What is Crosspathy?

Crosspathy refers to combining treatment methods from different systems of medicine, such as modern allopathy with traditional practices like Ayurveda, Homeopathy, Unani, or Siddha, to treat patients. This approach often aims to provide more comprehensive care by integrating the strengths of different medical systems. Read here to learn more.

Homoeopathic practitioners in Maharashtra were allowed to prescribe allopathic medications following a controversial decision to address a shortage of doctors in rural areas and improve healthcare access.

The move was facilitated by amendments to the Maharashtra Medical Practitioners Act, allowing qualified homoeopathic doctors with additional training in pharmacology to prescribe certain allopathic drugs.

Reasons for the Decision

• Healthcare Access: The decision sought to alleviate the shortage of qualified allopathic doctors, particularly in rural and remote regions.
• Dual Training: Homeopathic practitioners were required to undergo bridge courses in pharmacology to gain the knowledge necessary to prescribe allopathic medications.
• Policy Experiment: It was seen as an attempt to integrate traditional and modern medicine to improve healthcare delivery.

Criticism and Concerns

• Crosspathy: The Indian Medical Association (IMA) vehemently opposed the decision, labelling it as “crosspathy” — the unauthorized mixing of different medical disciplines, which they argued undermines the integrity of medical practice.
• Patient Safety: Concerns were raised about the competency of homoeopathic practitioners in handling complex allopathic treatments without extensive medical training.
• Quality of Care: Critics argued that allowing cross-practice could lead to substandard healthcare services and potential risks for patients.

Crosspathy

Crosspathy refers to combining treatment methods from different systems of medicine, such as modern allopathy with traditional practices like Ayurveda, Homeopathy, Unani, or Siddha, to treat patients.

This approach often aims to provide more comprehensive care by integrating the strengths of different medical systems.

• Combination Treatment: Physicians may prescribe allopathic drugs alongside traditional medicines for a more holistic approach.
• Controversy: Crosspathy has sparked debates in the medical community, with concerns about the potential for drug interactions and the scientific validation of traditional treatments.
• Regulations: In India, only registered medical practitioners from a specific system are legally allowed to practice within that system. Practicing crosspathy without appropriate qualifications may be considered illegal.
• Patient Preferences: Some patients opt for crosspathy, believing it offers quicker relief or better outcomes by leveraging diverse medical approaches.

Challenges

• Scientific Validation: Limited research on the compatibility of drugs from different systems raises safety concerns.
• Quality Control: Traditional medicines often lack standardized formulations, increasing the risk of adverse effects.
• Ethical and Legal Issues: Practicing crosspathy without authorization may violate medical guidelines and regulations.

Legal Framework and Guidelines

In India, the legal framework for crosspathy (mixing different medical systems) is governed by laws and regulations related to medical education and the practice of medicine. Here’s a detailed overview:

1. Indian Medical Council Act, 1956 (Now superseded by the National Medical Commission Act, 2019):
   • Only doctors registered under the Medical Council of India (MCI) or now the National Medical Commission (NMC) can practice modern allopathic medicine.
   • Crosspathy by allopathic doctors without formal qualifications in alternative medicine may lead to legal action.
2. Central Council Acts for Alternative Systems of Medicine:
   • There are separate councils for Ayurveda, Unani, Siddha, and Homeopathy, like the Central Council of Indian Medicine (CCIM) and the Central Council of Homeopathy (CCH).
   • Practitioners registered with these councils are authorized to practice only their respective systems.
3. Ayush Guidelines:
   • The Ministry of AYUSH promotes traditional medical systems like Ayurveda, Yoga, Naturopathy, Unani, Siddha, and Homeopathy. However, it discourages unqualified cross-system practice.
4. State-Specific Legislation:
   • Some states, like Maharashtra and Tamil Nadu, have provisions for “bridge courses” under their medical acts that allow certain AYUSH practitioners to prescribe limited allopathic medicines after specific training.

Judicial Interventions

• Maharashtra’s Bombay High Court Ruling (2014): Allowed registered AYUSH doctors to prescribe allopathic medicines under certain conditions.
• Supreme Court of India (2018): Stated that prescribing allopathic medicines by unqualified practitioners is quackery and is punishable under law.

Ethical and Medical Concerns

• Patient Safety: Mixing treatments without scientific validation can lead to adverse drug interactions.
• Accountability Issues: In cases of malpractice, it becomes challenging to determine which system’s protocol was violated.
• Scientific Validation: Limited clinical trials on the efficacy of combining treatments from different systems.

Government Initiatives to Bridge the Gap

• Integration of AYUSH in Mainstream Healthcare: The government has established integrated health centres where AYUSH and allopathic doctors collaborate.
• Bridge Courses: Proposed under the National Health Policy, 2017 and Ayushman Bharat scheme for better utilization of AYUSH practitioners.
• Clinical Trials and Research: Increased focus on scientific validation of traditional medicines through organizations like ICMR and CSIR.

Reasons for Promoting Crosspathy

• Shortage of Specialists:
  • The Health Dynamics of India 2022-23 report indicates an 80% shortage of specialist doctors in Community Health Centres (CHCs) in rural areas.
  • Only 4,413 specialist doctors are available, while 21,964 are required to meet healthcare demands.
  • To mitigate this gap, the government has encouraged AYUSH doctors to fill critical roles, especially in rural healthcare settings.
• Expanding Healthcare Access:
  • As of June 2022, India had 13 lakh allopathic doctors and over 5.5 lakh AYUSH practitioners.
  • Though India’s doctor-population ratio of 1:836 exceeds the WHO standard of 1:1000, the majority of doctors are concentrated in urban regions.
  • Crosspathy provides a viable healthcare solution for rural areas, where allopathic doctors are scarce.
• Affordability for Rural Patients:
  • Crosspathy offers an economical alternative for rural populations who cannot afford specialist consultations or travel to urban healthcare facilities.
• Workforce Distribution Challenges:
  • Poor working conditions and inadequate remuneration in rural areas discourage MBBS doctors from accepting rural assignments.
  • AYUSH practitioners willing to work in these areas help bridge this gap, ensuring a continuum of care for underserved communities.

Conclusion

The debate highlights the ongoing conflict between different medical systems in India and raises questions about the effectiveness and ethics of bridging traditional and modern healthcare practices.

Frequently Asked Questions (FAQs)

Q. Can a Homeopathy doctor practice allopathy?

Ans: Yes, it is possible to continue practising homoeopathy alongside allopathy. Many healthcare professionals integrate both systems of medicine into their practice, offering patients a holistic approach to healthcare.

Related articles:

• Donor agreement between Ministry of Ayush and WHO
• Traditional medicine
• National Medical Commission (NMC)
• Healthcare sector in India

-Article by Swathi Satish