Sunday, June 9, 2019

Prefixing “Dr”: Taking the Shine Away

With the pharmacy council allowing its degree holders to use the “Dr” prefix, practitioners of modern medicine are irked and patients are left confused as to whom to go to in an emergency   

By Dr KK Aggarwal

As per Medical Council of India (MCI) ethics regulation 2.1, every doctor has an obligation towards the sick: “Though a physician is not bound to treat each and every person asking his services, he should not only be ever ready to respond to the calls of the sick and the injured, but should be mindful of the high character of his mission… A physician advising a patient to seek service of another physician is acceptable, however, in case of emergency a physician must treat the patient. No physician shall arbitrarily refuse treatment to a patient…”

Regulation 2.4 says: “The patient must not be neglected: A physician is free to choose whom he will serve. He should, however, respond to any request for his assistance in an emergency….”

In an emergency situation, the only answer is a modern medicine doctor or one registered with the Medical Council of India.

But it is regulation 1.1.3 that is especially important and defines who is a physician: “No person other than a doctor having qualification recognised by Medical Council of India and registered with Medical Council of India/State Medical Council(s) is allowed to practice Modern system of Medicine or Surgery. A person obtaining qualification in any other system of Medicine is not allowed to practice Modern system of Medicine in any form.” So, in an emergency, the public must find a doctor with an MBBS degree and the accepted way of doing it is to search for a person who has prefixed Dr before his name.

MCI ethics regulation 1.4.2 also says: “Physicians shall display as suffix to their names only recognised medical degrees or such certificates/diplomas and memberships/honours which confer professional knowledge or recognises any exemplary qualification/achievements.” In the case of MBBS doctors, it will be modern medicine.

Article 18 of the Constitution talks about abolition of titles: “No title, not being a military or academic distinction, shall be conferred by the State. No states can officially issue titles.” When I got the Padma Shri by the president in 2010, I was cited a Supreme Court ruling as part of the briefing: I cannot use Padma Shri Dr KK Aggarwal under Article 18. But I can use Padma Shri awardee Dr KK Aggarwal or recipient of Padma Shri Dr KK Aggarwal.

The prefix Dr used by modern medicine doctors is not given by the Medical Council of India, a medical college or a state university, but by society to differentiate us from others and identify us as modern medicine doctors. However, today, even a person who has completed doctoral research and is awarded a PhD, prefixes Dr to his name. Practitioners of AYUSH systems of medicine also prefix their names with Dr even though they have their own appropriate terms such as Vaidya (Ayurveda), Hakim (Unani), Naturopath (Naturopathy), Yogacharya (Yoga) and Homoeopath (Homeopathy). One must remember that in an emergency, these systems of medicine are not effective. That’s not all. Universities also felicitate eminent individuals for their contribution in many fields such as literature, science, sports, music, cinema, social service, etc, with doctorate degrees. These individuals also prefix Dr to their names.

Now there is talk of the Pharmacy Council of India (PCI) authorising candidates receiving the Doctor of Pharmacy degree (Pharm D) from recognised universities to use the “Dr” prefix. This title reflects entitlement and identity and the Indian Medical Association (IMA) is against it being used by those trained in other streams of medicine as it confuses people during medical emergencies. In a letter issued to the director of Board of Examination and Evaluation of Sant Gadge Baba Amravati University, the registrar-cum-secretary of the PCI, Archana Mudgal, has informed that the University should use the “Dr” prefix before the names of candidates while awarding them degrees. But as universities in Maharashtra were not issuing degrees with “Dr” prefix, members of the Doctor of Pharmacy Association of Maharashtra approached the PCI for clarification. The PCI then issued a circular stating that Pharm D candidates can use Dr before their names. Legally, this is only an executive order and not a legally sanctioned clause.

Physiotherapists have also been asking for Dr as a prefix. Tomorrow, even nurses will start writing Dr as a prefix. Of course, quacks are also prefixing Dr before their names. And surprisingly, even health products are using Dr liberally such as Dr Morpen, Dr Fixit, etc.

The use of Dr as a prefix is widespread, be it dentists, veterinary doctors, acupressure and acupuncture specialists or occupational experts. The easiest solution to distinguish these branches of medicine would be to have specific degrees such as XYZ, Doctor of Pharmacy.

When I was the National President of the IMA, this matter was discussed on many occasions. We were getting many complaints from the public of being misguided and exploited by untrained doctors during emergencies.

Different variations of Dr were being used—DR, DR., Doc, Doc., Doctor, Dr (Modern Medicine), Dr (Homeopathy), Dr (Ayurveda), Dr (Naturopathy), Dr (Dental), Dr (Veterinary), Dr (Yoga), etc. I personally started carrying a stethoscope around my neck as a symbol of modern medicine and being available in any emergency.

While one can stop pharmacists or physiotherapists from using Dr before their names, one will never be able to stop AYUSH doctors from doing the same. So the IMA copyrighted an emblem for modern medicine which is to be used by all its doctors to differentiate themselves from those in other fields.

The government must come out with a regulation so that ordinary people can differentiate between doctors of different systems of medicine. The confusion can cause fatal errors and delay in treatments. Will the government listen or should we again look to the judiciary to intervene and take a decision?

Dr KK Aggarwal
Padma Shri Awardee
President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)
Group Editor-in-Chief IJCP Publications
President Heart Care Foundation of India
Past National President IMA

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