Definition of Medical Quackery in India Needs to be Redefined

A recent article published in Times of India, entitled, "Docs Market Themselves with Fancy Degrees that Authorities say are Invalid," quite rightly condemns a certain form of quackery but does not address a far more dangerous form of quackery which masquerades as legitimate medicine.

I heartily agree with the author that quackery should not be tolerated.

However, the term quack is highly clichéd and has lost its actual meaning through abuse. I feel we should desist from incorrect usage.

Having worked for 15 years in various streams of healthcare practices across the globe, I believe that labeling ALL doctors whose degrees are not recognized in India as quacks is unfair! There are several doctors with valid degrees obtained abroad, who practice legitimate branches of medicine not currently available in India. Just because the Indian medical system does not recognize these degrees does not make them quacks.

There is a strong movement in the West (especially in the UK) to discredit Homoeopathy as quackery. Would India then discredit all Indian Homoeopathists as quacks, even those with certified degrees?

Would it be fair to address a qualified Ayurvedic doctor a quack in a western country, just because his degree is not recognized there?

The article mocks a doctor who "practices Siddha medicine which he learned not from a reputed institute, but from his uncle".

While the above tongue-in-cheek statement sounds justified, it is in fact erroneous.

It is only recently that we have copied the western system of medical education and artificially created degree programs for our native medicines. Ask any traditional Indian doctor and he will tell you that it takes years to become a skilled practitioner of Siddha, Ayurveda, etc...and this intricate system cannot be crammed into 4 or 5 years in a classroom.

All our indigenous forms of medicine such as Ayurveda and Siddha have been passed on for thousands of years from guru to shishya. So learning from one's uncle or grandfather (provided they are skilled practitioners) is actually the CORRECT way to learn the tradition of Siddha and should not be ridiculed. In fact, what we need to examine in these branches of medicine is NOT the certificate, but the KNOWLEDGE and SKILL of the doctor. This seems to be a forgotten priority in the Indian medical education system!

Let us not ape the West by following their system of medical education which may be suitable for allopathic education but not necessarily for our traditional systems. By moving to western-style degree programs we have clearly traded quality for quantity.

Why not let both approaches be recognized by the government (Degree Programs and Guru/Sishya).

And lastly, we need to look at another, (possibly uglier form of quackery), which does not seem to draw much attention.

There is a large group of quacks who go unchallenged in India. I call this group "Certified Quacks".

I am of course referring to those MBBS doctors who score low marks at the high school level, buy their way into medical colleges and though they have no aptitude for medicine, are allowed to practice legally because they have "Valid Degrees".

These doctors I believe pose a far greater threat to the public than the alleged "quacks" cited in the article. Here's why...

While the alleged "quacks" practice non-invasive therapies, the "Certified Quacks"

·         Practice invasive treatments (even surgery) causing far more harm (horror stories abound)

·         Prescribe potent drugs even though they are incompetent

·         Give the patient a false-sense of security because they have "Valid Degrees"

If TOI's investigation did chip deeper into the iceberg, they would also find, a long list of “real” doctors in corporate hospitals, who generously prescribe unwarranted tests and surgical procedures, to propitiate the management.

Quackery and corruption exist in all branches of Indian medicine, not only at the practitioner level, but also at the university and medical board levels.

Punishing a few individuals who comprise a very small part of the problem while giving the majority wrongdoers a free ride is either a hypocritical double standard or willful negligence.

In conclusion, we need to address two important issues:

    1.           Move government and public opinion to get our health authorities to revise our archaic laws such as Indian Medical Degrees Act 1916, Drugs and Cosmetics Rules 1945, Indian Medical Council Act 1954 in order to recognize doctors with overseas degrees in branches of medicine which are not covered by our current laws.

By stubbornly holding onto old laws, we are depriving the public of effective branches of medicine such as Complementary and Alternative Medicine, Traditional Chinese Medicine, Energy Medicine, and many, many more.

  2.    Create public awareness on how to discriminate between "Real" doctors and Certified  Quacks"!

Understanding Down Syndrome better: By Dr. Deepthi Jammi, Department of Fetal Medicine, Apollo Cradle, Karapakkam, OMR

21st March is observed as World Down Syndrome Day. The date represents the three copies of chromosome 21, which is unique to people with Down syndrome. Such people have 47 chromosomes instead of the usual 46 (23 pairs). The extra chromosome appears with the 21st pair.

On the eve of this day, Dr.Deepthi Jammi, from the Department of Fetal Medicine in Apollo Cradle, elaborates on the importance of ultrasound scanning during pregnancy. “An early pregnancy scan done at 11 – 14 weeks of pregnancy along with a blood test referred as first trimester biochemical screening is being offered to all pregnant mothers these days to understand the possibility of them carrying a chromosomally affected child”, she says.

What is Down syndrome?
Down syndrome is the most common chromosomal disorder which leads to intellectual disability and other various health problems in a child. Children with Down syndrome typically display mild to moderate intellectual disability and other health problems. They generally have a flat facial profile with low set ears and upward slanting eyes. Long term health issues are a concern in these children who require adequate prophylactic treatment.
During their formative stages, a child develops the expected physical, cognitive, communication and social skills expected of him/her. However, there may be certain other areas where they may progress slower than normal and it is for this reason that early detection is strongly recommended. Therapies such as occupational, speech and language therapy have been devised to boost the quality of life that a child with Down syndrome can enjoy.

