Ayurvedic Surgery: 10 Technical Questions? About safety concerns


      If there are certain doubts about the safety of the patient, the apprehension needs to be addressed.

      The government has issued a notification which authorises post-graduate practitioners in specified streams of Ayurveda to be trained to perform surgical procedures such as excisions of benign tumours, amputation of gangrene, nasal and cataract surgeries.

    The notification by the Central Council of Indian Medicine, a statutory body under the AYUSH Ministry to regulate the Indian systems of medicine, listed 39 general surgery procedures and around 19 procedures involving the eye, ear, nose and throat by amending the Indian Medicine Central Council (Post Graduate Ayurveda Education) Regulations, 2016.

     Any  Surgery, how-so-ever simple it may look to the people sitting on fence, carries some  risk and needs  some kind of precautions and regulations to make it risk free.  Therefore if there are certain doubts about the safety of the patient, the apprehension needs to be addressed. If the service of surgery by Ayurveda surgeon has to be availed by public, a certain confidence needs to be generated about the safety and quality assurance. Mere push by an enforced law will not lead to genesis of trust and confidence. So there needs to be technical analysis of some kind, whether  it is a genuine original  strategy or merely  an imposed law.

     If it was an accepted practice till now, there was no need for such notification. So apparently,  if the need was felt  to be said in a forceful manner, there has to be something unusual about the practice.

      No doubt, ancient Ayurvedic text referred to surgical practices. But  in present era of consumerism, patients need to know, how it was being practiced for last 200 to 300 years. What are the results and data about complications.

  There are two main categories for the purpose of discussion.

A. Existence of a robust system

B. Individual competencies.

    Firstly, there should be basic robust system  that will generate Ayurvedic surgeons.

To start with, the  CCIM need to  satisfy on following questions. Following are the basic requirements of surgery.

1. What  kind of Anaesthesia  will be used in surgeries by Ayurveda surgeons? Who will be the anaesthesiologist?

2. What are post op pain killers be used in surgeries by Ayurveda surgeons?

3. What antibiotics  will be  used;. Allopathic or ayurvedic?

4. What are principles of pre-op evaluation?

5. How surgical techniques are different. Are they same used in allopathic surgery or different ones described in Ayurveda?

6. How the post op complications are being managed. Is it by using allopathic medications and investigations?

7.  Data of surgeries done in last decade or two in all of  Ayurvedic medical colleges, especially those done by Ayurvedic surgeons.

8. Who is teaching Ayurveda doctors about the  surgeries? Are there ayurvedic teachers  or being taught by allopathic surgeons?

9. Will  the people in higher positions and government  officials be availing such facilities or it is only for the  poor people? 

10. Will the patients be given enough information or an informed consent about such Ayurvedic surgeons before  surgery?

         More than a law, the whole exercise   will require a trust building   in public  along with quality assurance and something unique to make such surgeries practically happen.

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How to implement bridge course, if necessary: A suggestion #NMC


Crosspathy is dangerous to human race and potential global catastrophe because of antibiotic resistance.  All  allopathic medicines are hazardous chemicals in inexperienced hands. Incorrect and massive use of antibiotics will  cause antibiotic resistance, which has global ramifications. From this angle, it is a retrograde step. When all over the world, need is being felt that there has to be better control of antibiotic prescription.  We are entering an era, where antibiotics are getting useless and more so because of rampant misuse of antibiotics.  Rather than exercising a better control, it will be a catastrophic to human race world over by causing antibiotic resistance.

Will  thousands or lac   of alternate medicine graduate will dispense all antibiotics,  anticancer , anti diabetic , cardiac medications? It is hard to think about hundreds of potentially dangerous medicines being given without structured training and  proper exams in this system of crosspathy.

   Although it appears to be an avoidable decision, but still if required can be done by creating “doctors for area of need.

Following steps should be taken before implementation:

 Main Aim; to create doctors  for area of need. (AON doctor)

  1. To identify areas of need; most basic step is to identify the areas of need, where doctors are not available. Government should identify area of need and implement the scheme in selected areas, and with  selected simple drugs. Such areas should be such that which do not have medical facilities or lack doctors. Areas which already have doctors will not accept the diluted  or sub-optimal care, for example urban population.
  2. Limited seats-To identify the number required; let us say start with pilot project of  selecting 500 to1000 such doctors. All the lakhs of alternate doctors  can not be allowed to prescribe allopathic medicines. It will put the community at risk.

Each and every seat of AON and its doctor needs to be identified , earmarked and  trained for the particular seat.

  1. To identify the skills required for the area; for example emergency, for paediatrics or obstretics and gynaecology, trauma.
  2. Willingness to work in area of need- to identify the doctors: have a written competition from all candidates who apply for bridge course. To identify doctors who have given willingness to work in these areas of need. People who perform well should be taken for bridge course  only on limited seats. Bridge course should not  free for all.
  3. To develop a structured bridge course, which should be around one year after comparing the course of MBBS and the course done by the candidate.
  4. Admission and exit in the bridge course should be through exam and limited seats.
  5. Bridge course and allopathic medicines should not be made free for all, that any body can dispense it. We can get benefit only if is specific to needs of people. If everyone is allowed to practice allopathy in all locality, it will be a global hazard besides our community .
  6. These trained doctors will have an undertaking to serve in area of need only. For a period at least 10 to 20 years.
  7. Number should be limited but training should be good.
  8. A special course needs to be designed separately for one year, so that people in area of need do not get substandard care

Without proper planning and implementation and identification of area of need, this bridge course will not benefit anyone, rather it can be disastrous.

 

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