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 medical system).
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 during joint meetings of 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, emphasizes a holistic approach. The government think tank NITI Aayog is examining various reform ideas in the health sector, including the alignment of traditional and modern approaches for the ‘common 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 diagnostic method, causal reasoning, and treatment protocols.
The modern medical system is an internationally recognized treatment system while other systems have regional acceptance and dominance. Just as different regional languages cannot be integrated to form a single language, neither is it possible to formulate a common processing system.
Example: how can the antimicrobial concept of the modern medical system be integrated into the “tridosha theory” of Ayurveda? Or would the homeopathic concept, which says that dilution increases the potency of a biologically active substance, be reconciled with modern pharmacology? Homeopathic principles that substances retain memory upon dilution have not stood up to scrutiny in 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 simultaneously treat a patient with different systems. Scientists and clinicians have yet to study drug interactions between drugs of different systems inside the complex human machine, which can undergo different metabolic changes due to the stress of trauma, operative procedure or the recovery of anesthetic agents apart from the onslaught of infections and immune factors. . All these questions must be answered by scientific research, both in experimental laboratories and in clinical practice before any type of integration exercise is implemented, by groups of independent experts. Or, we will put the proverbial cart before the horse.
Unlike the modern system of medicine, indigenous therapy systems are not evidence-based. And therefore have 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, as nearly 80,000 MBBS doctors are now trained by 642 medical schools each year, such an argument may no longer hold. On the contrary, there could 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) places were available for the year 2020-21. More than 44,000 medical specialists are also prepared annually by medical colleges and 60 exclusive postgraduate medical institutes.
Better infrastructure is needed in rural areas
Another argument advanced in favor of integration is that physicians in the modern medical system are not inclined to provide services in remote or underdeveloped areas. However, the unavailability of qualified doctors in rural areas can also be attributed to the unavailability of other essential services. Qualified doctors would like to serve the sick masses in rural areas if the infrastructure and social environment to practice modern medicine are made available by the government.
Policy makers should focus on correcting fundamental infrastructure gaps first, rather than making stop-gap arrangements to address the gap in demand and supply, if any, either by integrating different treatment systems or by providing modern surgical training to Ayurveda graduates as per CCIM Notice, (Amending Regulations 2016) dated November 19, 2020.
That each treatment system be individually developed by established scientific research methodology, to make it evidence-based and acceptable to those with 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 flourish.
(The opinions expressed are personal)