On a sunny afternoon in June, a popular Telugu film actress walked into a four-storey building in Kukatpally Housing Board Colony, a plush neighbourhood of Hyderabad dotted with hospitals, dental clinics and salons. The actress, in her late 30s, was looking for a routine beauty-enhancing procedure and zeroed in on ‘Layers Skin and Hair Clinic’, located on the third floor of the building. Above the signage of the clinic was a reassuring name: ‘Prystyn Care – Simplifying Surgery Experience’. But what began as a quest for self-care soon spiralled into a harrowing ordeal.
She opted for Botox treatment, a procedure meant to smooth out wrinkles on her face and restore a youthful glow. However, within days, her once-radiant smile was replaced by an unexpected swelling that was painful too. Overcome by distress and desperate for answers, she turned to the Telangana Medical Council (TGMC) for help. Her complaint led to an investigation that uncovered a shocking truth: the so-called dermatologist who had administered her the treatment had only a dental degree.
The revelation was as painful as the botched procedure itself. This wasn’t just a case of a treatment gone wrong; it was a blatant violation of trust and a breach of medical ethics. The TGMC wasted no time in taking decisive action, filing cases under Section 34 of the National Medical Commission (NMC) regulations and shutting down the clinic with immediate effect.
“It has been nearly two months since the incident and my face hasn’t healed. The medical council has already taken action, but I will also be filing a case against the clinic soon,” the actress says.
This incident, however, was only the tip of the iceberg. The same month, five teams of the TGMC conducted a series of raids across 40 skin, laser, hair, and cosmetology centres in Hyderabad, including upscale areas such as Jubilee Hills, Banjara Hills, Madhapur, Hitech City, Kukatpally, and Miyapur. The findings were grim: three fake doctors were identified, FIRs were filed against them, and 20 centres were found to be operating sans qualified dermatologists or plastic surgeons, and also without necessary permissions from the District Registration Authority. Further, the raids revealed that Ayurvedic and homoeopathic practitioners were performing laser treatments beyond their scope of qualifications.
According to NMC guidelines, only doctors with specialised medical education should perform treatments such as cosmetology, laser therapy, PRP (platelet-rich plasma)therapy, hair transplantation, dermatology, and plastic surgery, says TGMC vice-chairman Gundagani Srinivas. “This standard is crucial in ensuring patient safety and maintaining the integrity of medical practice,” he points out.
Cracking down on quackery
As the only government-authorised independent regulator for doctors in Telangana, the TGMC’s mandate is to protect, promote, and maintain public health and safety by ensuring that doctors adhere to the standards of good medical practice. The council fulfils this responsibility by controlling entry to the medical register and setting rigorous standards for medical schools, postgraduate education, and training.
TGMC also determines the principles and values that underpin good medical practice and takes action when those standards are not met. With strong and effective legal powers, the council is committed to maintaining standards that the public has a right to expect from doctors. When any doctor fails to meet the established standards, TGMC will act to protect patients from harm, even if that means removing the doctor from the register and revoking their right to practise medicine.
A senior official of the State Health department reveals that unqualified individuals are often recruited by hospitals through outsourcing agencies. “In some cases, the agencies are aware that these individuals possess fake certificates, while in other cases, they even go to the extent of assisting them in acquiring fraudulent credentials,” he adds.
To counter this challenge, the TGMC, in March this year, established a Legal and Anti-Quackery Committee in accordance with Section 8 of the Telangana Medical Practitioners Registration Amendment Act, 2013. This legislation authorises the council to form two-member or three-member committees to inspect hospitals, nursing homes, and other facilities where unethical practices or the presence of unqualified practitioners — such as quacks or those using modern medicine without proper credentials — are reported. The committee’s role is to investigate and address these issues, ensuring compliance with modern medical standards and protecting public health.
Since January this year, TGMC has filed over 300 FIRs against unqualified doctors across Telangana out of which approximately 225 have been processed. “Despite so many inspections, there is a lot of work to be done. As per our estimate, there are roughly 50,000 to 70,000 quacks in Telangana who are directly or indirectly prescribing medicines and treating patients,” says Dr.Srinivas.
Only those registered with the medical council at the State or national level are legally permitted to practice medicine, thereby being known as a ‘registered medical practitioner’ (RMP). However, some people without an MBBS degree, often with backgrounds in just pharmacology or as lab technicians and without proper registration, take advantage of the common abbreviation of RMP. “They label themselves as ‘rural medical practitioners’ to mislead people,” the Health official says.
These unqualified RMPs are often the first point of contact in their local community to address urgent medical needs. Some partner with corporate hospitals, and refer patients in exchange for high commissions. Of late, many of these unscrupulous practitioners have shifted to urban areas, where they have set up clinics, prescribing medicines and administering steroids to unsuspecting patients.
