THE UNQUALIFIED MEDICAL PRACTITIONERS - Methods of Practice and Nexus with the Qualified Doctors

The private sector accounts for about 75 percent of outpatient as well as inpatient medical care in Andhra Pradesh. The presence of a large number of unqualified medical practitioners in the rural areas and urban slums indicate that they provide most of the outpatient services in the private sector. Given the huge quantum of services provided by the RMPs, the present study aims at identifying their number, characteristics and the nexus with the qualified doctors through a case study of one district in AP. The RMPs have no professional qualification and no license to practice any system of medicine. They practice on the basis of work experience in hospitals and clinics. On average, there are 12 RMPs per 10,000 population. About 90 percent of the RMPs are from the deprived social groups. They are relatively young and a majority of them have more than 12 years of education. The RMPs are very popular in the rural areas and urban slums because they are the first contact in the medical emergencies. The RMPs are an organic part of the private medical care and have referral arrangement with the qualified doctors on the basis of kickbacks. It is not possible to ban the RMPs without providing alternative sources of medical care in the villages. In the short term, it is in the public interest to train the educated RMPs and regulate their services. As a long-term solution, there is a need for introducing short-term medical courses to provide a trained medical person in every habitation. Once the state is able to provide access to alternative sources of treatment, the RMPs will vanish on their own.