Allopathy and Ayush- The Future Ahead

India is one of the few countries to have a highly developed form of traditional medicine and healthcare. India has been practising Ayurveda and Yoga since ages. These healthcare techniques that are now acknowledged and renowned globally, promote holistic development of the body and mind. In India, AYUSH or the Ministry of Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homoeopathy is the government body that deals with these traditional and indigenous healthcare systems.

Ever since the NMC Bill came to the fore, there has been a lot of buzz surrounding the integration of AYUSH in the field of modern medicine. A provision in this bill seeks to introduce a Bridge Course for AYUSH doctors in India that will allow them to practice allopathy.

AYUSH Doctors In India
In 2016, WHO published an eye-opening account of the incompetent health workforce of India based on the 2001 Indian census. According to WHO, the ideal doctor-patient ratio is 1:1000, whereas in India it is 1:1674. Furthermore, the report highlights the poor educational and medical background of the healthcare professionals in India -  in allopathy, only 31.4% of allopathic doctors are educated up to the secondary level, and around 57.3% among them did not have any medical eligibility. In urban areas, only 58.4% of allopathic doctors had a valid medical qualification, and this percentage was as low as 18.8% in the rural areas.

According to the Medical Council of India (MCI), the total number of medical practitioners in India was 9.32 lakh (as of September 30, 2014). However, the number of AYUSH doctors practising traditional medicine in the country is around 6.8 lakh, which is quite impressive.

The NMC Proposal For AYUSH

Given the fact that the number of AYUSH practitioners in India is quite large, the NMC proposal doesn’t seem like such a bad idea. However, we need to make an in-depth analysis of this issue to know about the benefits and disadvantages of integrating AYUSH into modern medicine.

Rural Welfare
Both, the WHO report (2016) and the Rural Health Statistics (2014-15) of the Ministry of Health & Family Welfare, clearly depict a lack of adequate medical infrastructure in rural India. Even though a large population of the country resides in rural areas, there is a massive shortage of trained medical professionals in those regions. Almost 8% of the Primary Health Centres (PHCs) in rural India run without trained doctors. Also, the number of allopathic doctors in the rural PHCs was 11.9% short of the ideal requirement for the existing health infrastructure. These figures only depict the grim reality of rural India - a vast rural populace has no access to the primary healthcare facilities such as treatment of minor injuries and ailments, immunization, and maternal and child healthcare. Moreover, with little or no private investment in the rural healthcare sector, there is an urgent need to improve these issues in the system for the benefit of the rural populace.

In such a scenario, AYUSH doctors might be of great help. They can make up for the shortage of doctors and healthcare professionals in rural and backward areas.

Any Qualified Doctor Is Better Than ‘No’ Doctor At All!
With such an enormous shortfall of qualified doctors across the country, the aid of 7 lakh AYUSH practitioners in dispensing the primary and essential healthcare services should be a welcome move. While it is true that AYUSH practitioners may differ from allopathy doctors on the grounds of their understanding of human anatomy, physiology, and treatment procedures, it should also be considered that just like an MBBS qualified doctor, they too undertake a five-year course in studying other forms of medicines.

With the increasing incidents of illnesses and ailments throughout the country, the inclusion of AYUSH doctors could help manage the disease shift burden. Instead of crowding already pressurized doctors, patients can rely on AYUSH practitioners for the primary healthcare services.

Challenges
While many believe that incorporating AYUSH in modern medicine will be advantageous, many are still sceptical of this proposition. They are concerned about the lack of scientific validation for AYUSH therapies and treatment. The 4^th Common Review Mission Report, 2010 of the National Health Mission, brought to light a significant find - various states across India including Assam, Chhattisgarh, Maharashtra, Madhya Pradesh and Uttarakhand had deployed AYUSH practitioners as medical officers in PHCs. However, due to the lack of proper training in allopathy, the AYUSH practitioners were unable to dispense the primary healthcare facilities satisfactorily. In medicine, it is a known fact that you must practice what you preach - it is unethical to study one system of medicine and practice another.

The Future Of Indian Healthcare System
As the talks about the integration of AYUSH into modern medicine will be prevalent now, one can’t help but wonder what the near future holds the Indian healthcare system. Even if AYUSH is incorporated into the modern medicinal system, several mandates need to be fulfilled such as fortifying the educational and training infrastructure of AYUSH practitioners. Real success will only come when both the allopathy clinicians and Ayush doctors are willing to collaborate with each other; to learn from one another, and use the beneficial tools at their disposal to serve the people.  There has been an online doctor or app-based medical services that have made sure that technology is being able to reach out to people of India in terms of medical help, aid or assistance.

Conclusion
While it is clear to us that there exists a substantial rural-urban divide in the healthcare ecosystem of India, there is an immediate requirement for active 'intervention.' Healthcare startups can be a great way to disrupt the Indian healthcare ecosystem for good. With useful applications and digital tools, healthcare startups can educate both AYUSH practitioners and the commoners about primary health care management. They can empower the people of the country with powerful digital healthcare tools such as m-health, telemedicine, and remote monitoring. Not only will these tools simplify many cumbersome and routine processes in the healthcare industry, but they will also bring down the costs drastically. India will witness a revolution in its healthcare ecosystem only when all the facets (allopathy, AYUSH, healthcare providers, and health startups) of the healthcare sector come together to function as a closely-knit unit.

This article has been authored by Dr.Aditi Gupta Jha, Consulting physician & chief editor, JustDoc