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NITI Ayog needs ‘two-eyed’ approach to achieve doctor-population ratio of WHO by 2024

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The statement of Prof. Vinod Kumar Paul, Member of NITI Aayog on the occasion of 10th convocation of the Jawaharlal Institute of Postgraduate Medical Education and Research that India is about to achieve doctor-population ratio of 1 physician for 1000 population by 2024 and government headed by Narendra Modi is on such mission; as prescribed by World Health Organization (WHO).

Further he stated that “overall, the number of doctors does not address the problem of distribution, skills and locations but nonetheless we have now a trajectory to achieve this great goal which at times looked very illusive”. According to him, India also facing acute shortage of specialists and for example, India need 3 lakh Obstetrics and Gynaecology experts but India has only 60,000 such specialists practicing.

The major challenge in providing effective health care delivery system lies predominantly in our rural areas where the specialists and not even MBBS doctors are instantaneously enthused to settle and practice both due to the lack of infrastructure and rural practice is not that lucrative. In India, even today the greater proportion of health care delivery is being addressed private players than by PHC’s, CHC’s etc.

The efforts of government to achieve the doctor-population ratio as prescribed by the WHO should not cause new set of problems. Government and the Ministry of Health and Family Welfare must look for near permanent solution and not quick fix remedy by converting AYUSH vaidyas as equivalent of MBBS doctor through some crash course.

Knowing the brand names of several drugs and broad indications for which such drugs are given is quite easy to acquire. Already many AYUSH vaidyas in private practice, especially some Siddha vaidyas are engaged in cross pathy by having third or fourth hand wisdom from advertisement manuals like CIMS etc.

Treatment of any disease not likes just in prescribing the right medicine, but knowing the nuances of diagnosis and other health aspects of the patient. If the real health condition of the patient is not understood, sometime even the right drug may harm the life of the patient as revealed by the case of Poonam Agarwar’s where an AYUSH vaidya adventures into cross pathy illegally and that resulted in the death of the patient.

Subsequently the Honourable Supreme Court of India defined the term quackery and made cross pathy illegal. Such judgment also vindicated the ultra-virus status of the attempt of CCIM to misinterpret the term integration of modern science as permission to prescribe and practice allopathic drugs by AYUSH vaidyas.

More than doctors to treat various diseases or to offer specialist consultation or surgery, we need experts to provide wellness and health consultations. The present day generation has breached all norms of food discipline, diet, exercise, mind-body balance, and healthy way of life, seasonal re-adjustment of our personal habits, spirituality and humility. Unfortunately our present day life also demands from people to be on their toes as life is full of tension, pressure and anxieties etc.

Time has come the government of India must appropriately use the AYUSH resource to impart moral and health awareness and consciousness among our society. Instead of defining and promoting AYUSH as yet another medical science, AYUSH must be promoted as superb paramedical system essential for health and wellness of every individual. Further the AYUSH recipes must be re-defined as health and wellness preparations so that the Licence Raj for all such products can be removed completely.  

Today the unnecessary licensing norms, the financial burden of both the state and central government in having licensing officers, drug inspectors etc., also can be avoided. 

Essentially most of the AYUSH products use herbs which are reasonably safe or their safety profile is known.

While setting target to achieve the one doctor per 1000 population by 2024, the government also must re-define the role and responsibility of AYUSH system for providing paramedical wellness cum health discipline to our society.

Making our society healthy, conscious of all health titbits and morally and spiritually responsible is equally important as achieving WHO prescription of doctor-population ratio.

We must integrate AYUSH into our moral, philosophical, spiritual and cultural practices than medical science.  Paramedical tag would set the growth of AYUSH possible more effectively than repeatedly describing AYUSH as scientifically proven medical system.

The clear differentiation between AYUSH expert and duly qualified doctor must be made visible and vivid even to the last man in the society.  Similarly the AYUSH vaidyas must be made conscious of the fact that they can serve the society effectively and also can earn their livelihood through engaging in AYUSH practice than cross pathy and resulting in medication health fraud.

Short-cut methods, quick fix solutions and remedial approaches should not be adopted to mitigate the challenge in our health care delivery system or achieving WHO prescription. We must promote the science and philosophy of healthy living than offering plenty of medical experts, drugs and treatment centres, no one would deny the want of such facility.

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