In December 2024, the Maharashtra Food and Drugs Administration (FDA) issued a directive allowing homeopathic practitioners with a pharmacology certificate to prescribe allopathic medicines.
What is Crosspathy?
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About: Crosspathy refers to the practice of healthcare professionals prescribing or practicing medicine outside their recognized scope of expertise.
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Specifically, it involves practitioners of alternative medicine systems (like Ayurveda, Yoga, and Naturopathy, Unani, Siddha and Homoeopathy (Ayush)) prescribing or performing treatments typically reserved for allopathic (modern) medicine.
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Concerns: This practice is often criticized because it can lead to misdiagnosis, inappropriate treatments, and risks to patient safety, as these practitioners are not fully trained in the methods and practices of modern medicine.
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Regulations and Legal Precedents:
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MCI Code of Ethics 2002: The Medical Council of India (MCI) established the Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations, 2002, under the Indian Medical Council Act, 1956, which restricts unqualified individuals from conducting medical procedures such as abortions or issuing medical competence certificates.
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It also mandates that qualified doctors cannot assign non-qualified personnel for medical tasks.
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Supreme Court Judgments: In a landmark 1996 case, Poonam Verma Vs. Ashwin Patel, the Supreme Court of India held a homeopath liable for negligence after prescribing allopathic medicines, which led to the patient’s death.
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The Court ruled that cross-system practice constitutes medical negligence.
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This has been upheld in subsequent rulings, stating that crosspathy is only permissible if explicitly authorized by the concerned State Government.
What are Reasons for Promoting Crosspathy?
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Shortage of Specialists: A report on Health Dynamics of India 2022-23 highlights an 80% shortage of specialist doctors in Community Health Centres (CHCs) in rural areas, with only 4,413 specialist doctors available, while 21,964 are needed.
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The government has been promoting AYUSH doctors to help alleviate the shortage of medical professionals, particularly in rural areas.
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Expanding Healthcare Access: As of June 2022, there were over 13 lakh allopathic doctors and over 5.5 lakh AYUSH practitioners in India.
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India's doctor-population ratio is 1:836, surpassing the World Health Organization (WHO) standard of 1:1000, but most doctors are concentrated in urban areas, limiting rural healthcare access.
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Crosspathy improves healthcare access in remote areas with fewer allopathic doctors, offering an affordable alternative for rural patients who cannot access specialists or urban facilities.
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Poor working conditions and low remuneration deter MBBS doctors from taking up rural posts.
What are the Concerns Regarding Crosspathy in India?
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IMA's Concerns: The IMA criticizes the Maharashtra FDA’s latest directive, arguing that the National Medical Commission (NMC) Act, 2019 does not authorize AYUSH doctors to practice allopathy.
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Maharashtra's decision contradicts national policies, as even the Central Council for Homeopathy does not permit homeopaths to practice allopathy.
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The IMA insists that such practices would be detrimental to patient safety and could potentially lead to negligence or malpractice.
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IMA argues that it promotes "crosspathy," undermining the integrity of medical qualifications and specializations.
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Quality of Care: Compromises the standard of healthcare, as AYUSH practitioners lack formal training in modern medicine.
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Hospital Practices: The directive encourages appointment of AYUSH doctors in allopathic roles, violating medical ethics and contributing to reduced employment opportunities for Bachelor of Medicine and Bachelor of Surgery (MBBS) or Modern medicine doctors