India’s baby steps towards Universal Health coverage are held back by the triad of accessibility, affordability and quality. When one tries to provide for access to Health care it is imperative to maintain quality. When the standards of care have to be ensured there is always a cost. It is not possible to reconcile all the three factors without compromising on one. Government of India’s policy of Mixopathy is the result of attempting to provide care on a shoestring budget to all Indians. The Government is concerned about care for all. The IMA is concerned about standards of care. Government’s urgency and anxiety in providing minimum care to all is shared by IMA. Unfortunately, IMA’s concerns on standards of care appear to be not shared by the Government.
IMA’s concerns: Why Mixopathy is harmful
It is intriguing why the Indian Government should adopt China as its role model in Mixopathy and barefoot doctors. IMA’s concern is legitimate since countless lives could be lost in the advent to find cheap alternatives. IMA firmly believes that the Health care delivery system of today is quite robust in spite of withdrawal of the Governments.
The Public Health infrastructure and the ubiquitous private sector have withstood the onslaught of the Covid pandemic. Our 600 odd medical colleges are turning out nearly one lakh MBBS graduates every year. What is required is the political will to move from ad hoc brief appointment of doctors to creation of thousands of new posts deploying them in strength to meet the needs of our people.
How Mixopathy operates
An understanding of how Mixopathy operates will open our eyes.
In modern medicine surgery is one component of the comprehensive solution to the patient’s disease.
For example, when the tumour load is heavy in a cancer breast patient bulk reduction by surgery followed by radiation is resorted.
Similarly, when surgery is completed chemotherapy is initiated in many patients.
What is the equivalent of radiotherapy and chemotherapy in alternative systems?
During surgery, emergencies can occur. In case of shock (sudden and severe fall of BP) during surgery drugs like dopamine infusion or blood transfusion have to be used.
What is the equivalent of dopamine infusion and blood transfusion in alternative systems?
In post-operative period, the patient might have to be provided critical care in IMCU or ICCU. The patient might be on a ventilator.
What is the equivalent of critical care and ventilator in alternative systems?
In conditions like acute cholecystitis or acute appendicitis antibiotics are administered as a life saving measure before surgery. Moreover, antibiotics are used in the post-operative period to avoid sepsis.
What is the equivalent of antibiotics in alternative systems?
Anaesthesia is administered for painless surgery and several vital parameters are monitored. Amongst several other drugs oxygen is administered as well.
What is the equivalent of Anaesthesia and oxygen in other systems?
What is the equivalent of Laparoscopic surgery and robotic surgery in other systems?
It is evident that transplantation of modern medicine into other systems is not the answer. Interrupting the sequential flow of comprehensive patient care and the backup systems puts the life of the patient in peril. The concerns are genuine and well intentioned. IMA has the moral duty to resist Mixopathy.
When India is well advanced in modern infrastructure, has skilled medical doctors and a backup supply of 100000 doctors per year from her 600 odd medical colleges, the intention of the Government in pushing Mixopathy as a cheap alternative under pandemic situation and regulations is highly suspicious. Such a retrograde step will lead to the collapse of the modern medicine system of education and practice. In totality qualified surgical care and super specialities will become unavailable. As a matter of fact, modern medicine medical colleges would close down due to the need to maintain all these standards and backup systems and the cost involved. On the other hand, due to availability of cheap alternative students will shift to colleges of other systems. The casualty will be the patient whose care and safety are being compromised. Mixopathy will be a killer on the scale of world wars. We as a nation should resist this serious disruption in our Health care.
The columnist is former National President, IMA. Views expressed are the columnist’s own.