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AAPRA
Justification
for Licensing Ayurvedic Medicine of India (AMI)
in the US
Type of License: AMI practitioners are asking for
license only to use Ayurvedic procedures and therapies to diagnose,
prevent, and treat diseases and not
asking to use allopathic methods and treatments, thus, there is no
conflict with MDs. We
are asking the same type of license as given to Acupuncture and Oriental
Medicine which allows them initial point of contact physician rights.
1.
Medical
professional societies supporting regulation of AMI in Maryland
(1) Am Assoc. of Physicians of Indian
Origin (AAPI) (MDs and AMI degree
holders, >45000 members) V. Koli, MD,
President,
H. Sharma, Chair of Integrative medicine committee AAPI
(2) Assoc. of Ayurvedic Professionals of North
America (AAPNA)www.apna.org.
(3) Am. Assoc. of Practitioners, Researchers of
Ayurveda (AAPRA)
(4) Florida
Vedic College
2. No
conflict with conventional medicine: License will include only the right to use
ayurvedic diagnostic methods, diagnosis, prevention, treatment; the license
would NOT allow the use of conventional medicine diagnostic methods and
treatments.
3. Tragic Incidence:
AMI practitioners need to have the necessary training and license to practice
AMI so that incidences similar to the death of Coretta Scott King
(Washington Post, 2 6 06) do not adversely affect AMI practitioners.
4. Inadequate
Training: Inadequately
trained practitioners undermine the safety of the patients, provide
less than optimum treatment, may produce a delay in proper treatment, and
jeopardize the growth of the medical system. AMI is not regulated in any State at this
time.
5. Regulation of
common therapies: Non-conventional therapies regulated in other
countries are also regulated in the US. Ayurveda is not. Even non-drug therapies like massage and
chiropractic are regulated in the US. Massage therapy license requires 500 to
1000 hours of training, passage of National Board Exams, and other
requirements before being allowed to practice in most states. There is no ingestion of single herbs or
formulas in Massage Therapy, but, it is currently regulated where as
Ayurveda which includes use of herbals and procedures such as, blood
letting, strong purgatives and emetics, requiring significant training is
not.
6. Regulations:
Lack of regulation allows unqualified persons to practice Ayurveda which
has the potential for initiating and exacerbating health problems. Regulation will encourage qualified
Ayurvedic physicians to practice in Maryland.
7. AMI practitioners: AMI practitioners whose training is
limited to 500 total lecture hour and do not hold a separate medical degree
are really not qualified to treat diseases, however, they are often
implicitly advised by AMI schools that they can practice AMI as long as
they do not use the words like “diagnose, prevent, treat and cure’ in their
practice.
8. AMI Training
Schools: Currently there are over 20 educational facilities in the US
offering AMI training limited to a total of 500 hours which is drastically
low in view of the fact that a minimum of 3,560 total hours and one year of
internship is required in India
for licensing. These training
schools have created thousands of insufficiently trained AMI
practitioners. None of the schools
are accredited by regional accreditation boards such as WASC, SASC, etc.
9. Scope of AMI training: AMI is similar in scope to conventional medicine and
includes similar subjects: (1).Sharir Rachana (Ayurvedic Anatomy),(2) Sharir Kriya (Ayu. Physiology), (3) Kaya
chikitsa (Ayu. Medicine), (4). Shalya
Chikitsa (Ayu. Minor surgery), (5) Netra
Roga (Ayu. Eye), (6) Shalakya
Chikitsa, (Ayu. Ear, Nose and Throat), (7) Kaumarbhratya (Ayu. Pediatrics), (8) Prasuti Tantra (Ayu.Obstetrics), (9). Stri Roga (Ayu.
Gynecology), (10) Bhutavidya (Ayu.
Psychiatry), 11. Swasthyavrat
(Hygiene, mediation, Yoga, life style changes, dietary choices) (11) Agadtantra (Ayu.Toxicology) . 12.) Rasayan Tantra (Ayu.Science of
Health and Longevity), (13). Vajeekarantantra
(Ayu.Procreative Activity and Rejuvenation), (14). Bhasajya Kalpana
(Ayu.Pharmacy), (15) Rasausadhi
(Ayu.Drugs of Metals and Mineral origin), (16). Dravya Guna (Ayu.Pharmacology). (17) Padarth Vigyan (Ayu. Physics).
10. Training of
AMI also covers the comparative knowledge
of similar subjects in conventional medicine. It covers disease pathology, etiology,
diagnosis, prevention, treatment and cure.
In addition AMI has additional seven non-clinical subjects, such as, AMI
pathology, AMI toxicology, and AMI
pharmacy and others.
11. Hazards from AMI: Many AMI
drugs and purification procedures (Panchkarma
which includes strong purgatives, emetics and blood-letting) could be
hazardous and even fatal if not used under a physician’s supervision.
