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.
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