In an opinion piece entitled “Why AYUSH Must Go Mainstream,” a microbiologist describes varying strategies for integration of traditional medicine and Western medicine in his country. He notes that a decade ago, the National Rural Health Mission (NRHM) “attempted to integrate AYUSH systems and facilities with the existing healthcare infrastructure, with the intention of converging different paradigms of practice.” He reports little success. The fall 2014 initiative of Prime Minister Modi takes a different approach in this view: “To simply set up standalone AYUSH clinics alongside other departments of medicine within hospitals and promote a system of ’inclusion’ that enables patients to choose alternative treatments.” The writer questions this potential as well.
Missing in this view is a “clear establishment of the roles of AYUSH practitioners and doctors, and protocol for interactions and referrals, to facilitate a dialogue between ayurveda and allopathic doctors.” More fundamentally: “Practitioners of ayurveda or homoeopathy differ from allopaths in their understanding of anatomy, physiology, and disease and its treatment.” Generating the right evidence is yet another issue. Yet the writer calls “defeatist” the view that these systems cannot interact. One strategy recommended is to overthrow a prohibition on “cross practice” that keeps those from one school from using tools of another. The writer urges “identifying and documenting which illnesses respond best to which systems of medicine, and establishing treatment protocols” that “will enable us to realise the vision of integrative medicine in India.” At the present time, India has slightly more allopathic than AYUSH practitioners. The author concludes, “Adopting an ‘either-or’ approach to healthcare, which forces people to choose between allopathic treatment and AYUSH, is doomed to failure. It’s time for the AYUSH ministry to change its tune.”
According to a recent survey by the National Sample Survey Office (NSSO), “most Indians still seek the services of private, allopathic doctors when they are unwell.”
Comment: Interesting to encounter this legislation that guarantees that the regular and traditional practitioners not step into the others’ line of work. In the United States, the integrative medicine movement advanced as regularly educated medical doctors expanded their toolbox to new natural therapies and, on the other hand, naturopathic physicians increasingly broadened their scopes to include prescriptions of regular drugs. It may be that quality integrative care requires cultivating subsets of professionals who can go both ways. These act as translators. Then we must simply chuck the idea that any form of significant integration can take place via executive action—even if by a Prime Minister—without a strategic policy process to engage the significant cultural and scientific challenges.