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Are India’s quacks the answer to its shortage of doctors?

BMJ 2016; 352 doi: https://doi.org/10.1136/bmj.i291 (Published 21 January 2016) Cite this as: BMJ 2016;352:i291
  1. Priyanka Pulla, journalist, Bangalore
  1. emailpriyanka{at}gmail.com

They outnumber medical doctors; could they be trained to deliver effective care, asks Priyanka Pulla

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.1

The Indian Medical Council Act of 1956 punishes this with up to a year in prison and a fine of Rs1000 (£10; €14; $15)—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 Rs20 000.2 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.3 4

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.5 6

“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 …

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