Original Research Article
Perspectives of interns on integration of ayurveda and allopathy in health care: a qualitative study
Department of Community Medicine, Mysore Medical College & Research Institute, Mysuru, Karnataka, India
Received: 03 July 2017
Accepted: 28 July 2017
*Correspondence:
Dr. P. Dushyanth,
E-mail: dushyanthmys@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Background: The objective of the study was to generate perspectives of Interns on integration of Ayurveda and Allopathy in health care through focus group discussion.
Methods: Two focused group discussion (FGD) sessions with Interns (N=15) of our institution was conducted during October 2014. Interns were selected based on convenience sampling method. Both FGD was conducted by the same moderator after taking consent from the participants. Sessions were audio recorded and later it was transcribed and analyzed.
Results: The discussion showed that they had limited knowledge about Ayurveda which was from reading books and interacting with Ayurveda interns during the postings. There was mixed opinion regarding the integration of two systems of medicine. They opined that both the systems should not be integrated because Ayurveda is not based on evidence based research like Allopathy. Majority of interns opined that integration will benefit the patients as many chronic diseases can be effectively treated with Ayurveda. They suggested that providing knowledge about Ayurveda to Allopathy doctors at syllabus and training level will help in giving proper advice to patients on opting for ayurvedic treatment. Everyone had a positive opinion regarding inclusion of ayurvedic doctors in managing health programs as it increases the man power for effective management.
Conclusions: Integration of both systems will benefit the patient. Quality research evidence on specific diseases which are effectively treated in Ayurveda will encourage Allopathy doctors to recommend ayurvedic treatment. Thus, considering alternative medicine as an additional medicine will have a positive impact on effective health care.
Keywords: Integration, Interns, Allopathy, Ayurveda, Focused group discussion
INTRODUCTION
Ayurveda is most commonly practiced form of complementary and alternative medicine (CAM) in India. Recently ayurvedic medicine has become more and more noticeable from the point of view of dissatisfaction with modern medicine.1 Recently integrative medicine approach came forward with the optimism of providing an affordable and practical solution to the global healthcare crisis, especially in developing countries like India. Department of AYUSH, under the Ministry of Health and Family Welfare proposed a new approach by integrating Ayurveda, Siddha, Unani, and homoeopathy with allopathic system to ensure health for all citizens across the country.2 There are many hurdles like lack of knowledge and faith in indigenous system of medicine among public as well as Allopathic doctors for effective integration of other systems with Allopathy in India.3 World Health organization has recently published ‘WHO Traditional Medicine Strategy 2014-2023’ in order to provide strategic guidelines for countries to promote, protect and utilize regional traditional medicine systems.
One of the key objectives as elaborated by WHO is to promote integration of traditional medicine into existing health systems.4 Integration of Ayurveda and Allopathy will be meaningful if there is mutual acceptance from doctors of both the systems. The success of the new ‘integrative’ approach will lie in its capability to understand the respective values, beliefs, fundamentals, practices, strengths, and weaknesses of all the systems.1 Understanding perspectives of Allopathy doctors towards Ayurveda will provide an insight regarding the steps that need to be taken to promote integration. Focus group discussion which is a popular method in Qualitative research will help in analyzing personal as well as professional views of an individual towards an event. Hence, focus group discussion was carried out done for Allopathy interns as the scope of integration in the future will be greatly influenced by the attitudes of allopathic physicians and more so on future physicians.
Objectives
To understand the perspectives of Interns on integration of Ayurveda and Allopathy in health care through focus group discussions.
METHODS
Focused group sessions of interns were conducted during October 2014. The study participants were Interns of our institution. A total of 15 interns participated in the study and they were assigned to two groups of 8 and 7 each. Information regarding the study was given to Interns a day before the sessions. Convenient sampling method was used, that is all the interns who were willing to participate were included. The study was conducted after taking oral informed consent from the participants. Both sessions were conducted by the same moderator. Topics that needed to be discussed were prepared earlier and same topics were discussed in both the sessions. The sessions were audio recorded and later it was transcribed verbatim and analyzed. The participants were not informed about the topics for discussion.
The discussion was carried out regarding the following five topics. The topics were knowledge regarding Ayurveda, common diseases that you think are treated effectively by Ayurveda, Opinion about integration of Allopathy and Ayurveda, Providing knowledge of Ayurveda to Allopathy doctors, Inclusion of Ayurveda doctors in health programs.
RESULTS
The discussion was started randomly by any one of the participant. Everyone was encouraged to provide their opinion regarding the topic. When it was noted that there was no new opinion generated about the topic the discussion was moved to the next one.
The perspectives of interns regarding the above topics are as follows:
Knowledge about Ayurveda
This was used as an introduction topic for the discussion. Everyone agreed that they knew about Ayurveda. Few of them said that Ayurveda is based on tridosha principle. The medicines used for treatment of diseases are plant derived medicines. One of the interns said angrily that, “For treatment, what I have seen is that Ayurveda interns prescribe allopathy drugs.”
