The Indian government has announced “spot checks” in private hospitals, following revelations that clinical positions are increasingly and illegally filled with practitioners of alternative and traditional medicine who lack medical degrees.

The National Accreditation Board for Hospitals and Healthcare Providers, India’s hospital accreditation board, made the announcement after the Times of India revealed the prevalence of unlicensed doctors involved in clinical work, including night work in intensive care units at major hospitals. The Times did not indicate the number of unlicensed doctors in hospitals.

Why this matters

India has a parallel academic and clinical infrastructure for alternative and traditional medicine, including separate colleges and hospitals. Prime Minister Narendra Modi has made these practices a cornerstone of his Hindu nationalist administration. Shortly after his election in 2014, a new “Ministry of Ayush” — an acronym for Ayurveda, yoga and naturopathy, Unani, Siddha, and homoeopathy — was created to regulate and promote these treatments. The politician who leads it is perhaps best known for claiming that yoga can cure cancer.

While the “allopathic” or science-backed medical system is legally kept walled off from Ayush, doctors say these boundaries are eroding.

Mohammed Sibgatullah, a general practitioner at a hospital in Hyderabad, told me he has worked in hospitals where Ayush doctors have handled procedures including intubation in patients, as well as cases like road traffic accidents. Such procedures are always “going to be risky” in untrained hands, he said.

During the Covid-19 pandemic, the Ayush ministry has promoted a range of pseudoscientific anti-coronavirus prophylactics including herbal “immunity boosters,” a homeopathic tincture made from arsenic, gargling with salt water, and putting ghee in one’s nostrils.

The Big Picture

India has faced a longstanding shortage of certified doctors, particularly in rural areas. Besides scarcity, one incentive for hospitals to hire Ayush doctors instead is that they simply cost less. According to the Times of India report, in some cases they can be hired for as little as half the salary of a doctor holding an MBBS, the equivalent of an MD.

To address the shortage, the national government has considered providing legal pathways for Ayush doctors to practice in allopathic hospitals, in the form of “bridge courses” which certify them to prescribe medications and perform some procedures. Critics argue these courses “give license to quackery.” In Maharashtra, where the state government has implemented the program, the bridge course only takes six months to complete.