Consumers beware!
Regulating the practice of physiotherapy
Pushpa Girimaji

From preventing non-communicable diseases such as diabetes and hypertension, to treating postural deformities, accidental and sports injuries, metabolic disorders, arthritis and age-related mobility problems, physiotherapy has become an integral part of the healthcare system. Yet, the Central government has failed to accord it due recognition and regulate the practice of physiotherapy, thereby exposing consumers to unqualified and unregistered physiotherapists. Now, a recent order of the apex consumer court holding a hospital guilty of negligence for employing an unqualified physiotherapist, has drawn attention to the urgent need for a statutory regulator for physiotherapy, on the lines of Medical Council, Pharmacy Council and the Dental Council of India.

The National Consumer Disputes Redressal Commission's order has its origin in the sudden death of 32-year-old Sudhir Sharma, while receiving electrotherapy for lower back pain. In her complaint before the National Commission, Sharma's wife blamed the hospital for his untimely death, saying that the hospital had not only employed an unqualified physiotherapist, but had also used the electrotherapy machine without proper arrangements for voltage control. Besides, the therapist had left the patient alone without supervision during treatment. The hospital alleged that Sharma had died of a sudden heart attack and could not be saved despite best efforts. The Commission, after examining the postmortem report and the circumstantial evidence, concluded that the hospital was liable for the death of Sharma. The hospital, the Commission held, was guilty of negligence for having employed an unqualified physiotherapist and for not ensuring the safety of the equipment used for treatment. It therefore directed the hospital to pay Rs 15 lakh as compensation, along with 6 per cent interest calculated from 2009. It also directed the unqualified physiotherapist to pay Rs 2 lakh with interest.(Anamika Sharma vs Chhattisgarh Hospital, FA no 451 of 2010). The hospital needs to be held accountable for employing an unqualified person as a physiotherapist, but the government is equally to blame for the failure to regulate the education and practice of physiotherapy and ensure that only qualified and registered physiotherapists are allowed to practice.

The government's lackadaisical attitude is visible in the half-hearted attempts in the past to introduce a legislation in this direction, first in 1994 (the draft was never introduced in Parliament) , then in 2007 through the "Paramedical and Physiotherapy Central Councils Bill" (the bill, introduced in the Lok Sabha, lapsed) and more recently, through the National Commission on Human Resources in Health Bill, that was introduced in the Rajya Sabha in December 2011. This Bill too was so flawed that the Standing Committee advised the government to consider the opinions of all stakeholders and bring a revised comprehensive bill before the Parliament. The Indian Association of Physiotherapists has filed a writ petition in the Supreme Court seeking a direction to the Centre on the formation of an independent physiotherapy council and establishing it as an autonomous specialty. Meanwhile, Maharashtra, Gujarat, Tamil Nadu and Delhi, have constituted such Councils at the state level and have been registering physiotherapists. As per the Delhi Council for Physiotherapy and Occupational Therapy, for example, only those persons with a recognised qualification and enrolled on the register of physiotherapists can practice physiotherapy in Delhi. In a recent advertisement warning consumers about quacks, the Delhi government exhorted consumers to look for the registration certificate issued by the Council, before seeking treatment from a physiotherapist. That's the advantage that a regulation will offer. Says Vishwa Prakash Gupta, a nominated member of the Delhi Council: "A central regulatory body will not only promote a uniform standard in physiotherapy education and practice around the country, but also ensure that the service is available to patients in their golden hour. Today, many patients do not get the advantage of physiotherapy when they need it most. Rough estimates put the number of physiotherapists in the country at around 60,000, About 250 colleges are said to be offering undergraduate (four and half years) courses in physiotherapy.

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