Quack hunt in Kerala: How a group of doctors and medical students is going after charlatans in the state

'Quack Hunt' was launched on 24 June. And it is already tasting success, with complaints about quacks pouring in.

ByDileep V Kumar

Published Jul 20, 2023 | 11:00 AMUpdatedJul 20, 2023 | 11:00 AM

Quack hunt in Kerala

  • In May this year, a West Bengal native, Dipankar Mondal, was arrested in Ernakulam. For months, Mondal, with no medical qualifications whatsoever, was undertaking telemedicine consultations for haemorrhoids (piles) from his apartment in Thevara.
  • Earlier, in April, a man posing as a doctor in a private hospital was arrested in Malappuram. The man, Ratheesh, had studied up to the pre-degree level and used to work as an assistant in a medical store. According to the police, Ratheesh used the registration number of another doctor with the same name and prescribed medicines or treatments after browsing the Net.

It is cases like these that prompted a group of doctors in Kerala to turn into “hunters”. Their “Quack Hunt” is aimed at smoking out untrained and uncertified doctors practising in the state — and bringing them to justice.

An initiative of the General Practitioners Association (GPA) — a collective of medical students, interns, and working doctors — the “Quack Hunt” was launched on 24 June. And it is already tasting success.

A dedicated phone number set up by the group — +91-7736593003 — has been busy, having received more than 50 complaints and tip-offs about suspected cases of quackery from various parts of the state that are now being investigated.

In the process, the initiative has exposed the unsavoury underbelly of the much-touted “model health system” of the state.

“Imagine you need quality medical care at a life-threatening moment, and you are attended by an unqualified individual posing as a doctor. The result obviously will be disastrous. Such is the situation now,” Dr Ashik Basheer, joint secretary of GPA, told South First.

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Dual Role

The GPA, with its head office in Thiruvananthapuram, was set up in 2017 by Dr Ajmal Shahaban, Dr Shimna Azeez, Dr Salahudeen KP, and 21 others.

It was formed with the aim to address the “innumerable exploitations and unethical treatment by administrative managements [of hospitals] throughout the state”, as well as the working conditions of junior doctors.

However, the growing menace of quackery in the state led them to widen the scope of their activities.

The complaints received at the “Quack Cell” of the GPA are not merely forwarded to the concerned medical authorities or the police.

“People in the Quack Cell have a dual role. First, they have to respond to the call of duty. Thereafter, they have to don the hat of investigators,” said Dr Basheer.

“A preliminary investigation is conducted by the Quack Cell. Only if we find merit in the complaint do we forward it to the concerned police stations and district medical officers (DMOs) for further action,” he added.

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First success

The Quack Cell’s first success came on Wednesday, 12 July, when the Kothamangalam Police in Ernakulam Rural arrested a woman working as a doctor and treating patients at Kuthukuzhy Life Care Hospital.

This, however, was not a classic case of quackery.

According to the police, 29-year-old Murukeshwari, a native of Tirunelveli in Tamil Nadu, completed her MBBS in Ukraine. But she did not clear the Foreign Medical Graduates Exam (FMGE) required for doctors who do their MBBS abroad to practise medicine in India.

She also used the registration number of another doctor to practise at the hospital.

According to Dr Basheer, it was a fellow doctor’s suspicions that led to the arrest of the woman.

“This doctor intimated us and we alerted the Kothamangalam Taluk Hospital Superintendent. The police then arrested her,” Dr Basheer said.

The Kothamangalam Police suspect that similar unqualified doctors might be operating in other parts of the Ernakulam district, including Muvattupuzha.

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What the law says

The Indian Medical Council Act mandates that an Indian citizen or overseas citizen of India, upon completion of medical studies abroad, has to pass the FMGE to get a provisional or permanent registration with the Medical Council of India, or any State Medical Council.

FMGE is a screening test conducted by the National Board of Examinations in Medical Sciences.

The Supreme Court in 1996 ruled that anyone practising modern medicine without training in the discipline, even if they were trained in alternative systems of medicine such as Ayurveda, is a quack or charlatan.

