Two Systems, One Patient: Inside Maharashtra’s Decade-Long "Mixopathy" Battle

Dr Neha Siddharth Pawar has become the first homoeopathic practitioner qualified under the Certificate Course in Modern Pharmacology (CCMP) to receive conditional registration from the Maharashtra Medical Council (MMC). The move, granted on August 4, has reignited a decade-old dispute over what associations representing modern medicine dismissively call "mixopathy."

The Indian Medical Association (IMA), Maharashtra Association of Resident Doctors (MARD) and other doctors’ associations took to the streets opposing the move whose origin lies in the 2014 amendment when state government paved the way for Homeopathic doctors who complete the one-year CCMP course to practise modern medicine within a restricted scope.

“We were opposing the decision of this crosspathy and mixopathy for the benefit of the patient's safety. Our main motive was that whenever these doctors are taught any of these pathies, they should practice their own pathies,” Central MARD President Dr. Atharva Shinde told Outlook India.

The strikes were called off within two days after the Bombay High Court intervened over concerns that disruption of medical services could endanger patients.

The immediate confrontation has eased, but the larger dispute remains unresolved, with the Maharashtra government putting further registrations on hold until the Bombay High Court settles the legal challenge.

What Was The 2014 Amendment?

The roots of the current controversy go back to June 2014, when Maharashtra amended both the Maharashtra Homoeopathic Practitioners’ Act, 1960, and the Maharashtra Medical Council Act, 1965.

The amendments allowed registered homoeopathic practitioners who completed a state-approved one-year CCMP course to practise modern scientific medicine only to the extent of the knowledge covered by the course.

The IMA challenged the amendments before the Bombay High Court in 2014, arguing that a short bridge course could not substitute for the clinical training required for an MBBS qualification.

“They are combining two different branches of medicine. Basically you are trying to invent a new technique which has no relevance, which has no scientific relevance, which has no evidence-based relevance,” IMA National Spokesperson Dr. Dhruv Chauhan told Outlook India.

The High Court, however, refused to stay the amendments at the interim stage in December 2014. The refusal to grant an interim stay did not amount to a final endorsement of the law, and the larger legal challenge continued.

“But the thing is that Honorable High Court has not stayed in order or neither has given interim period from stopping the registrations. So, it was at par to register them (CCMP-graduates) in the Maharashtra Medical Council,” Dr. Shinde said.

Why Doctors Are Opposing The Move?

Associations representing modern-medicine doctors argue that the arrangement could compromise patient safety. Their central concern is that a one-year CCMP qualification does not provide the same depth of training in modern medicine as the academic and clinical education undertaken by MBBS graduates.

They say the difference in training could increase the risk of misdiagnosis, inappropriate treatment and drug-related complications.

“They do not have a constructive knowledge in that CCMP. It is a certificate course in modern pharmacology. It doesn't give a vast knowledge about the modern medicine. And based on that, if you are giving them the license to practice modern medicine, it is going to cause a damage,” Dr. Shinde said.

Shinde also raised concerns over accountability in cases of medical negligence, arguing that dual registration could create confusion over which regulatory body would be responsible for disciplinary action.

“And if a patient dies because of that, then how can we prove that from which drug the patient died? Was it homeopathy or was it allopathy? And what action will be taken on the practitioners? Whether the homeopathic council will take action or the modern medical council will take action. Because already they are having their registrations in homeopathic medical council,” he said.

Shinde further argued that allowing practitioners to hold registrations linked to two different systems of medicine could set a precedent for cross-practice elsewhere.

Another objection concerns the National Medical Commission (NMC). Dr. Chauhan argued that Maharashtra’s CCMP pathway conflicts with the national regulatory framework governing the practice of modern medicine, under which practitioners qualified in another system are generally not permitted to practise modern medicine.

“The problem is that they are doing this without even the NMC approval. How can this be? They are simply denying what the NMC says,” he said.

The Maharashtra government, however, maintains that its authority comes from the 2014 state amendments and that CCMP-qualified homoeopathic practitioners will only be permitted to practise modern medicine within the competencies covered by their additional training. Whether this state-created pathway is legally compatible with the wider national regulatory framework remains part of the dispute before the Bombay High Court.

What Are The Government’s Arguments?

The Maharashtra government introduced the CCMP framework, citing shortages of MBBS doctors in rural and remote parts of the state and the need to expand access to basic healthcare.

