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Several people asked me this Q and I think this is a very good one that need answers from the medical fraternity ....

Q: Why are some state governments in India giving permission to unqualified people who don't know any thing about modern medicine to practice? Why are the central government and medical governing body here not doing  anything about it? Isn't it playing with the lives of common people? What can we do about it?

Krishna: A World Health Organisation (WHO) report  in 2018 claimed that 57 per cent of allopathic doctors in India do not have medical qualification and they are fake. It also says more than half of the 'doctors' here don’t have any medical qualification, and in rural areas, just 18.8 per cent of allopathic doctors are qualified ( Indian government thrashed this report though saying it 's not correct).

But several highly qualified doctors I spoke to said WHO report is correct! Uffffffff ....

According to 2001 census (that is the latest data we have right now) here ...

I was shocked when one of my friends told me her B.A.M.S. (Bachelor of Ayurvedic Medicine & Surgery) qualified sister 's  'practising allopathy' now after working under a highly qualified gynaecologist for two years! I myself know that this is happening here and is true atleast to some extent and we cannot push the problem under the carpet totally when we are dealing with things like safety of people and their lives.

In general, any person practising allopathic medicine who does not have a registered medical qualification comes under quackery. Even Indian doctors are protesting against plan to let ‘quacks’ practise medicine (1). Indian Medical Association says short bridging courses for traditional healers will lead to ‘army of half-baked doctors’

Dr. Om Lakhani,  Consultant Endocrinologist at Zydus Hospital, Ahmedabad and Founder of Endocrinology.co.in gave this sarcastic answer to this important Q. Think about it ....

If you are looking for a career in the ‘lucrative’ medical field, you are in luck. This answer takes about 10 minutes to read (5 minutes if you have completed 12th standard). Once you complete reading the article, you will know how one can become a doctor in India. You don’t need any medical qualification, you don’t need to go to a medical school or pursue an internship followed by post-graduation or super-specialty, you just need enough literacy to be able to read this article. So if you can read basic English, here is your chance to become a doctor overnight.

FIRST, THE CONTEXT

We recently admitted a patient with diabetes who 's present to us with severe abdominal pain, severe anemia, severe weight loss, and poorly controlled diabetes mellitus. He had a hemoglobin of mere 6 g/dl on admission.

He gave us a history that he had taken some indigenous medication from some quack in Rajkot. Since we had a similar patient a few weeks back, we suspected heavy metal toxicity hence send a lead level. To our surprise, the lead level came to 160 ug/dl ! We have started him on Chelation therapy.

We dug deeper into trying to find out who this quack is. He proudly calls himself a ‘Super-specialist’, has a Google presence and a website. It seems very clear from his visiting card and website that this person does not even have a medical qualification!

It seems he used to run a Laser center earlier. I am sure someone must have lost his vision, hence now he is concentrating on diabetes. I am sure you would be thinking, if someone loses his vision or someone has lead levels to the extent which can potentially kill him, surely the health authorities in India would take some action against him, right? You are so wrong. Not only is this guy flourishing in this ‘practice’ but he also has a picture on his website which shows him receiving an award from the Chief Minister of (a state in India) receiving an award for ‘Curing most number of patients with diabetes and kidney failure’.

It is unfortunate that my home state has sought to alleviate the doctor shortage by equipping some children with stethoscopes and allowing them to administer Ayurvedic treatments for “minor diseases” to their classmates.

HOW TO BECOME A DOCTOR IN 10 MINUTES IN INDIA?

It’s very easy to become a doctor in 10 minutes in India.

1. Write the term ‘Dr.’ in front of your name. Who said you need medical education for that? If you think you are a doctor then you are a doctor. In India, it is allowed. Trust me.

2. Rent a place in the middle of the city and put up a board saying you will cure patients of every disease under the sun with some home-made medications. Call it ‘Ayurvedic’ because if you say its ‘Ayurvedic’ our AYUSH ministry will allow you to put any toxic heavy metals in your product. You are allowed to make any poison in name of Ayurveda and basically destroy the ancient Indian science of healing.

(Read Dr. Krishna Kuamri Challa's article about this here: This is what a liver transplant surgeon told me recently... )

3. Do some online promotion. Make a viral video which claims everything we right now know through modern science  from Diabetes to AIDS is fake. Have a website with some pictures with your Chief minister giving you an award for wiping-off cancer from the face of this earth with your unique potions. Have your politicians praise you for an innovative drug, like BGR-34 or IME-9.