12. Validity and
Scientific Basis of Ayurvedic
Therapies: Indian government agencies and universities have studied AMI
and published findings in conventional medical journals subscribed by
National Library of Medicine and indexed in Index Medicus. Additionally,
the NIH, private foundations, and ayurvedic herbal products manufacturers
have expended millions of dollars in funds to underpin the safety and
effectiveness of AMI therapies. Many
of these findings from the pharmacological, biochemical and clinical studies
have been summarized in Scientific Basis of Ayurvedic Therapies, CRC Press Florida,
2003.
13.
Popularity
of AMI:
“Even in such major cities as New Delhi,
which boasts several world-class medical facilities, AMI is widely
embraced. Pharmacies stock AMI
remedies alongside conventional medical products such as antibiotics” (Washington
Post, 1/8/06).
14.
Ayurvedic
Pharmacopoeia and Formulary of India:
Briefly, AMI has over 1000 therapeutic herbs of which 326 have
been included in the Ayurvedic Pharmacopoeia of India,
2004. In addition, the Ayurvedic
Formulary of India
has over 780 Text formulas of animal, mineral and plant origin. These books
provide specific standards for Ayurvedic herbs and Text formulas. The Government of India has set up the
following permissible limit for heavy metals in Ayurvedic products
containing only herbal ingredients for oral administration: lead, 10 ppm, Cadmium, 0.30 ppm, arsenic
10 ppm, and mercury, 1 ppm.
15.
Usefulness
of AMI: Ayurvedic Text formulas
and single herbs are known to be useful in the management of chronic
diseases, psychiatric disorders, neurological disorders and maintenance of
good health, particularly when patients become resistant to conventional
drugs or are unable to utilize conventional drugs due to co-morbidities
which put them at risk for side effects from conventional treatment. Volumes of effectiveness/ efficacy, and
safety data have been published both in India
as well as the West.
16.
Health
Care cost: AMI may bring down the
health care cost by providing an alternative therapeutic system.
1) AMI is known to produces desirable
therapeutic effect without causing acute toxic effects, it may save health
care costs from the treatment of side effects that may result from
conventional drugs.
(2) AMI is not known to cause delayed adverse
health effects or secondary diseases which sometimes develop years after
the use of a conventional drug, again saving the cost of treating the
secondary disorders.
(3) AMI formulas are cited in Texts as useful
dietary supplements to improve health, strengthen the cardiovascular
system, immune system, improve memory, and relieve depression. The formulas are cited in Texts to reduce
the frequency of illnesses thus may save health care costs.
(4) AMI therapies and Text formulas are herbal
or herbo-mineral formulas and do not have patent rights on them by
manufacturers, therefore, they are generally less expensive.
(5) AMI formulas are relatively
simpler to make than conventional drugs and does not require chemicals to
manufacture. Since AMI therapies in
general are more economic than conventional therapies, their use may also
facilitate treatment in rural or economically depressed areas.
17. Supply of AMI Products: With
regulation, Ayurvedic suppliers will be encouraged to open outlets in Maryland
increasing the tax base while providing local access to high quality
Ayurvedic products.
18.
Educations: Education in AMI
will be more easily facilitated in states where it is regulated
19.Growth
of AMI: No medical system can grow to its full potential without
regulation, support and state protection.
Maryland could be on
the forefront of the growing interest in Ayurvedic medicine with
co-operation among practitioners, users of the medical practice and the
government.
20.
Third part payment: Although,
Complimentary Alternative Medicine health services are often not covered by
third party payers in a way conventional medicine health services are,
however, many CAM therapies (Acupuncture and
Oriental Medicine, Chiropractic) are given a certain amount of discount
by health care providers. AMI
services are not given such discounts.
21.
It is apparent from the scope and extent of AMI that there is a great need
for the regulation of AMI in the US so that a minimum standard of education
and experience necessary to practice clinical as well as non-clinical
aspects of AMI can be enforced to protect public and establish it in
the US in a reliable and safe manner.
Post Regulation
Question: How will regulation work since we do not have enough
qualified AMI practitioners in the US?
Response: We have no shortage of qualified AMI
practitioners. We already have 100s
of qualified practitioners in the US and another over 368,000 registered qualified AMI
practitioners (BAMS) in India and many of them may be interested in coming
to the US if they can get license to practice. Right now, many qualified AMI practitioners are leaving the US because they can not get license to practice. These people will form the back bone of
the infrastructure of AMI in the US. After
regulation of AMI, training schools will be started. Training access will follow a path
similar to that experienced with the growth of Acupuncture and Oriental
Medicine (AOM) back in 1973 when it was first regulated in Massachusetts, USA. Qualified
practitioners with a degree in AOM came to the US and were given licenses in the States where it was
regulated. Slowly, other states
regulated AOM and these qualified practitioners provided the
infrastructure. Currently AOM is
regulated in 44 states.
Lakshmi C. Mishra, B. Pharm., M. Pharm.,
Ph.D., BAMS
President, AAPRA
Betsy
B. Singh, Ph.D. Mr.
Onkar Sharma, Legislative Director
Vice
President, AAPRA Sharma
Law Group
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