Common diseases that you think are treated effectively by Ayurveda
There were varied opinions for this topic as
One of the interns quoted her experience, “What I have heard is that, for chronic sinusitis which is difficult to treat in allopathic medicine, ayurveda has a better technique.”
A discontent intern said, “They basically target chronic diseases like arthritis and skin conditions as ayurveda doesn’t have effective drugs to treat acute diseases.”
Opinion about integration of allopathy and ayurveda
There was mixed response towards the topic. There was more positive response for integration and limited response towards non integration of both the systems.
Positive perspectives for integration
- • People’s benefit- “integration must be there, everyone should practice what they learn so that people are benefitted by both.”
- • Treating chronic diseases-“for treating chronic diseases, where allopathy drugs cannot be used for long duration due to side effects, ayurveda could be useful.”
- • Good quality research encourage integration
-“probably if more studies are done best of both worlds can come up for benefit of all”
-“encourage good research in ayurveda methods and medicines, and then integration would be useful.”
-“research can be done on few diseases in which Ayurvedic treatment is beneficial, so that we also can advice that treatment for those specific conditions.”
Perspectives against integration of systems
- • Lack of good quality research in ayurveda
-A determined opinion: “I am strongly against integration, basic pillar on which allopathy stands is good quality research, whereas ayurveda and other systems are based on relatively less quality study designs.”
-Another opinion on same lines: “most of alternative systems of medicine do not follow evidence based practice.”
Providing knowledge of Ayurveda to Allopathy doctors
Everyone agreed that knowledge of Ayurveda is needed for the Allopathy doctors also.
- • Help in proper treatment- “Basic knowledge about Ayurveda for us will help in giving advice to patients in order to choose the treatment methods.”
- • Exposure during training- “providing knowledge about Ayurveda at syllabus level will be a burden, may be during internship if we are exposed it will be helpful.”
Inclusion of ayurvedic doctors in health programs
There was an overwhelming positive response for inclusion of doctors to manage health programs. Main opinion generated towards this was that it will provide additional strength for the government and ensure effective management of these programs.
- • Additional human resource- “It will improve man power as dedicated man power is an issue in management of health programs.”
- • Training is necessary- “they must be included only after proper training as the concepts of health programs may be new to ayurvedic doctors.”
- • Increase effect- “As effective execution of health programs is a main hurdle, it can be tackled by the inclusion of Ayurveda doctors.”
An overview of opinions generated in the focused group discussion is described in Figure 1.
DISCUSSION
Integration of Allopathy and Ayurveda has been in stream line in the process of health planning in India since past decade. National Policy on Indian systems of Medicine and Homeopathy (ISM & H policy) was launched in 2002. Many experts in the field of public health also had the opinion that its integration would benefit Indian health system.5 In this study, we made an effort to understand the views of Allopathy interns towards this effort of integration. The whole perspective was understood by focus group discussion on selected topics. Knowledge regarding Ayurveda was limited among interns. This is expected as there is no information regarding other systems of medicine in the Allopathy syllabus. This is in agreement with study conducted among medical students which showed poor knowledge about principles of other systems.6 Interns had a view that ayurveda treatment is largely helpful in treating chronic diseases only.
CONCLUSION
Government of India in recent years has realized the potential of other systems of medicine in creating a positive impact on public health. National Health Policy draft – 2015 also considers utilization of AYUSH services as a key approach to achieve health objectives in the future.7 This study conducted among allopathic interns helps in understanding the viewpoint of upcoming doctors towards integration of indigenous system with modern medicine. Steps to provide proper knowledge regarding other systems of medicine to allopathic doctors will cause a major impact on success of integration. Effective integration can act as a catalyst in improving public health system in India.
Funding: No funding sources
Conflict of interest: None declared
Ethical approval: The study was approved by the Institutional Ethics Committee
REFERENCES
- 1. Gawde SR, Shetty YC, Pawar DB. Knowledge, attitude, and practices toward ayurvedic medicine use among allopathic resident doctors: A cross-sectional study at a tertiary care hospital in India. Perspect Clin Res. 2013;4(3):175–80.
- 2. Department of AYUSH. National Policy on Indian Systems of Medicine & Homoeopathy-2002. 2002. Available at: http://www.whoindia.org/ Accessed on 3 June 2017.
- 3. Basisht GK. Symbiohealth - Need of the hour. Ayu. 2011;32(1):6–11.
- 4. World Health Organization. WHO Traditional Medicine Strategy. 2014. Available from: http://www.who.int/medicines/publications/traditional/trm_strategy14_23/en/ Accessed on 3 June 2017.
- 5. Singh B, Singh A, Kumar M. Unification of Indian Systems of Medicine and Homoeopathy Policy and National Health Policy in India. Stakeholders Perspective. 2012;2(3):141–6.
- 6. Mankar NN, Zad VR, Agharia MM, Sawant SD, Bansode AA. Knowledge, Attitude And Practices Towards Ayurvedic Medicine Use Among Second Year MBBS Students. 2015;4(2):223–7.
- 7. Department of Health and Family Welfare. National Health Policy 2015 Draft. 2015: 1–57.