This below is the guest article by Dr. G.R. Vastrad who is a Rtd professor and principal from TAMC, Bellary. Previously we have read about his journey in ayurveda “My Journey and Ayurveda [Part 1]“. Let’s continue with with his experience in Ayurveda…
There is drastic change in the medical practice in last 50 years. There is also a change in Ayurvedic practice. As I have seen upto 1980, general practitioners of pure Ayurveda were handling common general health problems like jwara, kasa, etc. as their counterparts of modern medicine. Dispensing of medicine by doctors was the trend. Then three typical Ayurvedic Packets (chits) were made by combining various powders/Bhasma given to patients as three doses packet. Tablets and press swarasa and kashaya were also given to patients. Patients were supposed to come to hospital every day. Usually in those days common general practitioners problems like Jwara, Kasa, Swasakrichrita are effectively handled by Ayurveda practitioners also. Such diseases required day today fallow up. In this way five to seven days treatment was a usual practice. The doctor had a chance to assess the effect of medicine given on daily basis. This was the style at college hospital also. So the students had the opportunity to see the treatment of Jwara. Pratisyaya, kasa, atisara, etc.and used to have some confidence of Ayurvedic medicines. Then Ayurveda pharmacy industry was not that market oriented. Only few renowned pharmacies were in market that too with classical medicines. In those day Panchakarma was not so popular and in practice. Our college hospital was known for maternity and wound healing. In OPD patients were treated on daily basis. Now this style practice is changed. Now Ayurveda is limited to some chronic diseases like Amavata, sandhivata like. So now we have lost the skill of handling common diseases. Now a day’s patients with jwara, kasa such common diseases are coming to Ayurveda practitioners. This change in practice is also seen in modern medicine practice also. But general practice of Ayurveda is lost its originality and practitioners have lost the skill of Ayurvedic general practice. All Ayurvedic doctors who are practicing it are consultants.
Before 1980 in allopathic practice one antibiotic injection and simple tab like APC were given to patients in general practice and the fee was just Rs.3.00 to Rs.5.00. For five days treatment on daily basis patient had to pay just Rs.25.00. Usually, then no outside prescription unless it was very much necessary.
In next 10 years there was a drastic change in the medical practice both in Ayurveda and allopathy. Patient oriented practice has changed to pharma industry monitored practice. The injectable antibiotics some time used to cause fatal reaction. So there was lot of research on oral antibiotics. Lot of money was invested on it Because of fear of some reaction due to injections, sometime fatal, doctors preferred to give oral antibiotics which are freely available now. As it is heavy investment of research by pharma industry they want to get back their money as early as possible. The cost of medicine was very high. It was costly affair for the practitioner to dispense these medicines in their clinics. So these antibiotics were prescribed and to be purchased by patients. Doctors started to prescribe some other drugs which they were dispensing earlier at low cost as they used to purchase them at whole sale rate in bigger quantity which used to be cheaper to patients. Offers by Pharma companies to doctors to prescribe their market brand is prompting doctors to prescribe unnecessary medicine.
During those day doctors after collecting Rs. 5.00 for their services and medicine were forced to collect only Rs.5.00. As patients were given prescription of complete dose for duration, patients were not necessary to come back to doctors. Doctors were supposed get Rs.5.00 only by one patient. total amount of doctors fee for five days on those days used to be Rs. 25/- to 50/-. In today’s genereal practice doctors as charging Rs.50 to Rs.100/- .The values of money of those days and today’s doctors are still at loss. It has affected their income so they started to cheat the patients by advising next visit for some useless injections considering the mind set of patients. The clinical practice which was on moral basis converted into non ethical practice.
By this change there was boon, in pharmacy business and pharmacy industry. The poor patients are financially burden and doctor who are centre of clinical practice are not much benefited. It benefited only the business class. To understand this, I am giving a classical example.
One ophthalmic doctor with MS in ophthalmology, spending around 9 to 10 years in his study started his ophthalmic consultation few years back at one city, with huse investment to establish the clinic. A doctor has to do lot of things to impress the patients by his talk, behavior, examination skill etc. Simultaneously one optician also followed him and opened his shop with least investment, of course with the support of this ophthalmologist. Then the ophthalmologist with all his skill to examine and treat the patients with knowledge he acquired though out his 5 and half year MBBS and three years MS, used charge patient Rs 50.00. The specialist after examining he used prescribes spectacles and sends the patient to this optician. On those days, the spectacles prepared at the cost of Rs 300.00. out of this Rs 300.00 the opticians profit margin used to be around Rs150 to 200, where in consultant used to get only Rs 50/- . The doctor was living in a rented house where as the optician was owner of some property in the same period. Today the situation has not changed. Still doctors’ consultation is between 150 To 200 rupees. But business person’s profit margin has considerably increased and doctors are blamed for the so called high consultation fees which seem to be high in comparison to earlier days fees. Few doctors have an opportunity to earn more by other means like hospital charges, surgical or procedural charges. Let me not talk on corporate hospital business. But in general practice the doctors and patients are at loss.
As Ayurveda practitioners are usually not having such opportunity as they get patient give prescription for month or two and collect consultation fee of Rs. 100/-. The drugs prescribed used cost patients in few hundreds to few thousands rupees. Many times, if the patients get cured or not, some patients do not come back to Ayurvedic consultants. By the prescription medicine shop owner has a margin of 30% profit. Ayurvedic practice now limited to treatment of few chronic diseases where cure a question mark. Belief on Ayurveda by public and TV and print media advertisement has supported Ayurvedic practice.
To conclude the present day’s medical practice of either science is financial burden to patients and less profitable to honest practitioners.