Good morning all.. Recently I read an article (BMJ) about quackery in Indian medical practices. The facts were shocking. Here I am sharing a part of that article. * Are India’s quacks the answer to its shortage of doctors? Unqualified practitioners who pose as qualified doctors and administer potentially dangerous treatments to patients so called quacks are numerous throughout India. But state governments and police aren’t taking action, say officials from state medical councils, who are grappling with complaints against these practitioners. “There is no political will” to deal with quacks, because they are popular among the electorate, Anil Bansal, former chairman of the antiquackery cell of Delhi Medical Council, told The BMJ. An Indian Supreme Court ruling in 1996 defines anyone practising modern medicine without training in the discipline, even if they are trained in alternative systems of medicine such as ayurveda, as quacks or charlatans. The Indian Medical Council Act of 1956 punishes this with up to a year in prison and a fine of Rs1000, a weak penalty, argues Bansal. State medical councils, meanwhile, have their own penal provisions; the Delhi Medical Council Act, for example, punishes quackery with imprisonment of up to three years and a fine of Rs 20 000. Quacks can also be tried under provisions of the Indian Penal Code, which punishes impersonation and cheating with up to seven years in prison. Several studies of unqualified practitioners have found that drug companies supply drug samples to quacks, leading to indiscriminate prescriptions. * How many unqualified doctors? Although there have been no India wide surveys to estimate the number of such unqualified doctors, regional surveys indicate that more than 70% of healthcare providers in rural India have no formal medical training. “Suppose one qualified doctor has a private practice. He has someone called a compounder or a helper. When the helper masters a few medicines, he starts working in an area where there is no other doctor,” GS Grewal, president of the Punjab Medical Council, told The BMJ. He estimates that there are close to 100 000 quacks in Punjab alone, a state with only 30 000 registered doctors. Quacks proliferate for two main reasons. Firstly, India simply does not have enough physicians, at 0.7 doctors for every 1000 people. The World Health Organization recommends at least one doctor for every 1000 people. And India’s doctors do not wish to practise in rural areas because of the lack of critical infrastructure, Bansal says. Secondly, the police do not take action against quacks even when medical councils lodge complaints, says Bansal, because the government lacks the will. In a working paper on such practitioners in the former state of Andhra Pradesh, KV Narayana, a health economics researcher at the Centre for Economics and Social Studies in Hyderabad, noted that they enjoy the patronage of local political leaders in rural areas because they are the only medical workers available, and they cultivate strong relationships with their clients. Such popularity and political support make it difficult to take action against them. * Government inaction and public support Bansal, who estimates that there are two quacks for each of the 40 000 registered doctors in Delhi, says that efforts by the Delhi Medical Council to bring these offenders to book have been thwarted by inaction from the local police and the state government’s own antiquackery cell. In May 2014, reacting to this inaction, the High Court of Delhi approved an order requiring local police officers to conduct monthly raids in each of Delhi’s 13 districts to bring unqualified doctors to the notice of the Delhi Medical Council. The council, in turn, was asked to verify the credentials of the doctors within 72 hours. “Until today, more than one year and two months later, hardly any raids have been conducted. Police are not cooperating at all,” Bansal told The BMJ in July 2015. Of about 250 doctors that the council flagged to the police in response to public complaints last year, very few have had cases lodged against them, Bansal said. Kishor Taori, president of the Maharashtra Medical Council also blames the government for lack of action. “The antiquackery cell has been given teeth by the government; they can seek, raid, and file criminal cases. Unfortunately, their meetings do not take place regularly.” The damage caused by quacks is serious, say the members of state medical councils. For one, Bansal says, quacks overuse intravenous drugs because these fetch them higher fees from patients. Grewal attributes the high incidence of hepatitis C infections in Punjab to the unhygienic overuse of syringes by quacks. AK Jamrani, the chief district medical officer of the central Delhi region, whose office is required to conduct inspections and report quacks to the Delhi Medical Council, told The BMJ that taking action against these practitioners was a big problem because they were so numerous. “When we visit a quack in an area, all others run away,” he said. In late November 2015, an unqualified practitioner of Unani medicine in Hyderabad allegedly tried to burn the body of one of his patients after an intravenous drug administered by the practitioner killed the patient. The local police subsequently raided several city clinical establishments and arrested about 100 unqualified practitioners. But Rao says that the number of complaints from patients about quacks continues to remain low, despite such extreme cases of malpractice. “We get complaints about corporate [private] hospitals, but there are very few complaints against rural medical practitioners [quacks]. Nobody complains against them. [The public] excuse unqualified people very liberally, but don’t do so for qualified doctors.” Rao adds that when his office shut down the hospitals run by quacks, the practitioners merely moved to another locality and began practising again. Kindly share your views regarding this. Thank you.