4. Mint money. Nobody can touch you if you have a picture with all prominent politicians in your place and their endorsements and permission from AYUSH ministry. All this is allowed in India.

WE NEED MAGICIANS NOT DOCTORS.

I wonder why the health ministry of India is so worried about the poor doctor-patient ratio in India. Why do we need more medical seats in India? We don’t need doctors, we need magicians. In fact, I propose a bridge course where anyone who practices magic can apply for a medical license after a short 10–15 min bridge course.

In India, our patients don’t seek medical care. They seek ‘magical care’. A patient comes to me with poorly controlled diabetes mellitus. I prescribe him Insulin and ask him to check sugars daily and inform me so that I can titrate his insulin dose. He never sends a single message. He comes back to me after 3 months saying his sugar is not controlled. I ask him, ‘Why didn’t you inform me your sugars so I can titrate your Insulin dose?’. His answer, ‘But I did not start Insulin at all’ !

So basically, the patient expects that when he sees me and pays my fees, his sugars will be controlled automatically. He doesn’t need to follow any advice I give him. I am like some God. The patient comes, places money in the ‘dan-peti’ (donation box), I bless him with good health and ‘Abracadabra’ his blood sugar will be controlled.

It is sad that they don’t teach magic in medical college. When you practice you are not supposed to practice medicine, it has to be pure magic.

ADVICE TO PRACTICING DOCTORS.

Here is my advice for qualified doctors. It is sad that you had to spend so many years to study medicine. I am sorry, we cannot bring your youth back. The time you could have spent networking with politicians was lost networking with ‘videshis’ like Harrisons and Davidsons. However, all is not lost. You can still learn a lot from these ‘magicians’ who don’t have any medical qualification but can cure every disease. If you follow these steps, your practice will double in 7 days, 100% guarantee.

1. Promise 100% result. If you are a surgeon and some patient asks you what are the complications expected from surgery, your answer should be standard, ‘It has no complications. We will 100% cure you, you will be a new person from tomorrow.’

2. Don’t give advice. Give blessings. If a patient comes to you with obesity, instead of wasting time talking about calories and exercise, bless him that he will lose 10 kgs in 1 month. Your blessings would work more because your advice is anyways not going to be followed.

3. Stop prescribing pharmaceuticals. Mix a few drugs in your secret lab and give it to the patient in small packets without any label. Patients are more likely to take medications from unlabeled bottles or wrapped in newspapers than from scientific foil packs.

4. Stop wearing your white coats. It scares people. They develop ‘White-coat’ hypertension. Instead dress like a Pujari, Maulvi or Priest. Your patients are more likely to trust you then.

Finally, share this article with your friends and family members who do not have a medical qualification but are ready to give medical unsolicited medical advice. If they read this, they too will be able to practice medicine without any medical qualification. After all, we need more doctors in this country, even if they are fake ones, right?

(All the opinions expressed above and highlighted in italics are Dr. Om Lakhani's )

                                                                                

                                                                                    ********

The reasons other doctors gave me for this flourishing business of fake medicine ...

1. Most of them say people in this region trust everybody and anybody without questioning  their credentials. In their desperation to get a cure, they just try to clutch any straw provided to them without questioning the authenticity of the medicine. 

2. It is very difficult to be a recognised genuine practitioner of modern medicine today. Decades of formal education with certification and licencing at every step of the way. And it's very easy to be a quack. All you need is an authoritative voice and a little knowledge on how to twist your words. You can go in front of a crowd with a Dr in front of your name but don't have to tell them that that Dr is assigned part of a shady doctoral program from a non existent university and preach how diabetes doesn't exist. And people will lap it up.

 Or you can go on social media and tell people that nipah doesn't exist and it's all the result of over dosage of paracetamol. And people will lap it up!

Example: Source: https://www.deccanchronicle.com/nation/current-affairs/030118/heale...

The Consumer Disputes Redressal Forum at Kozhikode slapped a Rs 4 lakh fine on a nature cure activist and anti-vaccine propagator Jacob Vadakkanchery and others in a petition filed by relatives of advocate Vinayanadan, who died during treatment. 

