What is Crosspathy?

What is Crosspathy?

In December 2024, the Maharashtra Food and Drugs Administration (FDA) approved homeopathic practitioners with pharmacology certificates to prescribe allopathic medicines. The decision has sparked significant criticism, especially from the Indian Medical Association (IMA), which fears the rise of "crosspathy" could compromise patient safety.

What is Crosspathy?
Crosspathy refers to the practice of healthcare providers prescribing or performing treatments outside their formal medical expertise. This practice is typically associated with practitioners of alternative medicine (e.g., Ayurveda, Homeopathy, Siddha) prescribing allopathic (modern) treatments. Critics argue this could lead to misdiagnoses, improper treatments, and overall harm to patients, as such practitioners lack the necessary training in allopathic medicine.

Regulatory and Legal Framework

• MCI Code of Ethics (2002): Under the Indian Medical Council Act, 1956, this regulation restricts unqualified individuals from performing medical tasks like surgeries or issuing medical certificates.
• Supreme Court Ruling: In the 1996 case Poonam Verma Vs. Ashwin Patel, the Court held a homeopath responsible for patient death after prescribing allopathic medicines, reinforcing that cross-system practice constitutes medical negligence.

Reasons Behind Crosspathy Advocacy

• Shortage of Specialists: India faces a severe shortage of specialist doctors, especially in rural areas. A 2022 report highlighted that only 4,413 specialists are available in Community Health Centres, while 21,964 are needed. To address this, the government is promoting AYUSH practitioners as a stopgap measure to help alleviate healthcare gaps in underserved regions.
• Healthcare Access: With a doctor-population ratio of 1:836, surpassing the WHO's standard of 1:1000, the majority of doctors are concentrated in urban areas. Crosspathy has been viewed as a means to provide affordable healthcare in rural areas where allopathic doctors are scarce.

IMA’s Concerns
The IMA strongly opposes the Maharashtra FDA’s decision, citing several concerns:

• Violation of National Policies: The IMA points out that the National Medical Commission (NMC) Act, 2019, does not grant AYUSH practitioners the authority to practice allopathy. The Central Council for Homeopathy also prohibits such practices.
• Patient Safety Risks: The IMA argues that allowing crosspathy could compromise healthcare standards, as AYUSH practitioners are not trained in modern medical practices, leading to malpractice and negligence.
• Quality of Care: Crosspathic practices threaten to undermine healthcare quality by diluting the specialization in modern medicine and allowing unqualified practitioners to prescribe complex allopathic treatments.
• Impact on MBBS Professionals: This directive could lead to the appointment of AYUSH practitioners in allopathic roles, reducing opportunities for MBBS graduates, further straining the medical profession's integrity.

Way Forward
To address the issues raised by crosspathy while improving healthcare access, experts suggest:

• Attracting MBBS Doctors to Rural Areas: Strengthening incentives and improving working conditions in rural areas could motivate MBBS doctors to serve in underserved regions, improving overall healthcare access without compromising safety.
• Enhancing General Practice (GP) System: It is essential to provide mid-level healthcare providers with specialist training in modern medicine, enabling them to better serve in rural settings without stepping beyond their expertise.
• Regulated Collaboration: Establishing a structured framework for collaboration between AYUSH practitioners and allopathic doctors, with strict role definitions and adequate training in modern medicine (especially pharmacology), can ensure patient safety.
• Promoting Telemedicine: Expanding telemedicine initiatives, such as the eSanjeevani platform, can help bridge the gap between rural patients and urban specialists, ensuring that healthcare is accessible without sacrificing safety or quality.

By promoting a balanced approach to healthcare, the government can address rural healthcare gaps while maintaining strict regulations to protect patient safety and uphold medical ethics.

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