In March this year, Minister of State for Medical Education Madhuri Misal reiterated that argument, saying the decision was aimed at ensuring basic healthcare services remained available in underserved regions.

The government’s case is also that CCMP practitioners are not being treated as equivalent to MBBS doctors. Their right to practise modern medicine is supposed to remain restricted to what they have been trained to handle under the course, with a separate registration mechanism under the MMC.

However, Shinde told Outlook India that the shortage argument sits uneasily with another recent policy decision. Just days before the first MMC registration was issued, Maharashtra scrapped the mandatory one-year bond service for MBBS graduates, citing a growing pool of graduates and insufficient government postings.

“The (MBBS) seats which were there in 2014, now they are already doubled in 2026. And just because of that, the government of Maharashtra also cancelled the bond service, Since they do not have adequate posts to be filled. So, when the government is saying that we don't have posts and we have enough doctors now. Then what is the need of this CCMP course?” Shinde questioned.

Homoeopathic practitioner Dr. Rani Rajshree, however, said scrapping the bond system does not necessarily establish that rural Maharashtra no longer faces healthcare shortages.

“There is certainly a shortage of healthcare personnel and an uneven distribution of doctors in rural areas. Recruitment, rural postings, infrastructure and working conditions also matter,” Dr. Rajshree told Outlook India.

‘All Doctors Are Equal’

During the strike, Maharashtra Chief Minister Devendra Fadnavis focused primarily on ensuring that patient services were not disrupted.

“The protests should not be conducted in a manner that disrupts patient care. All doctors, regardless of the medical system they practice, are equal. Doctors serving in our medical colleges and hospitals are especially important to us. I would like to assure, government has no intention of treating them unfairly,” he said.

Dr Chauhan strongly rejected Fadnavis’ remarks, arguing that equality between professionals should not be confused with equivalence in qualifications, training or scope of practice.

“If all the doctors are equal then why do the politicians come here (to the allopathic doctors). Have you ever heard that if a politician is sick then he is admitted in homepathic hospital? No one has been admitted and no one will be,” he said.

The Legal Battle Continues

After the strikes were called off, Shinde said medical associations would continue to oppose the CCMP framework through legal channels.

The main challenge to Maharashtra’s 2014 amendments remains pending before the Bombay High Court. The court heard arguments in the matter on August 13 and 14, but has not yet delivered a final ruling.

The Bombay High Court has so far refused to impose an interim stay on CCMP registrations. However, it has made clear that the registrations remain subject to the final outcome of the case.

At the August 13 hearing, the Maharashtra government raised a preliminary objection to the IMA’s case. Advocate General Milind Sathe argued that the IMA, being a voluntary association, must first establish its locus standi — its legal right to challenge the legislation — and demonstrate what legal injury it has suffered.

The state has also argued that Maharashtra’s amended laws create a separate state-level registration mechanism and questioned why neither the statutory national medical regulator nor the NMC itself has challenged the provisions.

The Maharashtra government on August 18 put further CCMP registration and certification on hold pending the High Court’s decision.

Separately, the Bombay High Court’s suo motu proceedings concerning doctors’ strikes and their impact on patient care are scheduled for September 8.

The Way Ahead

Dr. Rajshree called for a “balanced” approach, arguing that the larger concern should remain the availability of safe and accessible healthcare in rural areas.

“A balanced approach would be to have a clearly defined scope of practice for CCMP practitioners, standardised training, prescribing limits, mandatory referral protocols and proper monitoring. At the same time, the government should improve the incentives and working conditions that encourage MBBS doctors to serve in rural areas,” she said.

Dr. Rajshree acknowledged that CCMP could help address an immediate gap, but said “it should not replace efforts to improve the recruitment and retention of MBBS doctors in rural areas. Ultimately, patient safety and access to quality healthcare should remain the priority.”

Dr. Chauhan, meanwhile, expressed concern that if the High Court’s eventual ruling does not favour the position taken by modern-medicine doctors, similar policies could emerge in other states.

For now, the dispute rests with the Bombay High Court. Its verdict will decide the fate of the CCMP policy.

“If the Honorable High Court gives a decision in their favor, we will respectfully accept it. Or it gives in our favor then they have to respectfully accept it,” Dr. Shinde concluded.