Vinayanandan, 40, a lawyer in Kozhikode was suffering from diabetes, peptic ulcer and kidney stone and got admitted at the Nature Life Hospital and Remedies in Kochi, which is being run by Vadakkanchery, on November 7, 2005. After five days, Vinayanandan suffered fatigue, collapsed and subsequently died at the hospital. The petitioners approached the forum alleging that the hospital authorities’ insistence on practising yoga in the morning that day led to Vinayanandan’s death as the deceased was also a heart patient. 

 The forum president Rose Jose in her order said that though the direct cause of the death was not because of the treatment at hospital there was gross negligence on the part of Vadakkanchery, his hospital, Joshi M. Vargeese, a naturopathy practitioner at the hospital and Director of Sujeevitham, self-treatment centre in Aluva in giving care and attention to the patient. 

The forum took into consideration the submission of the hospital and Vadakkanchery that the relatives had not shown the ECG report of Vinayanandan at the time of admission indicating that the deceased was a heart patient. 

In its order, the forum also said that during the cross examination, Vadakkanchery and Joshi M. Vargeese had admitted that both of them did not know how to read and understand ECG. Advocate Vinayanandan had come to know about Vadakkanchery and his treatment after hearing a speech of the former in Kozhikode.

Jacob Vadakkanchery’s stance against modern medicine practice and vaccination has reached a scary level where a strong group was formed to campaign against immunisation programme. 

3.Rules for rigorous testing of Ayurvedic products have also been relaxed or waived, despite the concerns of medical scientists who say there is insufficient evidence to recommend their use in clinical settings.

4.Many systems are practiced and there is overlapping of prescriptions by an Ayurveda/Siddha/unani/ homeopathy practitioner (the true ones still don't) for an allopathic medicine.

5. The reach of allopaths in some areas are still lacking

6. Money minded modern medical practitioners crowd in towns and not in other areas.

7. The method to cross check and awareness in people in several areas in this region is lacking. Doctors who are fake exist because of gullible people. 

8. Getting caught and facing punishment is  rare and that is why these fake doctors flourish .

9. High fees taken by the genuine medical practitioners. People willingly  get duped in the quest of finding an easy affordable solution to their health problems. 

10. Migration of qualified doctors to greener pastures. 

11. Mismanagement and inadequate resources — infrastructure and human. 

12. Apathy... despite being routinely flagged, the shortages are seldom corrected. Learning from failure is rare, and course correction after mistakes is rarer.

13. Sci-com failure (yes, in the end they blame us too and that is why I am publishing this article). 

And, finally, what can we do about it?

Law is very non-co-operative right now. There have been no attempts on the part of the government to curb quackery, according to Dr. A.V. Jayakrishnan, Chairman of the Standing Committee on Anti-Quackery set up by the Indian Medical Association.It is a well-known fact that in many States, quacks are operating in large numbers. Laws are so weak that even if the frauds are caught, they get bail on the following day and start practising again, according to experts. 

So, what can you do? Stop visiting the quacks! Even if you 'feel' they are cheap. That feeling is not actually true. Taking the fake medicines will actually spoil your health more and you end up spending more money to improve it. Sometimes you might even lose your life. 

Don't believe everything you hear, see or read. Don't believe if your emotional neighbour says 'the street corner pundit' or a 'baba' cured her of her ailments. 

Don't believe 'doctors' who have qualifications like BAMS (Bachelor of Ayurvedic Medicine & Surgery) or Homeopathic Medicine and Surgery (B.H.M.S.) ... when they say they can prescribe 'allopathic' medicines and treat all medical conditions using modern medical practices. They are not qualified or trained properly to do that.

Agreed the health care system here is in crisis. But we need not take desperate steps and  make things worse. Bring pressure on your governments so that they won't allow unqualified people to practice medicine.  

Go for insurance if you have very complicated health problems and go to genuine doctors even if they charge you  a little bit higher. Verify the doctors' qualifications. Buy medicines only from genuine medical shops and when only they are prescribed by qualified medical practitioners.

Stop believing in magic. Magic doesn't work 100% of the time. Trust science and nothing else to get better or cured. Nothing else works. 

Stay informed. Take illuminated decisions, and stick with them.

References:

1. https://www.theguardian.com/world/2018/jan/02/indian-doctors-protes...

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