‘Bridge Course’ for ISM Graduates – Bad or Worse?

Ever since the Ministry of AYUSH was formed, the MH&FW was mulling with the idea of integrating ISM with main stream allopathic system. To achieve the above and also to overcome the shortages of allopathic doctors in rural India, a shortcut solution the Government had discovered, that is bridge course for ISM graduates to practice allopathic drugs.

The question is whether such proposal of Government is correct and prudent? The people in rural India are largely innocent, poor, gullible and not well educated. Further, several studies have shown that infectious diseases predominates in rural India and contrary to that, life style associated health problems dominate in urban India. ISM largely caters to non infectious health problems than infectious diseases.

Tread with caution and care

Every country in the world have become extremely careful in dealing infectious diseases these days because of the problem of emerging drug resistant, more virulent mutant variants. So the right and responsibility of treating infectious diseases are given only to the duly qualified allopathic doctors. The varying clinical manifestations of the diseases and the unpredictable virulent potential of the pathogens, even the experts in allopathic system these days take time to diagnose even the most common diseases and only then the treatment is offered.

The science, the philosophy and the fundamentals of ISM are completely different from allopathic medicine. Allopathic system gives importance to non subjective diagnosis of the disease. Subjectivity always causes error and science always tries to avoid subjective assessments and evaluations.

On the contrary, ISM believes fully in subjective evaluations (skill based) and diagnosis. The treatment approach of ISM is also largely on correcting the Tridosha than addressing the diseases as like in allopathic system. ISM seldom addresses the etiology than correcting Tridosha.

Solution or problem?

The big question is how the ISM graduates who have studied a ‘different science’ and philosophy exclusive of ISM can be qualified to prescribe allopathic drugs through one year bridge course? How one can acquire skill and proficiency to practice allopathic drugs and diagnosis in just one year? The allopathic doctors who have studied 5 ½ years of MBBS are still struggling and updating their medical knowledge in diagnosis and treatment.

Further, the descriptions, cause and diagnosis of the diseases mentioned in ISM are completely different. None of the terms like Psoriasis, Eczema, fungal diseases, Impetigo etc., are ever described in ISM literature the way allopathic system has explained.

The modern day ISM practitioners conveniently extrapolate some of the descriptions of diseases described in ISM as Psoriasis or Eczema etc. How accurate are such comparison/extrapolation, impossible to establish.

Rural people need better medical care

When Government proposes the bridge course for ISM graduates, it was said that, rural India suffer from the shortage of allopathic doctors and hence the service of ISM graduates have to be ‘used’ to meet the shortage ‘doctors’ in rural India.

It means, the Government of India, ‘in letter and spirit’ accepts the fact that allopathic system is only the recognized system of medicine in India. If so, why the ISM is promoted as system of medicine and incurs huge revenue from public exchequer?

Does it not such an approach of the Government in gifting ‘hybrid’ doctors to rural people amounting to discrimination of rural India? Should we be responsible to provide best medical facility and health care system to rural India or promote cross-pathy?

Cross-pathy would affect the epidemiological understanding

If we look at the evolution of every microbe, they would have evolutionally traveled great distance to become a perfect human pathogen. Syn-anthropophization and anthropophization were some of the evolutionary events that had facilitated most of the microbes to become deadly pathogens of man.

These pathogens, like human being, do constantly adapt and evolve to retain their statuesque.

The opportunity for these pathogens to become more virulent and drug resistant is not nature’s gift but it is only human contribution.

Correct diagnosis and usages of correct drugs for treating infectious diseases is therefore essential. If we make a mistake in the above, we may have to huge price. Therefore the special expertise required for treating infectious diseases, the one year bridge course cannot provide especially to ISM graduates as they were groomed totally through a different science and philosophy which is not only exclusive but also can be understood only by ISM.

Then, whom are we risking through cross-pathy? It will not only risk the life of poor, innocent patients in rural India, it would also affect our understanding of the epidemiology of various infections diseases, their clinical manifestations, emerging trends in the virulence pattern of pathogens, the clinical variability of the diseases, susceptibility pattern etc.,

Why don’t we develop AYUSH?

The question is why the Government cannot develop the relevance and science of AYUSH? Ministry of AYUSH must draw a clear road map. Government must identify the problems for which the ISM may offer some relief. Today, ISM is promoted in bizarre manner. From Tuberculosis, to AIDS to Cancer, ISM not only claims they have treatment but also claim cure.

Time has come; the Government must ask the following questions

1. Today we have proven, quick and safe drugs for managing allergic conditions

namely antihistamines. These drugs are also cost effective, thanks to DPCO. Is there any effective products equivalent to antihistamines available in ISM? If not such area of treatment should be removed from ISM.

2. Does ISM have antibiotics and antimicrobials (antibiotics, antifungal, antiviral and anti parasitic) like allopathic system? If the answer is no, treating infections diseases should be removed from ISM.

3. Does ISM have potent, safe, quick analgesic and anti-pyretic drugs like allopathic system? If the answer is no, then treatment of these problems should be removed from ISM.

4. Does ISM have potent, life saving steroids like in allopathic system? If the answer is no, then ISM treatment should not be offered to such problems.

Unless such series of questions are asked and answered, promoting ISM in every area of treatment and for every disease will only confuse and limit the acceptance & reputation of ISM. Further, if such treatment approach is continued, it would also prolong the agony of the poor patients, affect the diagnosis and cause unnecessary financial burden.

Palliative care

The question of how come ISM have drugs for incurable diseases (non-communicable diseases) whereas, ISM does not have drugs for curable diseases like that of allopathic system?

The true merits of ISM products needs to be ascertained and only then ISM should be promoted. Promoting ISM for offering palliative care than treating every disease will be one of the wisest approaches.

Definitely, it is unwise to promote ISM as ‘drug’ based system parallel to allopathic medicine.

When midwives can offer medical care in UK why not ISM in India?

It can be argued that the country like UK employ midwives for attending labor and pregnancy. The definition of ‘midwives’ is very clear and what they are permitted and not, are explained not only to them but also to every citizen in UK.

No adventurism and trespassing are allowed in UK. But in India, many ISM private practitioners are already engaged in cross-pathy. No midwife is allowed to treat infectious diseases in UK.

Cross-pathy- Social and medical evil

Recently the Honorable Minister of AYUSH has informed the Parliament that according to the survey of NSSO, 82% people who are aware of AYUSH are not opting ISM treatment and only 28% are opting ISM. The question is why such large percentage of people despite having awareness of AYUSH are not opting ISM?

The reason for the above is definitely the lack of trust due to lack of merit.

Some institutionally qualified ISM private practitioners when prescribe allopathic drugs to the patients along with ISM products, naturally some of the patients would raise doubts on why allopathic drugs are prescribed. This had compelled many ISM private practitioners to speak the truth to the patients that ISM products can only offer palliative care and nothing else. When an ISM practitioner themselves lack trust in ISM and accepts the truth, why should patients believe the system?

Interestingly some patients when taken only ISM products and not allopathic drugs found least to no effect from such products.

Define the boundaries

Government must define the boundaries of ISM. The policy of Government should involve science and scientific methods in our health care system and not the endless love and obsession for our tradition.

Medicine and medical system is the need of the hour for the sick and not tradition.

Home remedies

ISM has rich mention of home remedy tips for healthy life. Government should promote home remedy tips of ISM so that some relevance for ISM can be created. Further ISM has several simple tips for limited number of life style associated health problems that affects urban India. ISM should be promoted in Urban India for addressing life style associated problems and certainly not in rural India.

Dr S Ranganathan, Scientist based at Chennai

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