Doctors across the country have denounced the concept of ‘mixopathy’, which refers to the integration of different systems of medicine such as Ayurveda, Homeopathy, Unani, Siddha, Yoga and Naturopathy with allopathy (modern system of medicine).
The debate began when the provisions of Section 50 of the National Medical Commission Act, 2020 required that educational modules for the interface between the modern system of medicine, homeopathy and Ayurveda be prepared in meetings joint ventures of the Central Council of Indian Medicine, the Central Council of Homeopathy and the National Medical Commission. These provisions aim to promote pluralism in medical training.
The National Education Policy 2020, in its medical training component, emphasizes a holistic approach. Government think tank NITI Aayog is examining various reform ideas in the healthcare sector, including aligning traditional and modern approaches for the “bigger good”, for which the Aayog has formed four committees. These committees work in the areas of medical education, clinical practice, public health, medical research and administration.
No common ground
However, this concept of integrating different systems of medicine raises serious questions about its practicability, as each medical system has its own diagnostic method, causal reasoning, and treatment protocols.
The modern system of medicine is an internationally recognized treatment system, while other systems are regionally accepted and dominated. Just as different regional languages cannot be integrated to form a single language, neither is it possible to formulate a common system of processing.
Case in point: How can the antimicrobial concept of the modern system of medicine be integrated into the “tridosha theory” of Ayurveda? Or can the homeopathic concept, that dilution increases the potency of a biologically active substance, be reconciled with modern pharmacology? The homeopathic principles that substances retain their memory when diluted have not withstood the scrutiny of biology, chemistry, physics and related sciences. Would it be difficult to explain the logic of the yogic concept of alternate-nostril breathing (anulom vilom) to a student of modern anatomy and physiology because both nostrils have identical structures?
Further research is needed
Additionally, it is not possible to treat a patient with different systems simultaneously. Scientists and clinicians still need to study drug interactions between drugs originating from different systems within the complex human machine, which may undergo different metabolic changes due to the stress of trauma, operative procedure, or recovery. of anesthetic agents, apart from the onslaught of infections and immune factors. . All these questions must be resolved through scientific research, both in experimental laboratories and in clinical practice, before the implementation of any type of integration exercise, by independent expert groups. Or else, we will put the cart before the horse.
Unlike the modern medical system, indigenous therapeutic systems are not evidence-based. And therefore, there is no common ground to meet and mingle.
The shortage of qualified doctors has often been cited as one of the reasons for this integration. However, given that nearly 80,000 MBBS doctors are now trained by 642 medical colleges every year, such an argument may no longer be valid. On the contrary, there may be many unemployed MBBS doctors in a few years. There is no shortage of postgraduate doctors either, 36,192 Doctor of Medicine (MD) and Master of Surgery (MS) seats were available for the year 2020-21. More than 44,000 medical specialists are also trained each year by medical schools and 60 exclusive postgraduate medical institutes.
Better infrastructure is needed in rural areas
Another argument made in favor of integration is that doctors in the modern system of medicine are not inclined to provide services in remote or underdeveloped areas. However, non-availability of qualified doctors in rural areas can also be attributed to non-availability of other essential services. Qualified doctors would love to serve the sick masses in rural areas if the necessary infrastructure and social environment for practicing modern medicine were made available by the government.
Policymakers should first focus on correcting fundamental infrastructure deficiencies, rather than taking stopgap measures to close the gap between supply and demand, where applicable, either by integrating different treatment systems, or by providing modern surgical training to graduates in Ayurveda, as per CCIM notification (Amendment Rules 2016) dated 19 November 2020.
That each treatment system be individually developed through established scientific research methodology, to make it evidence-based and acceptable to those of a scientific temperament. Mixopathy is unscientific, unrealistic, unreasonable, and an attack on the uniqueness of individual treatment systems. Let the diversity of different systems prevail and prosper.
(The opinions expressed are personal)
