines for some systems, such as Ayurveda.
  • There is, however, a difference in approach in the systems of medicine, and hence models, which allow for cross-pathy.

An apprenticeship model for Ayurvedic surgeons working with allopathic surgeons might fall into a regulatory grey zone.
 

  • It might require re-training Ayurvedic practitioners in the science of surgical approaches in modern medicine.
  • Even then, there might be a limit to what they are allowed to do.
  • Any such experiment can put patient safety in peril, and hence, will need careful oversight and evaluation.

      IASbhai WINDUP: 

CAN THIS LEAD TO SUBSTANDARD CARE?

  • Many patients prefer to receive treatment exclusively from AYUSH providers.
  • While some approach this form of treatment as a complement to the existing allopathic treatment they are receiving.

For invasive procedures, like surgery, the risk element can be high.

  • Patients have a right to know and understand who their surgeon would be, what system of medicine they belong to, and their expertise and level of training.

There should not be a difference in quality of care between urban and rural patients.Everyone deserves a right to quality and evidence-based care from trained professionals.

     SOURCES:  THE HINDU | Should Ayurvedic Physicians be Conducting Surgeries? | UPSC

 

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