BioVoice News December 2016-January 2017 Issue 8 Volume 1 - Page 31

Statistics 2014-15 of the Ministry of Health & Family Welfare there is huge shortfall of doctors and specialists in the rural healthcare system . The report tells us that shortfall of allopathic doctors in Primary Health Centres ( PHCs ) was 11.9 % of the total requirement for existing infrastructure and even sanctioned posts were lying vacant in

these remote facilities .
There was huge shortfall of surgeons ( 83.4 %), obstetricians & gynaecologists ( 76.3 %), physicians ( 83.0 %) and paediatricians ( 82.1 %). Overall , there was a shortfall of 81.2 % specialists at the Community Health Centres ( CHCs ) vis-a-vis the requirement . What ’ s shocking is that around eight per cent of the PHCs across rural India are running without a doctor . Primary health care deals with basic medicine , treatment of minor ailments , immunization , child healthcare as well as natal and postnatal care . With little or no presence of private hospitals in rural areas , this leaves a large section of the rural population effectively without access to a doctor . In such circumstances , training AYUSH practitioners to fill the gaps in healthcare delivery at primary level can improve the doctor-patient ratio and provide the poorest masses in remote areas some medical assistance .
Some kind of ‘ doctor ’ is better than no doctor
The nearly 7 lakh AYUSH practitioners currently practicing in India already dispense basic medical care on a daily basis . In a country bedeviled by shortage of medical practitioners , they arguably provide some medical support to large swathes of populations deprived of healthcare facilities . In remote regions and villages where there is no MBBS trained doctor in sight for hundreds of kilometers at a stretch , thousands of AYUSH practitioners help dispense basic medical services and even help save lives by minimizing fatal effects of easily treatable conditions like diarrhea . Unless and until trained doctors are made available , millions of people will continue to flock to these practitioners anyway in desperate need of medical help . In such a situation , training these practitioners in providing the right care for minor diseases and identifying and referring serious conditions to specialists seems a viable solution in the short term . Right training can help reduce the public health challenges of anemia , malnutrition , pneumonia , diarrohoea , and other communicable diseases .
Is it workable on the ground ?
While the idea makes social sense theoretically , there are critical challenges to its flawless implementation . While the nod to AYUSH practitioners is for primary healthcare centres , how will government agencies ensure they do not claim to know modern medicine and practice in other areas where qualified doctors are also available ? In short , how will the authorities ensure the bridge course trained practitioners stick to their job description of dispensing only basic medical care in rural or remote areas ? Patients with serious conditions who need immediate critical care often end up aggravating their disease or even losing their lives in the hands of untrained doctors .
Any such training to AYUSH practitioners must therefore strictly be aimed to enable them dispense basic medical care and only in areas where qualified MBBS doctors are absent . This must strictly be a stop gap arrangement , not a long term solution . The long term solution lies only in producing more doctors and increasing the presence of public and private healthcare to remotest of regions .
DR DHARMINDER NAGAR Dr Dharminder Nagar is the Managing Director of Paras Healthcare . He has the unique advantage of being a doctor , hospital administrator and entrepreneur all in one . Several qualifications that include an MBBS from Mysore Medical College , MPhil from BITS Pilani , MS from Imperial College and MBA from Harvard , have propelled this young and dynamic MD to the forefront of healthcare . Dr Nagar was awarded the Entrepreneur of the Year ( 2015 ) Award at the India Health & Wellness Summit 2015 and Dynamic Healthcare Entrepreneur of the Year 2015 by Six Sigma Healthcare Awards at the World Entrepreneur Summit .