The Pulse | Society | South Asia

In India, Medical Titles Debate Raises Public Health Concerns

A landmark case and recent judicial ruling highlight tensions between healthcare access, professional titles, and risks of quackery undermining public health.

In 1996, Gujarat resident Poonam Patel approached the Supreme Court of India, alleging medical negligence by Ashwin Patel that led to the death of her husband, Pramod Verma. Trained in homoeopathy, Ashwin Patel administered allopathic treatment to Verma. Despite repeated complaints of worsening health, he continued treatment without conducting proper physiological investigations.

In his defense, Patel claimed that he had acquired knowledge of allopathic medicine while working at a private nursing home in Bombay between 1983 and 1989, after which he opened his own clinic. The Supreme Court rejected this argument, observing that anyone practicing a system of medicine without proper knowledge is “a quack and a mere pretender to medical skill — a charlatan.”

India’s public health system continues to grapple with deep structural challenges: a severely skewed doctor-patient ratio, the rapid expansion of expensive private hospitals and nursing homes and limited access to affordable healthcare for the majority.

Alongside allopathic medicine, postcolonial governments have sought to revive traditional systems such as Ayurveda, Unani, Siddha, and homoeopathy. While this has improved access to healthcare, it has also raised concerns about malpractice — especially in cases where practitioners lack clearly defined qualifications or titles. As a result, debates around medical education and professional recognition remain unresolved.

Recently, in a significant judgement, the Kerala High Court ruled that physiotherapists and occupational therapists may use the title “doctor,” provided they add the suffix “PT.” The court reasoned that the title is not the exclusive preserve of any single profession.

However, in a country still striving to ensure institutional childbirth, eliminate open defecation, and curb the spread of unqualified practitioners, this ruling raises concerns about potential risks to public health. Healthcare in postcolonial India has long been a contested domain, where medical professionals and allied health providers compete for recognition, standardization, and legitimacy under evolving legal frameworks.

The recommendation allowing physiotherapists to use the prefix “Dr.” and the suffix “PT” was formalized in the Competency-Based Curriculum for Physiotherapy-Approved Syllabus 2025, issued by the National Commission for Allied and Healthcare Professions under the Ministry of Health and Family Welfare.

This move, however, triggered strong opposition from sections of the medical community. The Indian Medical Association (IMA), the country’s largest voluntary organization of medical professionals, filed a petition seeking to restrict the use of the title “doctor” to formally trained medical practitioners. In its white papers, the IMA argued that physiotherapists are rehabilitation professionals governed by the Rehabilitation Council of India Act, 1994, rather than the Indian Medical Council Act, 1956.

Allopathic (Western) medicine, though a colonial legacy, remains the dominant system in India. Yet issues of affordability and accessibility continue to exclude large segments of the population, who often turn to traditional systems such as Ayurveda, Unani, and Siddha.

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