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Dear my Anandu, I appreciate your wonderful initiative on the very big burning problem about quackery. I read this article and felt literally bad that entire World comes to know about Indian quackery, and you had aptly selected a nice platform to share everyone's views and thought process. I strongly believe in the fact thst there are many culprits in this issue of quackery like 1) Doctors 2) Corporate doctors 3) Corporate Hospitals management. 4) Local Police 5) Local politicians 6) Local people and many more. Coming to doctors I have seen in my own city doctors encouraging quackery so as to get the patients and it has become a very profitable business for both, the doctors and the quacks. One doctor used to gift a motorcycle to the quack if they could secure 5 surgical cases for him. Many doctors I know they conduct classes for quacks with food and beverage including cocktails. Some doctors used to give 10% of the total amount to the quack who gets the patient to that particular doctor, and ultimate sufferer is the patient. Now that bid has been increased to an astonishing and unbelievable percentage of 60% , can you believe this , it's a bitter but naked fact. These quacks have a pet mame RMP. In fact we the qualified are called RMPs Registered Medical Practitioners. The expansion of quackery RMP is Rural Medical Practitioners. Doctors are generating quacks for their survival. Corporate Hospitals management is generating quacks for their benefits. Unfortunately Government of AP Andhra pradesh started encouraging the quackery by giving them training and issuing Certificates to them, by saying you can officially practice in the rural areas, but you should only give the first aid and refer the patient to qualified doctors, unfortunately the first one is being implemented successfully and the second one not. They have the certificates issued by Government of AP. THIS IS NOTHING BUT VOTE BANK POLITICS. AS LONG AS THESE FILTHY POLITICS AND POLITICIANS EXIST NOTHING COULD BE DONE. THE GOVERNMENT IT SELF IS ENCOURAGING QUACKERY FOR VOTES OF THE QUACK'S AND THEIR FAMILIES. THIS IS MISERABLE. PROSTITUTION IS MUCH BETTER THAN THIS. Police Department was silent before the Government issued official certificates and after that very much silent. This is the height of eccentricity. But this is a fact. Everyone is selfish. Everyone is running after money. If I practice anything other than Modern Medicine, I become a quack. Like wise any doctors who practice other systems of medicine other than what they are qualified to practice are quacks. Please stop Cross Pathy. Give respect to the system of medicine which you were taught in. We should boycott the Pharma companies who visit quacks. There are many companies like Blue Cross and it's sister concerns Mankind and it's all divisions. And so many. They want business, that's all, nothing beyond business. They offer special schemes to quacks. Quacks recently started their own Pharmacies Laboratories Nursing Homes. Astonishingly the quacks are able to pay the capitation fees in crores to make their sons and daughters qualified doctors in private medical colleges. You can imagine the earnings of the quacks. The Government which is supposed to stop quackery is promoting quackery. You will be shocked if you know that the Government of AP is running a monthly journal in Telugu on their party's name called MUNDADUGU, which means going forwards. The entire system from grass route to the highest authorities. What is local IMA doing ??? What is District IMA doing ??? What is National IMA doing ??? What is State MCI doing ??? What is Central MCI doing ??? Police immediately register a case against a qualified doctor if something goes wrong like the patient dies unfortunately in the nursing homes, but many are dyeing in the hands of quacks, but Police people do nothing. Surprisingly public lodge a complaint against a qualified doctor, but don't on quacks. Why this discrimination ??? What's wrong with qualified doctors ??? GOD SAVE THE QUALIFIED. ANY WAY GOVERNMENT IS THERE TO SAVE QUACKS. GOVERNMENT IS POWERFUL THAN GOD. GOD SAVE YOUR SELF. Thanks a lot Anandu for giving me an opportunity to say a few words about quackery.

