Ayurveda – A Way Forward - Prof. Dr. Shriram Savrikar Chairman, Scientific Body,(PCIM &H), Govt of India IASTAM Awardee

My article titled "Ayurveda – A Way Forward"  is published in the Nov 2020 News bulletin of INDIAN ASSOCIATION FOR THE STUDY OF TRADITIONAL ASIAN MEDICINE (IASTAM-India). It is being reproduced here for all my blog readers.  

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The story started following publication of my article titled ‘Untold story of Plight of Ayurveda in pre and postindependent India’ in the current spring-summer 2020 issue of Journal of Health Care Ethics and Administration (JHEA). The article appears to have generated a debate on the current and future status of Ayurveda in India. World Ayurveda Foundation invited me in a debate on this article in a live webinar series AYUR TALKS on 12th Sept 2020. In this debate I was asked a concluding question as to whether Ayurveda will become unwanted by 2024? This question was asked on the basis of my statement in the article that Ayurveda doctors will no more be required, as India will be achieving WHO recommended 1 doctor per 1000 population ratio with MBBS doctors only. My statement in the article had a reference to those doctors who hold educational qualification in Ayurveda but practice modern medicine. Listening to the debate some of my friends thought my statements very provocative and opined that the program should not be floated on open public platform like You tube and Facebook. Some friends thought that I belong to purist group. Some colleagues opined that I am talking out of frustration. However, majority of them appeared to have agreed that there exists a problem and hence felt a dire need to find a solution to that problem. May be they didn’t agree with the solution given by me. This article is an attempt to find such solution.

Current Status of Ayurveda and Ayurveda professionals - To find out the solution, we have to first find out the current status of Ayurveda and role played by Ayurveda doctors in the society. Many modern medicine supporters and intellectuals opine that the society doesn’t require Ayurveda or any system of medicine other than modern medicine. These people consider Ayurveda as a pseudo-science. Representing these people, the Wikipedia labels Ayurveda as a pseudoscience. Articles and news items branding Ayurveda as a pseudoscience, Ayurveda doctor as a quack and Ayurveda drug as a toxin; are published frequently across the world. Although majority of such articles are based on ignorance and misinformation, they definitely put a big question mark on the very existence of Ayurveda as a system of medicine and need of Ayurveda doctors as a health care service provider in the society.

Types of Ayurveda Professionals: Presently two types of Ayurveda professionals appear to be functioning in health care service sector. One providing health care through practice of modern medicine, some openly and some under the camouflage of Ayurveda, and the other providing health care through practice of Ayurveda as a system. Whatever may be the reason, the number of first type of Ayurveda doctors exceeds too much as compared to the other. These doctors are either practicing modern medicine on their own in their own clinics or they are employed as Medical officers in Primary Health centres or as RMOs in modern medicine hospitals to cater modern medicine services. Usually the young ones are employed as RMOs in private modern medicine hospitals as cheap labour. These Ayurveda doctors carry out all the services of an assistant of a modern medicine consultant expert. All these doctors will become jobless in coming few years. Because they will be replaced by MBBS doctors, becoming available in large numbers and lower wages as well.

Changing Trends of Acquisition of Health care - Another important factor is the changing trends of the society to acquire health care service. It is necessary to understand these trends for every medical professional, particularly for those who wants to practice medicine on his own. The trends in urban and rural areas and lower, middle and upper socio economical class vary widely.

Rural Trends: Rural and lower socio economical class population is now being covered under AYUSHMAN BHARAT and similar Govt schemes under which the health care services are offered at no cost. Not only medicines and surgical procedures but all investigative services are also off ered free of cost, under these schemes. In such a situation no individual from this class will have any reason to spend money from his pocket by visiting any doctor who doesn’t provide service under any such health schemes. No doctor except modern medicine doctor is eligible to get empanelled in any of these schemes. Hence the population covered under these schemes has been permanently weaned away for Ayurveda doctors.

