What Sparked the Controversy?

Crosspathy Controversy: Maharashtra FDA Allows Homeopaths to Prescribe Allopathy: In December 2024, the Maharashtra Food and Drugs Administration (FDA) issued a controversial directive permitting homeopathic practitioners with a pharmacology certificate to prescribe allopathic medicines. This has stirred strong criticism from the Indian Medical Association (IMA), which argues that such a move could jeopardize patient safety and dilute professional standards in modern medicine.

Understanding Crosspathy in India

Crosspathy refers to the practice of one medical system’s professionals prescribing or performing treatments belonging to another system without being fully qualified in it. In India, this mostly involves AYUSH practitioners—those trained in Ayurveda, Unani, Siddha, Homeopathy, and Naturopathy—engaging in allopathic practices. Critics warn that this practice often leads to misdiagnosis, incorrect medication, and medical negligence, especially when alternative medicine professionals lack modern clinical training.

Legal Precedents and Ethical Boundaries

Legal frameworks in India have repeatedly addressed this issue. The Medical Council of India (MCI) Code of Ethics, 2002, prohibits unqualified individuals from conducting modern medical procedures or issuing health certificates. In a landmark 1996 Supreme Court case (Poonam Verma vs. Ashwin Patel), the court held a homeopath guilty of medical negligence for prescribing allopathic drugs. It was clearly stated that cross-system practice is unlawful unless explicitly authorised by the State Government.

Why is the Government Promoting Crosspathy?

The major driving force behind crosspathy is the acute shortage of specialist doctors in rural India. The Health Dynamics of India 2022-23 report found that 80% of Community Health Centres (CHCs) lack required specialist doctors. While India boasts over 13 lakh allopathic doctors and 5.5 lakh AYUSH practitioners, most are concentrated in urban areas. This urban-rural gap in healthcare delivery has led to state-level solutions, like the recent Maharashtra directive, aiming to increase medical access in remote regions by leveraging the AYUSH workforce.

The IMA’s Objection and Patient Safety Risks

The Indian Medical Association has strongly opposed Maharashtra’s move, citing the National Medical Commission Act, 2019, which does not permit AYUSH doctors to prescribe allopathic drugs. The IMA also points out that the Central Council for Homeopathy does not allow such cross-practice either. The association warns that blurring lines between different systems undermines medical qualifications, leads to confusion in treatment, and can severely compromise patient care.

Challenges to Healthcare Standards

One of the major concerns is that this directive may allow unqualified AYUSH doctors to take up roles meant for MBBS graduates, thereby reducing employment opportunities for trained allopathic doctors. The IMA emphasizes that modern medicine requires clinical training and evidence-based understanding, which is not part of the traditional medicine curriculum. Assigning modern clinical duties to alternative practitioners could dilute hospital standards and increase instances of medical malpractice.

Way Forward: Regulate, Not Replace

Rather than allowing unqualified practitioners to adopt crosspathy, experts suggest revamping India’s general practitioner (GP) system, particularly in rural areas. Measures could include offering better salaries, housing, and training to attract MBBS doctors to underserved regions. A regulated framework could also be established where AYUSH doctors assist under supervision after undergoing additional training in pharmacology.

Telemedicine platforms like eSanjeevani are seen as a practical solution to bridge the urban-rural divide, connecting rural patients with urban specialists, and ensuring safe, expert-led treatment.

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Crosspathy Controversy: Maharashtra FDA Allows Homeopaths to Prescribe Allopathy: