Explained: Doctors' Strike Opposing Mixopathy

While the strike is on between 6am- 6 pm, emergency surgeries, casualty, labour room, ICU will sremain unaffected

Medical services in hospitals across the country are set to be affected following a call by the Indian Medical Association (IMA), for a nationwide strike against - Mixopathy - the government's recent order allowing a section of Ayurveda doctors to perform surgery. The IMA said that non-essential medical services will be withdrawn at hospitals and participating doctors will not practice between 6 am and 6 pm on Friday to oppose the government's order. While the strike is on, emergency surgeries, casualty, labour room, ICU will still remain functional.

The call for bandh comes after the Central Council of Indian Medicine on November 20, passed a gazette notification, allowing AYUSH professionals to perform general surgery.

The Shalya (MS General Surgery) Tantra and the Shalaka Tantra (Diseases of Eye, Ear, Nose, Throat, Head, Oro-Dentistry) curriculum uses modern medicine books as well as employs surgeons to teach the students. This mixing of schools of medicine, which IMA terms is - Mixopathy - is being opposed by the IMA.

According to the IMA, this "mixopathy" will affect the existing quality of care rather than making it easier for the patients to avail of good health services. The IMA believes the integration of AYUSH schools of medicine- Ayurveda, Yoga, Unani, Sidha, and Homeopathy into modern medicine nullifies the purpose of having different schools of medicine and reduces the choice for the patient.

BOOM contacted Dr. R.V Asokan, secretary general, IMA, who explained that the association wants every stream of medicine to flourish in itself. "Instead of integrating all the various schools of medicine, let them stay separate. Today, if allopathy does not work for patients, they have the choice to move to another school of medicine. Why integrate and take away this opportunity from the patient?" He added that the IMA believes that the CCIM should administer only Indian medicines without incorporating modern medicine techniques. "It also is against the two specialisations being labelled as general M.S general surgery and ENT. When people hear that an M.S surgeon is treating them, they expect pure medicine, not somebody using Indian medicine and a few techniques of modern medicine," Asokan continued.

Vaidya Jayant Deopujari, chairperson, CCIM, disagreed to this and said, "X-rays, CT scans, and all the other reports are inventions of modern physics, not something limited to modern medicine. Even AYUSH practitioners have a right to work with the modern updated technology."

Following in the CCIM's footsteps, the Society of Dental Surgeons has written to the Dental Council of India also suggested that dentistry be incorporated with general medicine as they possess the skills for the same.

What Is The CCIM Notification

On November 20, CCIM released a new gazette notification that was an amendment to Indian Medicine Central Council (Post Graduate Ayurveda Education) Regulations, 2016. This notification suggests that Ayurvedic students pursuing post-graduation in fields of Shalya (General surgery) and Shalakya (ENT) can now be trained to pursue these surgeries independently.

Over 39 general surgeries such as amputation of gangrene, removal of appendix and 19 ear nose throat surgeries have been included in this roster of training and practicing.

The curriculum, however, uses several books by allopathic doctors to explain the principles of surgery.

IMA's Opposition

Since the notification was published, the IMA has held two press conferences asking the CCIM to reverse this amendment. The IMA decided to hold walk-in protests on December 8. It then called for a all India strike on December 11, appealing doctors to withdraw from providing non-essential medical services and only administer emergency services between 6 am to 6 pm. Doctors will still be at hospitals but not provide out-patient services.

The IMA does not want "mixopathy" to take away the freedom of choice that patients currently enjoy where they get to choose the school of medicine they want to be treated with. The doctor body also highlights that Ayurveda lacks the essential services of anesthesiology and post-operative care, essential steps during regular surgeries.

Dr. Asokan lamented that this step is the government's way of employing cheap labour. "What the government needs to work on is to allocate more budget to the health sector. To achieve its goal of reaching every citizen and providing health to everybody, it cannot replace medical practitioners with AYUSH ones. Also where is the evidence that these practitioners will actually move to the rural areas?"

Emphasising that the IMA is not against Ayurveda, Dr. Asokan said that they want all the schools of medicines to be promoted on their principles instead of mixing. "Like vaccination is a part of modern medicine and not AYUSH, so are surgeries."

In the Shalakya Tantra curriculum, 25 of the 36 books are modern medicine books. The ministry has also employed surgeons to teach the students, an idea that also has also faced opposition from the IMA.

This is not the first time that the IMA has expressed displeasure at the integrating of the medical services. The IMA has in the past opposed the National Education Policy 2020 which mentioned integrating all systems of medicine under one roof and the proposal in the National Medical Commission Bill, introducing bridge and short-term courses permitting AYUSH practitioners and health workers to pursue medical courses.

While the IMA has been vehemently opposing an integration of all schools of medicine under the New Education Policy 2020, the Ministry of AYUSH intends to set up a new Department of Integrative Medicine at All India Institute of Medical Sciences, Delhi. The government plans to integrate modern medicine with the traditional system of AYUSH through the NEP. "Given that people exercise pluralistic choices in healthcare, our healthcare education system must be integrative, meaning thereby that all students of allopathic medical education must have a basic understanding of AYUSH and vice versa", the NEP states.

Origin of Shalya and Shakalya

CCIM Chairman Deopujari said that he did not see the reason for the hue and cry. "The post-graduate Shalya and Shakalya courses have been a part of the curriculum since 1991. These courses have been existing for several years," said Deopujari. He further added that before officially becoming a part of the curriculum, the courses were taught at Banaras Hindu University in 1984.

Furthermore, the chairperson of the CCIM did not feel that it was incorrect that Indian medicine was using references from modern medicine to augment its reach.

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