You gave a wonderful elaborate assessment of this scenario sir. The facts shared by you were really shocking. While starting this discussion I was unaware that this issue had grown beyond all limits. I am not able to digest these bitter facts you shared sir. Nothing more to say....INCREDIBLE INDIA !! Thank you so much sir for spending your valuable time for unveiling the bitter truth regarding this issue.
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Each system of practitioners should restrict themselves in their own system. Other than that they may consider as quack.

Well said dear Aditya
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I THOUGHT NOT TO SAY ANY THING ON THE TOPIC OF QUACKERY BUT MY CONSCIENCE FORCED ME TO WRITE THIS... SIR, I AM PRACTICING IN A VILLAGE IN LUDHIANA PUNJAB..... I AM MBBS AFFILIATED TO PUNJAB MEDICAL COUNCIL..... REGD. NO. 35726 . .. REASONS FOR QUACKS. AND QUACKERY :-1. NON AVAILABILITY OF QUALIFIED DOCTORS IN VILLAGES..... 2.LACK OF INFRASTRUCTURE, LIKE PUCCA ROADS AND SANITATION. 3. TREATMENT BY CHEMIST AND QUACKS IN VERY LESS MONEY.... 4.LOCAL SUPPORT OF POLITICIANS..... 5.LACK OF PROPER RESPECT IN VILLAGES ,,,,, THE BEHAVIOR OF THE PEOPLE TO DOCTOR, THEY WILL CALL AS OYE DOCTORA...... THAT IS ILLITERACY. 5, POLICE AND QUACKS COMING TOGETHER....... 6. AND GENERALLY QUACKS RUN AWAY IF THERE IS. SOME RAID FROM HEALTH DEPARTMENT... 7. AND IN THIS COVID TIME ALL QUACKS ARE OPENING THEIR CLINICS AND ALL RULES OF PREVENTION ARE THROWN AWAY LIKE SOCIAL DISTANCE ETC..... BUT MY CLINIC IS OFF SINCE 22 ND OF MARCH. 8.NEXUS OF BIG NURSING HOMES AND QUACKS, THIS IS VERY IMPORTANT AS AND WHEN THE CASE OF A PATIENT IS SPOILED BY QUACKS , THEY REFER IT TO THEIR GODFATHER'S NURSING HOMES, INDIRECTLY OUR QUALIFIED DOCTORS ARE SUPPORTING THEM AND EVEN ATTENDING CLINICS OF QUACKS ON CONSULTATION BASIS AND EVEN PUT THEIR SIGNBOARDS ALSO.. YOU ARE NEW... SOME YEARS BACK I POST SIMILARLY ON CUROFY PLATFORM BUT OF NO USE.... EVEN I AM A MEMBER OF IMA. AND I RAISED THIS ISSUE BUT NO ONE TOOK NO STEP.... SO LASTLY....... WHY TO CRY, WHEN YOU ARE NOT LISTENED BY ANY ONE....... BOSS YOU MIGHT HAVE READ IATROGENIC CAUSES OF DISEASE AND QUACKS ARE NO. 1. CAUSES........ KINDLY VISIT LUDHIANA TO MY CLINIC AND SEE THE SURROUNDING AREAS AND QUACKS BLOOMING THERE .. MY MOBILE NO. IS 9876472916 . SANTOSH CLINIC. VILLAGE BHATTIA.... LUDHIANA RURAL.....

