A recent judgement, from the High Court of Tamil Nadu, made provision for the recognition and registration of ‘Unqualified Medical Practitioners’ (UMP), in various systems of medicine. This is not like the LMP of the olden days, who actually received formal education and training in the field of medicine, to earn the diploma, and the license to practise.

        Two issues arise out of the UMP provision. On the one hand it provides a legally sanctioned opportunity to an experienced person to serve the community in Ayurveda, or Homoeopathy or another system of his choice, except Allopathy. This is useful, as the community gets a few more experienced hands which the health care system badly needs. But on the other hand, the number of quacks will rise phenomenally, making the verification of claims a formidable task.

        The issue of the UMPs should be examined carefully and in detail, and regulatory bodies be set up to prevent the misuse of a well meaning provision.

        The British Medical Association was engrossed with the problem of the practice of complementary medicine in the United Kingdom and in 1993 made the following recommendations, which can be suitably modified and adopted for other countries like India:

a) The present situation, which allows any one to practise in any (Alternative/Complementary) system of medicine freely irrespective of training and experience, is unacceptable.

b) If unregulated practice poses danger to the patients, it should require statutory regulation.

c) Good and safer complementary therapies should be identified and encouraged.

d) A single regulatory organisation should represent each complementary therapy with a well defined code of ethics, a system of communication with the general allopathic practitioner, disciplinary and grievance procedures, and requirement for continuous education and development.

e) Recognised training should be established for each therapy with appropriate clinical and medical information.

f) Research and development should be encouraged in all complementary fields.

g) Post-graduate education for doctors with degrees in allopathy should be organised to illustrate complementary medical techniques available and for possible patient benefits.

h) Doctors wishing to practise a complementary technique should undertake recognised training and only treat patients after registration with a professional/statutory body.

        The belief that one should have an adequate and appropriate training and experience to practise in any system of medicine has received a serious dent with the very recent judgement of the Supreme Court of India (October 14, 1998), which permitted the Hakims and Vaidyas to prescribe and so to practise in Allopathy. This might be a just interpretation of the existing Law and may hormonise the provisions of the State Register of Indian Medicines, Central Register of Indian Medicines and the mandatory State Medical Register. Nevertheless, since Hakims and Vaidyas do not receive any recognised training in Allopathy, their prescribing and practising Allopathy is unethical and is not in the interests of the patients. The need to integrate different systems does not mean an unrestricted practice in systems where the practitioner did not receive any training.

NON-PROFESSIONAL PRESCRIPTIONS AND SELF-MEDICATION

        India is one of the few countries in the world, where most members of the general public feel compelled to dispense oral prescriptions of medicine to every one around. Many are only too willing to take this non-professional advice seriously. Besides, almost every one is also capable of prescribing for self. This is nothing short of quackery (alloquackery and autoquackery respectively), and should be discouraged.

        For several reasons, both non-professional prescription and self-medication are dangerous practices. There is nothing like a safe medicine and medicine of any system should be prescribed and administered only under competent medical supervision.

        In the western world, except for analgesics, throat lozenges, externally applied non-antibiotic ointments, and the like, no medicine can be bought across the counter, without a proper medical prescription. If the supply on a particular prescription is made, the chemist does not return the prescription, as he has to keep it in his records to account for the sale. If the patient has to repeat the same medicine, a new prescription is needed. The sale of over 95 per cent of medicine is strictly controlled. Even a qualified physician cannot prescribe medicine for his family and self. Hence the opportunity for self-medication is almost totally absent.