To,

All Office Bearers of IMA

All State/Local Branch Presidents/Secretaries

All Central Council Members

Dear Colleague,

Your attention is drawn to the following agenda item No. A-2 (a) discussed in the  75th Meeting of the Central Council of IMA held  on December 27-28 December, 2014 on Govt. Sponsored Quackery :

“AGENDA ITEM NO. A-2: MENACE OF QUACKERY:

(A) GOVT. SPONSORED QUACKERY:

Maharashtra Govt. has promulgated an Ordinance permitting AYUSH doctors to practice modern medicine. It is understood that the Governor has sent back the Ordinance without signing.

When even a small shortcoming in treatment by qualified doctors of modern system of medicine is taken seriously with civil and criminal liabilities, what justification is there in this action of the Maharashtra Government.

IMA should publicise this as a social evil, malpractice and should take it as a very serious issue. At the same time IMA, along with MCI, should give stringent directions to hospitals and doctors not to appoint AYUSH doctors as RMO / Assistants and strong action taken against those violating the directions”.

Discussion

Kindly note, the following as mentioned in MCI Code of Medical Ethics and Regulations 2002:

• “7.9 Performing or enabling unqualified person to perform an abortion or any illegal operation for which there is no medical, surgical or psychological indication”.

            The above Regulations clearly prohibits taking assistance from any un qualified person      for  surgery, especially abortions.

• “7.10 A registered medical practitioner shall not issue certificates of efficiency in modern medicine to unqualified or non-medical person”.

            The regulation again clearly talks about that any allopathic doctor shall not appoint any     non-allopathic doctor for any allopathic services.  As appointing him/her, would amount   to issuing a certificate of efficiency in modern medicine.

• “2.4 The Patient must not be neglected: A physician is free to choose whom he will serve. He should, however, respond to any request for his assistance in an emergency. Once having undertaken a case, the physician should not neglect the patient, nor should he withdraw from the case without giving adequate notice to the patient and his family. Provisionally or fully registered medical practitioner shall not willfully commit an act of negligence that may deprive his patient or patients from necessary medical care”.

            The regulation clearly talks about that if there is any emergency, we have to take care of    our patients ourselves.  We cannot pass on this responsibility to a unqualified persons.

• “7.20 A Physician shall not claim to be specialist unless he has a special qualification in that branch”.

            The above regulation clarifies that because Ayush Doctors do not have special       qualification in allopathy they cannot be treated as allopathic practitioner.

• “7.19 A Physician shall not use touts or agents for procuring patients”.

            As this regulation we should not use touts or agents for procuring patients.  Any non         allopathic doctor, if assist us in procuring patients, the same will be a violation of the above clause.

• “7.18 In the case of running of a nursing home by a physician and employing assistants to help him / her, the ultimate responsibility rests on the physician.”

            This regulation clearly mentions that if any MBBS doctor, appoints any Ayush Doctor,     the responsibility will be of an MBBS doctor and not that of Ayush Doctor.

• The Maharashtra FDA has recently issued guidelines regarding prescription where it clearly mentions that another doctor cannot sign on the prescription paper of treating doctor.

• There are many Supreme Court Judgments which has clearly mentioned that Ayush          Doctors cannot prescribe allopathic drugs

1. NATIONAL CONSUMER DISPUTES REDRESSAL COMMISSION

NEW DELHI ORIGINAL PETITION  NO.214  OF  1997,

" 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 Unani doctor."

" As laid down by Apex Court in the above case (Jacob Mathew case) , 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.  We do not wish to attribute negligence on the part of Dr. Rehan alone while the patient was in his charge in terms of directing to pay compensation but solely on the hospital authorities for leaving the patient in his complete care knowing he is not qualified to treat such cases."