Dear Dr Krishna Mohan sir Your Single answer covering everything. Yes sir. -It is qualified doctor responsible for producing quacks. -It is qualified doctor offering some amount of knowledge of medicine to quacks. -It is qualified doctor feeding quacks. -In majority places qualified doctors are depending on quacks for their practice. -In order to meet the corporate targets, it is qualified doctor in ethically. It is corporate sector spoiled qualified doctors for their needs. -In this money making process it is the patient suffering a lot and becoming scape goat. -Patient is afraid of these heavy charges and encouraging quacks. -Governing bodies (IMC IMA AYUSH DCI ) are keeping mum. -Unless a complaint is lodged, what police can do? -How dare anybody issue a certificate other than University? Please think all CUROFIANS who are held responsible for this quackery in our country First we the qualified doctors should practice ethnically and become roll model in the society.

Agree sir.
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Respected Doctors More than anything else the following points must be thought of 1 who are/ which institution is responsible for their production? 2 What is the source of their knowledge in medical practice? 3 It is whose duty to prevent them from such practice? 4 who is encouraging them to practice medicine? 5 What is the opinion of average indian patient on a correct qualified doctor? 6 why they could able to attract the patients? 7 What medical council, dental council, AYUSH are doing? 8 What is their role in this regard? Thanks

Wonderful observation sir. Thank you.
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I strongly feel, following are the main points we should think about seriously. * Their popularity and political support. * Support of pharma companies. * When the helper masters a few medicines, he starts acting as a doctor. * Unhygienic overuse of syringes by quacks. * Complaints about private hospitals are more. But there are very few complaints against these quacks!! Very pathetic situation! We should treat it from the root cause and spread awareness among the society.

One is the most cause of sprayed quack in field is do not have any good option by govt or qualified doctor at in very low fees and charges at very rural areas or slum urban areas in a good hospital fee of a doctor is 500 to 1000 and he not capable to pay for a cold cough or fever or diarrhoea. And in govt have a psc at 135 vi
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About our own fraternity Dear Doctors Let us not encourage quacks to our premises. Let us not offer anything to quacks. Let us be too honest in discharging our duties. Let us not become money making tools for others. Let is be friendly with the patients. Let us be rational in preparation of our hospital charges. Let us be too honest in recommending investigations. LAST BUT NOT LEAST LET US RESTRICT OURSELVES TO IN OUR OWN SYSTEM OF MEDICINE IN WHICH WE ARE QUALIFIED. Let us represent the problem and it's severity to our apex bodies.

I am extremely thankful to you sir for taking this issue seriously and sharing the most valuable comments...what you described above should be pledged by all qualified doctors. Thanks again sir for sharing your valuable time in this discussion and made us think, how a doctor be to the society.
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if any doctor use a medecine of other system calld quak but unfortunately in india only who called quek those traind with ayurveda or himoeo or unani and other then use medicine of alopThy.. but who are not those complete mbbs or md or other and use ayurveda or homoeo or unani or other patent brand. shorteg of doctor is a very big ishue to pramot the quek. the quak is a part of our medical system and indian health because he work on place thatdo not go any qualifid doctor. is my persinal idea

Thanks for sharing your views on this issue dear Shyam.
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About pharmaceutical company representative After all pharma sector is a very big corporate. Medical representative too will have targets which are set by company. For fulfilling he will approach all possible places. And as matter of fact do we right to prevent anybody's movements? How can we order them not to visit quacks. Whose duty is it? Maximum thing a qualified doctor can do is to restrict himself not to accept any offers from them.

Good advice sir...thank you
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stop funding or you can say stop giving rewards by medical practitioner.Many of us giving rewards on reffral pt by these quacks.I am agree with all your comments.Many practitioners have one or more PRO they're regularly in-touch with quacks and fixes percentage per patient.Punjab,Haryana n Rajasthan has these kind of practice.Other than those states having same cultural pls comments

Thank you for expressing your views regarding this sir. Agree with you. We should not promote such practices.
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