Who is at risk?
Worldwide, one in every 700 live births is a Down syndrome baby. Until the first trimester screening test became available less than a decade ago, a woman over the age of 35 would have routinely been offered an invasive testing such as Chorionic villous sampling in her first trimester (uptil 3 months of pregnancy) or an Amniocentesis (4th month of pregnancy) in her second trimester. This is because older mothers are at an increased risk of bearing a child with Down Syndrome. The frequency rises from one in 1,400 babies for a woman between 20 and 24 years old, to one in 25 for a woman over 45 years of age.
What constitutes a first trimester screening?
The first trimester screening examines features unique to fetuses with Down syndrome between 11 and 14 weeks of pregnancy.
In an ultrasound scan which emits high frequency sound waves through the uterus to monitor the pregnancy, Fetal Medicine specialists check the Nuchal translucency (NT - thickness of skin at the back of the neck) and Nasal bone of the fetus to assess the risk of the baby having Down syndrome. The absence of the nasal bone and a thicker-than-normal neck skin indicates an increased risk of the fetus having the abnormality.
Following this the mother's blood is also tested for a combination of markers such as pregnancy-associated plasma protein A(Papp-a), which tends to be low in Down syndrome pregnancies and beta human chorionic gonadotropin (B Hcg), which is raised in such pregnancies .Other factors, such as the mother's age, are used to assess the risk using the Fetal Medicine Foundation risk calculation software.

If the result is one in 250 or higher, it is typically recommended to undergo an invasive diagnostic procedure such as Chorionic villous sampling (CVS) or Amniocentesis which carries a small percentage risk of miscarriage. Dr.Deepthi explains that in these procedures, a needle is inserted in the woman's uterus to draw out either amniotic fluid (amniocentesis) or tissue from the placenta (CVS). The fluids contain cells from the baby which are examined for the chromosomal abnormality.
Recent technologies such as Non-invasive prenatal testing , a blood test which tests the fetal cells in the mother’s blood, have revolutionized the field of prenatal medicine offering tremendous potential as a screening tool with high sensitivity and specificity of the test for diagnosing such fetuses.

What causes Down syndrome?
While the exact cause is currently unknown, research indicates that as a woman ages, the probability of her bearing a child with Down syndrome increases. However, there is no research finding that suggests that the mother’s lifestyle before or during the pregnancy influences this probability.There are multiple types of Down syndrome. Irrespective of the type, all those born with Down syndrome have the extra partial or full pair of Chromosome 21, which may be obtained either from the father or the mother.

How can we support them?
Dr.Deepthi strongly stresses that those with Down syndrome, with the help of timely intervention, can be benefited to a significant extent. While they may learn and develop at their own pace, they can have a clear idea of the choices that they make to be as productive, independent and confident they can.
From a parenting perspective, she recommends that parents adopt a system of constantly encouraging a positive attitude and independence. With a balance of guidance and independence, those with Down syndrome can make rapid strides to be strong members of society.

To celebrate and spread awareness: Join DR.DEEPTHI JAMMI : MBBS., M.S.(OG)., Obstetric Sonology(Mediscan).,Postdoctoral fellowship in Fetal Medicine (TN.Dr.MGR University) at DEPARTMENT OF FETAL MEDICINE, APOLLO CRADLE,KARAPAKKAM,OMR on March 21st 9am – 4pm

Touching Lives @ Apollo Speciality Hospitals, OMR

Apollo Speciality Hospitals' at Perungudi, OMR

Grossed over 1000 cases with successful stories in the CCU and & Emergency Department.

Listed below are a few highlights 

1. 23 yr old female with multiple injuries admitted in life threatening situation walked back home in 2 weeks time well treated and celebrated new years at home. 

2. 31yr old was brought into #ApolloHospitalsOMR ER complaining about loosing stability and balance and distorted vision. The ER specialist suspected stroke and suggested an MRI. Patient was reluctant because he was well aware of the symptoms of stroke (FAST) and what he was experiencing didn't fall into that bracket. However on being coaxed he underwent an MRI and was diagnosed with a Basilar Artery Occlusion.

What does that mean? Basically a clot formation in the most vital part of your brain which supplies blood to control your heart and breathing. . In most cases such a condition has greater than 85% of fatality rate. The young man had just a few hrs ticking before his heart and breathing would've been compromised. Highly skilled Core Stroke Team which was able to conclude that stroke condition in time. Patient went home, back to his normal life on fifth day after stroke with no weakness or disability.

3. 33 yr old pregnant woman near term was admitted with stroke, walked back home carrying her healthy baby. 

4. 34 yr old patient admitted post cardiac arrest with sleek chance of survival resumed routine work within 6 weeks. 

5. 35 yr old It professional with paralysis below the neck due to neuromuscular weakness was restored to fitness in 3 weeks to resume official duty. 

6. 3 in 1 procedure, for the first time in south India was successfully performed on an octogenarian farmer. He underwent valve replacement, bypass, carotid surgery (to prevent stroke). 

7. 90 yr old gentleman with acute cardiac arrest was treated, stabilized and returned home after an angioplasty. 

Note: It was very rare for a nonagenarian to survive a massive heart attack. ASH, OMR has handled over 50 cases in the octogenarian sector with Over 87% of mortality rate. This suggest that there is an increase in elderly patients who require highly specialized care with the state of the art technology, highly skilled consultants and ICU care as available at ASH, OMR. 

#Apollo Speciality Hosptials, OMR has started a special initiative to support the Senior Citizens: Golden Age club. The services offered as a part of the club are free for all senior citizens and the core focus of the services is to make world class healthcare facility for elder care convenient and accessible.