"Supreme Court came down heavily in cases where Homeopathic Doctors treated the patients with allopathic medicines.  In Poonam Verma Vs. Ashwin Patel and Others (1996) 4 SCC 332 where a doctor holding Diploma in Homeopathic Medicine and Surgery  (DHMS) and registered under Bombay Homeopathic Practitioners Act, caused the death of a patient due to administration of Allopathic medicine, the Supreme Court held him being not qualified to practice Allopathy, was a quake or pretender to the medical knowledge and skill as a charlatan and hence guilty of negligence per se. The facts being similar in this case, we hold that there is total negligence in treating the deceased patient."

"Thus, we feel that an amount of Rs.7,50,000/- would be appropriate amount of compensation in face of peculiar facts and circumstances. "

2. Dr. Mukhtiar Chand & Ors. Vs.   State Of Punjab & Ors., decided by the Supreme Court on 08/10/1998, reported as AIR 1999, SC 468, (1998 (7) SCC 579) K.T.Thomas, Syed Shah Mohammed Quadri,

" A harmonious reading of Section 15 of 1956 Act and Section 17 of 1970 Act leads to the

conclusion that there is no scope for a person enrolled on the State Register of Indian medicine

or Central Register of Indian Medicine to practise modern scientific medicine in any of its

branches unless that person is also enrolled on a State Medical Register within the meaning of

1956 Act."

3. Rajya Sabha Question

AYUSH practitioners prescribing allopathic medicines: Rajya Sabha, information given by the Minister for Health & Family Welfare, Dr. Anbumani Ramadoss in a written reply to a question in the Rajya Sabha.

The matter regarding qualified practitioners of Ayurveda, Unani, Siddha and Homoeopathy systems prescribing allopathic medicines has been examined in depth by the Hon'ble Supreme Court of India in Civil Appeal No.89 of 1987 Dr. Mukhtiar Chand & Others versus State of Punjab & Others.

Representations have been received from time to time on this matter and accordingly Department of AYUSH entrusted the study of the contemporary acts on medical practice in the light of judgement of Hon'ble Supreme Court in 1987 Dr. Mukhtiar Chand & Others versus State of Punjab & Others and other similar judgements. Drugs can be sold and supplied by a Pharmacist or a Druggist only on a prescription of a Registered Medical Practitioner and who can also store them for treatment of patients.

According to Section 2 (ee) of the Drugs and Cosmetics Rules, 1995, Registered Medical Practitioner means a person -

(i)            holding a qualification granted by an authority specified or notified under Section 3 of the Indian Medical Degrees Act, 1916 (7 of 1916), or specified in the Schedules to the Indian Medical Council Act, 1956 (102 of 1956); or

(ii)           registered or eligible for registration in a medical register of a State meant for the registration of persons practicing the modern scientific system of medicine (excluding the Homoeopathy system of medicine); or

(iii)          registered in a medical register (other than a register for the registration of Homoeopathic practitioners) of a State, who although not falling within sub-clause (i) or sub-clause (ii) is declared by a general or special order made by the State Government in this behalf as a person practicing the modern scientific system of medicine for the purposes of this Act.

Hon'ble Supreme Court upheld the validity of Rule 2 (ee) (iii) as well as the notifications issued by various State Governments there under allowing Ayurveda, Siddha, Unani and Homoeopathy practitioners to prescribe allopathic medicines.

In view of the above judgment, Ayurveda, Siddha, Unani and Homoeopathy practitioners can prescribe allopathic medicines under Rule 2 (ee) (iii) only in those States where they are authorized to do so by a general or special order made by the concerned State Government in that regard. Practitioners of Indian Medicine holding the degrees in integrated courses can also prescribe allopathic medicines if any State act in the State in which they are practicing recognizes their qualification as sufficient for registration in the State Medical Register.

KR/SK/95 – RS :

https://pib.nic.in/newsite/erelease.aspx?relid=30117, 20th August 2007

IMA suggests the followings:

 1.      IMA members should not appoint Ayush Doctors to assist them in their medical/surgical operations.

 2.      IMA should not assist Ayush doctors if they are performing any surgeries like giving Anesthesia, providing post operative care and or using them as assistants in providing medical or surgical care.

With kind regards

Yours sincerely,