In April, during an inspection at Citi Neuro Centre in Karkhana area of Hyderabad, TGMC members made a startling discovery: two persons were actively performing duties in the Intensive Care Unit (ICU) and critical care wards of the medical facility by falsely claiming to be doctors. Recognising the seriousness of the situation, the council registered an FIR against the two accused, Niranjan and Bhuvaneshwari.
While this swift action prevented any potential harm from occurring, not all such cases have ended without tragedy. In Neelwal village of Adilabad district, a 14-year-old girl suffering from fever was taken to a local healthcare facility called Santosh Clinic.
“It was run by a quack named Santosh who administered five injections of various drug combinations to the girl in the space of an hour, leading to her death due to severe side-effects,” says a source.
A similar tragedy struck in Wardhannapet town of Warangal district, where a 45-year-old man suffering from diarrhoea sought treatment at a clinic run by a quack in April. The man was given intravenous (IV) fluids, which resulted in his death. Just last week, a 42-year-old man of Medapalli village of Karimnagar died after he was given IV fluids and antibiotics by a rural medical practitioner at his clinic, without proper medical evaluation. The TGMC has launched an investigation into the matter.
In another incident, a man named Bhaskar, claiming to be a doctor, was running Bhaskar Hospital in Chityala town of Nalgonda district which was seeing 50 to 100 patients on a daily basis. During a routine inspection at the hospital, it was revealed that Bhaskar was merely an Intermediate pass candidate, with no formal medical degree. His only medical experience came from working under an MBBS doctor for 10 years.
“The hospital even provided free autorickshaw services for patients traveling from distant areas,” says Ramachary, a vigilance officer who conducted the inspection. An FIR has been filed against Bhaskar.
Protecting public health
Since 13 members were elected to the TGMC in January this year, the fight against medical malpractice in Telangana has gained momentum. In the past eight months alone, the TGMC has launched hundreds of raids across the State, revealing a disturbing trend: unqualified practitioners, often referred to as quacks, and individuals with homoeopathic backgrounds prescribing allopathic medicines.
These raids have not only led to the shutdown of clinics operating under false pretenses but have also sent a stern warning to those attempting to deceive the public with fraudulent medical credentials. Through this crackdown, the TGMC is sending across a clear message that patient safety is non-negotiable, and those who endanger lives will face severe consequences.
The TGMC has been conducting a series of inspections across hospitals and clinics within the Greater Hyderabad Municipal Corporation limits, and unearthed numerous deficiencies.
During an inspection in February, Sri Raghava Hospital in Shivrampally of Rangareddy district came under scrutiny upon the discovery of a grave violation. A vigilance officer, posing as a patient, visited the hospital and got a prescription. The officer noticed that a man named Gurupad, running the hospital, was presenting himself as a qualified MBBS and MD doctor. However, a deeper investigation revealed the truth: Gurupad held only a Bachelor of Ayurvedic Medicine and Surgery degree, and even that had been obtained from a fake university in Karnataka.
The inspection further revealed that 13 other doctors working at the hospital were in possession of fake degrees. This led to the registration of an FIR against those involved, ultimately resulting in the closure of the hospital.
Vulnerability of rural population
In rural areas, the scarcity of public healthcare facilities often drives people to seek treatment at clinics run by quacks. Despite government efforts in recent years to enhance infrastructure by establishing Primary Health Centres (PHCs) and Community Health Centres (CHCs) in some villages, these facilities remain insufficient. Even in places where PHCs and CHCs exist, staffing remains a big challenge, with too few doctors and medical personnel available to serve the population, says TGMC chairman Mahesh Kumar K.
According to a 2021 dossier released by the National Health Systems Resource Centre on Telangana, rural areas face a 12.4% shortfall in PHCs and a 53.04% shortfall in CHCs. In urban areas, the shortfall of PHCs is even more pronounced at 27.41%. The situation is particularly dire in tribal regions, where there is a 44.12% shortfall in CHCs and a 46.38% shortfall in PHCs, leaving these communities especially vulnerable and underserved.
This gap is thus filled by unscrupulous elements who set up their own practice after gathering fragments of medical knowledge through experience or having worked alongside legitimate doctors. They operate mainly in rural areas where the access to licenced doctors is limited, and they become the primary healthcare providers for many.
“In rural areas, people often place their trust in anyone who claims to be a doctor, simply because they have no other option in case of a health emergency. It is heartbreaking to see how this vulnerability is being exploited. It is our duty to protect these communities from harm and therefore, such raids on dodgy clinics and so-called doctors must continue,” says a doctor affiliated to the Indian Medical Association-Telangana.
Published - August 16, 2024 08:25 am IST