RMPs thriving due to shortage of doctors

Hyderabad: The Telangana State Junior Doctors Association is against legitimising the role of RMPs and Unregistered Medical Practitioners (UMPs) and mainstreaming them in the healthcare sector. "Numerous small pharmaceutical companies support quacks because they are an inexpensive marketing source to clueless patients. Most villages in India are still without a doctor or proper healthcare facilities.

Quacks are giving costly medications to patients in an attempt to realise big margins and gifts from pharmaceutical companies, as they are not committed by oath to safely manage patients. Reckless prescription of drugs, even antibiotics, is adding to the impending antibiotic disaster even in remote villages," said PS Vijender, president, Telangana Junior Doctors Association (TJUDA).

It may be mentioned that in June 2015, the Telangana government had announced that it would go ahead with the training of Registered Medical Practitioners/Private Medical Practitioners under the Community Para Medic Training program at a cost of Rs 4.32 crore.

This was proposed by the erstwhile Andhra Pradesh government. RMPs are medical practitioners who are not qualified doctors, but have been trained in basic medical practices, and are registered with the government. The programme to impart para-medical training to RMPs, presumably working in private, is to improve their skills and utilise the work force in the health system. They would be trained in primary treatment, emergency treatments and acute minor ailments, said the erstwhile united AP government.

Several doctors and Medical Council of India opposed the GO saying it would dilute the quality of medical profession in the State. One common excuse given is that due to shortage of qualified doctors in rural areas, people have no choice but to use the services of these itinerant quacks.

The nexus between pharmaceutical companies and quacks is a much worse arrangement where numerous fledgling pharmaceutical companies support quacks, because they are a cheap source of marketing to unfortunate patients.

Dr Vishnu Vardan, MD, Osmania University, says, "After completing my MD, I started my clinic in a rural area and my consultation fees was just Rs 100 but the patients said there is another doctor who charges only Rs 50, then why are you charging Rs 100? Later I found out that the other doctor was an RMP and many patients preferred taking treatment from him. PG or MBBS makes no difference in rural areas, only fees does."

Says Dr Chandrasekhar, MS (ENT) from Vizag: "Once a patient came to my clinic. She was suffering from hyperthyroidism and one RMP gave her Eltroxin 125 mcg after which she visited me with tremors and tachycardia and profuse sweating. If we do the same mistake we will be punished. What punishment will this RMP receive?"

Dr Leela Prasad, a government doctor, says, "I daily attend 60 to 70 patients in the OP, out of which 15 per cent come to me following the failure of treatment from RMPs. Also, RMPs send patients to the Public Health Center (PHC) for diagnostic tests. The PHC not running 24 hours has become a boon for RMPs. The PHC timings are from 9 am to 4 pm. The RMPs start their practice after 4 pm.

They start visiting village after village on a bicycle. It has been noticed that RMPs give steroid injections to any patient so that the patient feels better. But, these steroids are harmful and they make patients feel better only for 2 to 3 days. The RMPs' business thrives before and after PHC timings." "Government should obey the directions of the Hon'ble high court.

Government should form the committee and submit the report as soon as possible. Government should also discourage the Quackery in view of Public Health. Govt also build appropriate number of Primary Health centers and Community Health Centers as per High Court Judgment. Government should encourage qualified professionals rather than Quacks.

There are many unemployed MBBS, Nurses, Pharma D, pharmacy, Para Medical people who knows anatomy, physiology and Pharmacology. Government should make use of them for improving the public health," adds Dr Vijayender.