Urban Trends: The urban middle and upper socio-economical class has now shifted his health care acquisition mode towards corporate hospitals or specialist consultants. They don’t visit general practitioner anymore for their health care service needs. In fact, the species of general practitioner is almost on the verge of extinction at least for middle and upper socio-economical class. The policy makers of Ayurveda courses need to consider these changing trends while restructuring the curriculum. The existing ones as well as those who are preparing themselves for practicing modern medicine while holding Ayurveda qualification have no future. But it doesn’t mean that Ayurveda has no future. Ayurveda doctors as professionals practicing Ayurveda as a system defi nitely have ample scope and good future prospects.

Scope of Ayurveda as a System of Medicine - Th e modern pharmacologists look towards Ayurveda as a source of new drug molecule whereas the physician look at it as a complementary drug source when they don’t find any definite treatment protocol. All this is happening due to ignorance of knowledge of Ayurveda as an independent system of medicine. On this background it is necessary to critically find what Ayurveda can offer to the world which will be accepted open heartedly.

Current Status of Yoga, An Illustration: In this regard the current status of Yoga will be illustrative enough. The world has accepted Yoga without any reservations as a wellness program. Modern medicine community has also accepted Yoga, because Yoga neither competes modern medicine as a system of medicine nor it competes with its doctor as a medical service provider. Yoga has its own domain which doesn’t interfere in the medical world in any way. Although some Yogacharyas are trying to promote Yoga as a therapy, but they will never succeed. The current Ayurveda as system of medicine and Ayurveda professional as a service provider, both are standing competing with modern medicine on all fronts. Th is competition has taken Ayurveda on a whirl wheel. If Ayurveda wants to grow as an independent system, it has to stop taking competing stance. It has to offer something which is not offered by modern medicine.

Current Scenario and Role of Ayurveda - Studies have shown following scenarios where Ayurveda is used. (1) Home remedy before seeking help from medical doctor. (2) Add on home remedy with modern medicine with or without knowledge of the treating physician. (3) Add on treatment by Ayurveda doctor. (4) Stand-alone treatment by Ayurveda doctor.

The above scenario indicates role of Ayurveda in the last two conditions. It is necessary to identify conditions where stand-alone treatments and add on treatments can be given. The Ayurveda professional needs to be trained for offering his services in these two areas. Critical look into current medical world exposes some areas which are left unattended by the modern medicine. Outside the Ayurveda community, the world looks towards Ayurveda as a system offering a wellness program, a home remedy or a complementary therapy. Ayurveda community has to take advantage of this mentality. The most important area is dietary and behavioural practices which make the life style management. Although modern medicine doctors do take the help of dietician and psychotherapists to address this issue, this help doesn’t appear to yield expected outputs. The current dieticians address only nutritional defi ciencies and caloric requirements of the patients, which doesn’t solve the problem. One has to look beyond nutrients and calories for streamlining the dietary requirements of a patient. This look can’t be provided through the eyes of modern medical science. Ayurveda can certainly provide these eyes. This is a grey area, where Ayurveda can gain entry. Moreover, the need to address this issue is ever increasing. The nature of this issue differs widely in urban and rural sector.

Restructuring of Ayurveda Curriculum – Need of Hour - Considering all above issues it is necessary to restructure and redesign the current Ayurveda curriculum. One has to understand that Ayurveda practitioner needs to be strengthened clinically in areas where Ayurveda is strong. This will be possible if he learns to apply advanced knowledge of science like biochemistry, medicinal chemistry, microbiology, fundamental principles of pharmacology and likewise. He doesn’t need modern pharmacotherapy. It is also true that such mass restructuring will not be possible or feasible considering its negative impact on the existing Ayurveda professionals. These professionals will find themselves uprooted if they are suddenly made to stop practicing modern medicine. Hence it will be wiser to introduce the proposed structure in a stepwise manner. May be initially both existing and proposed structure be run parallel with an object to introduce it as the only system in future. Along with structural reforms in education it is also necessary to introduce Ayurveda in public health care as an independent system. Currently the Ayurveda as an independent system of medicine has no existence in public health with few exceptions. A vertical infrastructure parallel to modern medicine in every State is the need of hour.

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