eMedinewS Editorial

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Tackling quackery

Dear Colleague

There is a shortage of at least 8 lakh doctors, 6 lakh dentists and 12 lakh nurses in the country. The net result is mushrooming of paramedical workers and others practicing in the guise of a doctor by adding ‘Dr’ as a prefix to their names and submitting fake certificates and degrees.

There are less than 7 lakh allopathic doctors in the country. What is required is a centralized register on a website which anybody should be able to access, click the required “State” and enter the state registration number. This way, any hospital, nursing home or even a patient should be able to verify the credentials of his or her doctor, including his or her photograph. A good IT should not need more than a month to work out a system of Centralizing registration. If it is difficult for the government to find such a solution, it can create a centralized website for registration with a facility of self–registration where all the doctors should be able to enter their details, upload their photograph and scanned copy of their registration. In this way, no two people of the same registration will be able to register. People, who have died will automatically be eliminated and anybody who is not registered should not be allowed to practice anywhere in the country. Once the process of registration is centralized, one can verify anyone practicing anywhere in India.

Quacks practicing in Delhi are usually arrested by the Police but released on bail after a few days. They can be seen practicing in their area even while on bail. This simply means that the council lawyer did not oppose the bail and, even if did, he did not ask for a conditional bail. The bail should specifically be conditional that the person released on bail cannot practice till the case is decided. If he or she still practices, it will amount to contempt of court and the bailable offence becomes a non–bailable offence.

It is also argued that quacks charge less fee, therefore, public goes to them for consultation. They may be charging less under “consultation head” but their bill per day invariably is much more than the bill of a general practitioner. Their bill includes medicines, injections and drips. You will never come across a quack who does not give one or two drips to his patient. So, a patient may end up paying Rs. 200–300 per consultation.

The concept of the ‘nurse practitioner’ is not prevalent in India. In the West, nurses are allowed to practice as ‘nurse practitioners’ under restricted conditions. Qualified nurses can provide better care than a quack and the services of the nurse practitioner can be utilized in those areas where doctors are not available. To practice is not difficult as about 85% of the diseases are self–limiting and the patients will become alright despite treatment. A quack only needs to know the following:

  1. Cough means a cough syrup.
  2. Allergy means any anti–allergic drug CPM or cetrizine.
  3. Malaria means 4 tablets of chloroquine.
  4. Fever means a combination of paracetamol, antibiotic and steroids.
  5. Wheezing means a combination of oral/IM steroid + nebulizer.
  6. A non–responding wheezing means add Lasix.
  7. Not passing urine means Lasix.
  8. High TLC (total leukocyte count) means adding antibiotics to their prescription.
  9. Low hemoglobin means iron–folic acid, B–complex.
  10. Any skin condition means any skin ointment containing antibiotic, anti fungal and steroid
  11. Weakness means IV drip.
  12. Loose motions or diarrhea mean IV drip

This is how most of the ‘quacks’ practice and if the patient is not responding in three days, they will refer him to the nearest hospital.

Dr KK Aggarwal
Padma Shri Awardee and Chief Editor