By Neeraj Mahajan and Ankit Mahajan
Medical practitioners all over India are on a war-path.
The National Medical Commission Bill 2019 passed by the Lok Sabha is making news for all the wrong reasons. The bill which seeks to repeal the Indian Medical Council Act 1956 seems to have ruffled the feathers of the Indian Medical Association (IMA), which is staging nation-wide protest against it.
IMA officials describe it as a draconian and undemocratic law that will dump healthcare and medical education in India into darkness and legalize quackery. The IMA has called for a 24-hour withdrawal of non-essential services in protest of the bill.
According to IMA sources, Section 32 of the NMC Bill provides for licensing of 3.5 lakh unqualified non-medical persons to practice modern medicine. Looking at things in detail, the new bill dilutes and loosely defines the term Community Health Provider to allow anyone to get registered and practice medicine. This means that even people without a medical background will become eligible to practice medicine and prescribe medicine for a price.
The entire medical fraternity is aghast at the manner in which the bill tries to fiddle around with medical examinations affecting the career of generations of medical students. Such inconsistencies in the Bill will seriously affect the health of the nation, they say.
The Indian Medical Association (IMA) is opposing the Bill in totality.
For the same reason, an Emergency Action Committee reviewed the situation and decided to call for 24 hours withdrawal of non-essential services across the nation. This would however not affect the emergency, casualty, ICU and related services which will function normally.
If the bill is not withdrawn, the state and local branches of IMA will launch public demonstrations and hunger strikes in which the entire medical fraternity will participate and medical students may boycott classes in solidarity.
“The struggle to redeem the Health of the nation is our privilege and sacred duty. We will never allow licensing unqualified non-medical persons to kill our patients. We will never allow our mothers and children to die in thousands forever due to this Black Law”, an IMA official said.
According to Dr. Girish Tyagi, President Delhi Medical Association the root cause of the problem is a perceived shortage of Doctors in the country. The Government’s plea is that there is a shortage of Doctors in the country and it wants to fill up the void by allowing BDS qualified Dentists to practice mainstream medicine as a normal MBBS Doctor after doing a bridge course.
This presumption is however contested by the Medical fraternity which claims that some 63250 MBBS students pass out of the 494 medical colleges in India. However, there only 23,829 postgraduate seats and hence the government does not have the capacity to absorb any more doctors in post-graduate MD/ MS courses.
Sounding an alarm Hony State Secretary Delhi Medical Association Dr. Arvind Sharma describes this as an unpleasant joke with precarious consequences. According to him, there is a specific role for Dentists, Nurses, Optometrists and Pharmacists in the mainstream medical field but to allow them to practice as regular Doctor after attending a six-month bridge course – amounts to playing with fire.
All this is a catch-22 situation where every year a large percentage of MBBS doctors fail to get admission in post-graduate courses and hence they are not found fit for government jobs. This leads to frustration and hopelessness in unemployed medical graduates.
According to sources another dimension to the problem is the manner in which the Pharmacy Council of India (PCI) has granted permission to all pharma D degree holders to prefix the word ‘‘Dr’’ before their given name.
As a result, a number of Pharmacists have started using the tag “doctor” and create confusion in the minds of patients. It may be mentioned that Pharma D is a 6-year doctorate level course, including five years of academic study and a year of internship or residency. It is offered by a variety of public and private universities in India.
The PCI has requested government and private universities all over India to add the prefix “Dr” to the names of students who complete their Pharma D degrees. A number of private universities have conceded to their demand, though the government colleges are still reluctant to acknowledge the change in prefix.
This is leading to a debate in the medical fraternity about the consequences of shedding the thin line between prescribing and dispensing medicine. A pharmacist is trained only to dispense medicine. Doctors prescribe and pharmacists dispense. This is a clear demarcation which if eroded will lead to misrepresentation and create confusion in the minds of gullible patients who might start asking pharmacists for medical advice and prescriptions.
They do so already but if formally allowed – even many pharmacists, having little or no knowledge will start prescribing medicine and the differentiation between a physician and pharmacist will be lost.