A quack is a “fraudulent or ignorant pretender to medical skill” or “a person who pretends, professionally or publicly, to have skill, knowledge, qualification or credentials he or she does not possess. Quackery is often described as “health fraud” with the salient characteristic of aggressive promotion. According to the Indian Medical Association (IMA), some 10 lakhs of quacks practice in India. This includes compounders, assistants to doctors, lab technicians, medical store owners and acharyas . Just in Delhi alone, some 60,000 quacks reportedly practice ‘medicine’, according to the Delhi Medical Council. India’s quacks imperil lives, but are ‘god’ to their patients. Only one in five doctors in rural India are qualified to practice medicine, found a World Health Organization (WHO) report on India’s healthcare workforce, highlighting the widespread problem of quackery. The WHO report, published in 2016, said 31.4% of those calling themselves allopathic doctors were educated only up to Class 12 and 57.3% doctors did not have a medical qualification. According to Chairman Anti-Quackery cell, Delhi Medical Association, RMP certificate was issued till 1956 to doctors who were practicing medicine for several years. However, in 1956, the Indian Medical Council Act was passed. The act stated that every doctor has to register him/herself with Medical Council of India (MCI) or a state medical council to prescribe allopathic medicines. A similar response came from Minister of Health and Family Welfare to a question in Lok Sabha in April 2016. He said, “The Indian Medical Council Act, 1956, prohibits a person other than a medical practitioner enrolled on a State Medical Register to practice medicine in the State.” “Governments keep announcing new AIIMS-like institutes in states, but where is the faculty to train these doctors? Setting up a building and buying equipment is not enough, you need trained doctors to provide care and to teach future doctors; medical students,” said one bureaucrat. Institutions without adequate faculty will produce quacks. A comprehensive law against quackery is still awaited. What will you say when qualified doctors of various systems of medicines practice cross-pathy and also prescribe medicines and tests with impunity, when it is not absolutely necessary? Some doctors/hospitals shout in the market to guarantee cure for various incurable diseases, neo-labeled as marketing of skills can also be included in quackery. To get faster results if any qualified person switches on to corticosteroids or latest generation of Antibiotics, it reflects a quack alike conduct! People staying in Administrative Duties for years together suddenly start operating again, that is diluted form of quackery, though you are legally safe. Anyone pretending to have special or magical powers is also a quack. Anyone guaranteeing cure is also a quack. Most worrisome situation is that patients and doctors are indulging in over-exploitation of medicines and clinical lab tests for simple symptoms as a result of smart phone abuse, lack of sleep, overeating, lack of water intake or exposure to dust! Quackery is just a straw on the camel’s back or a major problem in the healthcare?
Why quackery is flourishing in India?
Firstly health is not the priority area for the government, which can be seen by the state of affairs in the government-run hospitals as well as budget allocated to the healthcare sector. Healthcare in India is not government responsibility and that is the reason for 80% of healthcare is provided by private sector. Compare the healthcare with say food. Once I am going to say five start hotel, I know that food will be costly and I am ready to pay. If I do not have money, I will not go to five start hotel to eat and will restrict to home food or lower class hotel which suit my pocket. In case of health, even though the poor know that some hospitals are costlier, at the time of emergency, when the patient is not given the care in government set-up, they have no option but to go to these costly hospitals. It is unfair to expect the family members to leave relation to illness without medical care. It is also a fact that all patients cannot be saved in best of the hospital Once a poor patient dies in hospital and hospital ask for the money involved in patient care, then the blame game starts. Private hospitals utilize huge money to set-up such hospitals and they try to recover initial cost and ongoing cost of running these hospitals. No one should blame them for costly care. It is also a fact that any doctor cannot always prevent complications, inherent in various diseases. They are expected to manage once complications develop. Even in world’s best of the hospital, complications of illness do occur. Asking why a bone marrow transplant child develops an infection in the hospital is a foolish question. Infection is one of the most common complications of a bone marrow transplant. All said and done, doctors should also be little more responsible and also careful in the management of the patient. Initial and continuing communication with patient and family is a very important issue and often forgotten by best of the doctor resulting in misunderstanding and blame game. Media most of the time is not aware of medical issues involved in the case and factual position and interpretation of the medical words and situation, but, still give very dogmatic and catchy statements, as if they are the medical experts of that particular situation. “Hospital horror will shock you”, “Health Mafia strikes again”. What are these statements? What is the solution? Government must own responsibility for affordable and good health care in government-run hospitals for a common man. By government mismanagement of overall healthcare in the country, poor should not be allowed to land into these five-star hospitals. Ideal is if the government could save the people from falling sick by healthy life style and preventive measures.