Section 15 of the Indian Medical Council Act, 1956, prohibits a person other than a medical practitioner enrolled on a State Medical Register to practice medicine in the state.

Any person acting in contravention shall be punishable with imprisonment for a period of up to one year or with a fine up to ₹1,000, or both.

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Ways of Cheating

Barely a month into the activation of the Quack Cell, its members can already discern patterns. The common elements found in the complaints received so far are:

  • People with no medical qualification practising medicine

  • ‘Practitioners’ not displaying their registration numbers

  • People who use the registration number of others

  • People who use random five-digit numbers as registration number

  • Dropout medical students practising as doctors

  • Those who graduated from foreign universities not meeting prerequisites like house surgency, Medical Council registration, license, and others

  • People using fake MBBS certificates

  • Practitioners of alternative streams of medicine like Ayurveda or homoeopathy practising modern medicine

Problem is in the private sector

According to Dr Basheer, most fake doctors operate from private hospitals and clinics, making it more difficult to identify them without physical verification of documents. Clearly, private hospitals are not doing adequate due diligence before their hires.

“One doesn’t have the mechanism to verify who is real and who is an imposter,” Dr Basheer pointed out.

The GPA has contended that the problem has proliferated in the private sector as the motivation behind hospital managements employing quacks is primarily financial, as they are paid far lower wages.

This allegation is, however, dismissed by the Kerala Private Hospitals Association (KPHA).

Hussain Koya Thangal, KPHA president, told South First that the concern about unqualified doctors or quacks at private hospitals is totally unfounded.

“KPHA comprises more than 1,300 hospitals. The issue of quackery has not come to the notice of the association. We have reminded our members to be extra cautious while selecting staff, including doctors, and ensuring their registration,” said Thangal.

He added there was a probability that quacks were employed in small private hospitals and clinics.

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Inordinate delay vs procedural delay

The GPA is also critical of the Kerala State Medical Council (KSMC), especially for cases where unregistered doctors are found practising medicine.

It has alleged that inordinate delays in issuing provisional and permanent registrations by the KSMC are one of the reasons why some take matters into their own hands.

However, a member of KSMC’s Council of Modern Medicine told South First on condition of anonymity that the delay is procedural, and the council is steadfast in protecting the interests of applicants.

“If there is a delay, it is procedural. New changes as well as challenges are happening in the medical sector and KSMC is committed to following the same,” the member said.

“To avoid problems in the future, students who studied abroad as well as outside Kerala must comply with all formalities. Though it takes time, it is for their good,” the member added.

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QR Code — the panacea?

Another pitfall being cited in the fight against quackery is the absence of an updated list of registered practitioners in modern medicine in the state. The GPA alleged that though the KSMC is tasked with publishing the data, it had dragged its feet in the past couple of years.

The KSMC member, however, said that an Indian Medical Register (IMR) maintained by the National Medical Commission exists, and the state-level data is being updated.

The member also added that talks were on at the national level to set up individual QR codes for registered practitioners so that anyone could access a doctor’s details, including his name, address, qualification, registration number, date of registration, university’s name, and other details.

“Once a decision comes, the state will act accordingly. The move will be a game-changer as quacks could easily be weeded out,” added the member.

As per the IMR, Kerala has 67,104 registered doctors, with seven doctors being added to the database between January and July this year. The register also shows that the state is yet to blacklist a doctor.

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‘Quackery picking up after a lull’

According to Indian Medical Association (IMA) state president Dr Sulphi N, incidents of quackery are picking up in the state after a long lull.

“Some 10 to 15 years back, quackery was rampant in the state. At that time, IMA’s Anti-Quackery Cell made some meaningful interventions to plug the issue. Taking note of some recent quackery incidents, the IMA state chapter has decided to strengthen the operation of the cell,” Dr Sulphi told South First.

Appreciating the GPA for its “Quack Hunt” initiative, the IMA state president added that the focus should be on addressing both “external quackery and internal quackery”.

“By internal quackery, we mean doctors without adequate specialisation or knowledge faking it and practising. And external quackery means those without any medical knowledge doing the same. The two will have to be addressed effectively,” said Dr Sulphi.