Harmonising Ayush and Modern Medicine

Why in news?

Modern medicine practitioners are being urged to be more open to working with the traditional or alternative systems of medicine, to move towards an integrated medicine.

Integration Models

AYUSH stands for Ayurveda, Yoga & Naturopathy, Unani, Siddha, and Homeopathy, they are practiced in India and are based on well-defined medical philosophies.
Integrated medicine is the combination of modern medicine and traditional or alternative system of medicines for the larger good of patients.
3c approach- It provide a framework for understanding the different approaches to integrating traditional and modern medicine namely Competitive, Coexistent and Cooperative.,
Competitive model- There is rivalry between modern and traditional medicine, with disputes and litigation at the association level.
Coexistence model- Both systems recognize each other’s legitimacy, with clear boundaries set to avoid encroachment1.
Cooperative model- The ideal scenario where both systems work together to provide the best care, acknowledging each other’s strengths2.

What are the challenges?

Trust deficit- There's a lack of trust between modern medicine and Ayush practitioners, often due to anecdotal evidence and unsupported claims of cures by Ayush.
Heterogeneity- AYUSH is diverse, and each of these therapeutic disciplines requires separate consideration.
Contention over prescription- The compatibility of dosha based management with modern medicine’s protocol is debatable.
Operational complexities- For a team-based approach, members must understand their limits and others' strengths, which is hindered by a lack of knowledge about AYUSH among modern practitioners impacting decision making.
Lack of awareness- Patients may not be well informed to make choices between AYUSH and modern treatments.
Regulatory challenges-The integration faces significant regulatory hurdles, particularly in ensuring that practitioners do not prescribe treatments outside their expertise.
Problematic prescription- Modern medicine practitioners sometimes prescribe Ayurvedic treatments without fully understanding them.
Lack of accountability- There is a lack of confidence in professional councils to enforce regulations and hold practitioners accountable for their actions.
Curriculum challenges- The addition of AYUSH subjects to the already extensive MBBS curriculum may not be feasible.

What can be done?

Evidence based approach- There is a need for evidence to bridge the trust gap and suggest building composite standard treatment guidelines.
Promote research- Developing standardized protocols for integration where evidence exists and promoting further research for areas lacking evidence can aid in addressing technical challenges.
Enhance operational efficiency- Establish clear roles, responsibilities, and referral pathways within healthcare teams.
Regulatory framework- A strong regulatory framework is crucial to ensure safe, coordinated care and clear accountability.
Holistic approach- The regulatory framework should address issues such as insurance coverage, quality control of medicinal products, and mechanisms for handling disputes or adverse events.
Medical education- Optional or elective courses within MBBS curriculum may be a viable approach, provided they are adequately resourced and incentivized to encourage uptake.
Selective integration-It involves teaching basic principles and concepts of AYUSH modalities alongside modern medicine, promoting interdisciplinary understanding among future healthcare professionals.
Pilot projects- It can serve as testing grounds for integrated healthcare models, allowing stakeholders to assess feasibility, efficacy, and acceptability in real-world settings.

Steps taken by Ministry of AYUSH to harmonise AYUSH and modern medicine

Co-location strategy- AYUSH facilities are co-located at Primary Health Centres, Community Health Centres, and District Hospitals, offering patients a choice of medical systems under one roof.
Training- AYUSH doctors and paramedics receive support and training from the Department of Health & Family Welfare.
Financial assistance- It is provided through the National AYUSH Mission (NAM) for the establishment and operation of AYUSH facilities, it helps in infrastructure development, procurement of equipment and medicines, as well as the training of AYUSH personnel.
State Annual Action Plan- States and UTs can obtain financial aid for AYUSH facilities through the State Annual Action Plan as per NAM guidelines.
Evidence based approach-Collaboration between the Ministry of AYUSH and the Directorate General of Health Services for initiatives such as the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke (NPCDCS) demonstrates a concerted effort towards evidence-based practice and integration of traditional and modern medicine.
Research-The Ministry of AYUSH collaborates with health services to manage non-communicable diseases through research councils, integrating Ayurveda with modern medicine in various health programs and studies.

Central Council for Research in Ayurvedic Sciences (CCRAS),
Central Council for Research in Unani Medicine (CCRUM) and
Central Council for Research in Homoeopathy (CCRH)

Promotion of Yoga- The Morarji Desai National Institute of Yoga, under the Ministry of AYUSH, operates 4 yoga therapy centres in collaboration with various government medical hospitals in Delhi.
Siddha system integration: The National Institute of Siddha in Chennai has signed MoUs with institutions such as National Institute of Epidemiology and AIIMS Raipur to create a synergy with modern medicine

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Why in news?

What are the challenges?

What can be done?

References

Challenges of Post Retirement

WTO MC13

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