Doctors across the country have decried 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 provisions under Section 50 of the National Medical Commission Act, 2020 mandated that educational modules for interface between the modern system of medicine, homeopathy and ayurveda be prepared through joint meetings of the Central Council of Indian Medicine, Central Council of Homeopathy and National Medical Commission. These provisions aim to promote pluralism in medical education.
The National Education Policy, 2020, in its medical education component, lays emphasis on a holistic approach. The government think-tank NITI Aayog is perusing through a variety of reform ideas in the health sector, including aligning traditional and modern approaches for the ‘larger good’, for which the Aayog has formed four committees. These committees are 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 unique method of diagnosis, reasoning for causation and protocols for treatment.
The modern medicine system is an internationally recognised system of treatment whereas other systems have regional acceptance and dominance. Just as different regional languages cannot be integrated to make one language, it is similarly not possible to formulate one common system of treatment.
Case in point: How can the anti-microbial concept of modern medicine system be integrated with the ‘tridosha theory’ of Ayurveda? Or the homeopathic concept, which says dilution increases the potency of a biologically active substance be reconciled with modern pharmacology? The homeopathic principles that substances retain memory on dilution has not stood the scrutiny of biology, chemistry, physics and related sciences. It would 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?
More research needed
Furthermore, it is not possible to treat one patient with different systems simultaneously. Scientists and clinicians are yet to study drug interactions between medicines from different systems inside the complex human machine, which may be undergoing different metabolic changes due to the stress of trauma, operative procedure or recovery from anaesthetic agents apart from the onslaught of infections and immune factors. All such issues need to be sorted out through scientific research, both in experimental laboratories as well as in clinical practice before any type of integration exercise is put into action, by independent expert groups. Or else, we shall be putting the proverbial cart before the horse.
Unlike the modern system of medicine, the indigenous systems of therapy are not evidence-based. And hence, have no common grounds to meet and mix.
Shortage of qualified doctors has often been cited as one reason for such integration. However, as nearly 80,000 MBBS doctors are now being trained by 642 medical colleges every year such an argument may not be valid anymore. Rather, there may be many unemployed MBBS doctors few years from now. There is no dearth of postgraduate doctors too, 36,192 doctor of medicine (MD) and master of surgery (MS) seats were available for the year 2020-21. Over 44,000 specialist doctors are also being prepared by medical colleges and 60 exclusive post graduate medical institutes every year.
Better infrastructure needed in rural areas
Another argument made in favour of the integration is that doctors of the modern system of medicine are not keen on providing services in remote or underdeveloped areas. However, the non-availability of qualified doctors in rural areas can be attributed to non-availability of other essential services as well. Qualified doctors would love to serve the ailing masses in rural areas if infrastructure and social milieu to practice modern medicine is made available by the government.
Policy makers must work on correcting the basic lacunae in infrastructure first, rather than making stop-gap arrangements to meet the demand and supply gap, if any, by either integrating different systems of treatment or by imparting modern surgical training to ayurveda graduates, as per the CCIM notification, (Amendment Rules 2016) dated November,19 2020.
Let each system of treatment be developed in an individual manner by established scientific research methodology, to make it evidence-based and acceptable to those with scientific temperament. Mixopathy is unscientific, unrealistic, unreasonable, and an onslaught on the uniqueness of individual systems of treatment. Let diversity of different systems prevail and flourish.
(Views expressed are personal)