NEW DELHI: In a U-turn, the Centre has issued a directive to physiotherapists in the country not to use the prefix ‘Dr'.
The change in stance came after a strong protest from the Indian Medical Association (IMA), which has over 4 lakh medical practitioners as its members, and other medical bodies and organisations.
Interestingly, the letter by the Directorate General of Health Services (DGHS), under the Union Health Ministry, was issued on September 9, a day after World Physiotherapy Day was celebrated globally.
Prime Minister Narendra Modi also posted on X recognising the work of physiotherapists, stating that they play a vital role in enhancing the well-being and dignity of people, particularly the elderly.
Physiotherapists were given the go-ahead to use the prefix 'Dr' after the National Commission for Allied and Healthcare Professions (NCAHP) under the Ministry of Health and Family Welfare published its approved curriculum for them on April 23.
In the letter by the DGHS, Dr Sunita Sharma said by using the ‘Dr’ prefix, physiotherapists will be in legal violation of the Indian Medical Degrees Act, 1916.
She, however, suggested that a more appropriate and respectful title may be considered for graduates and postgraduates of physiotherapy, without causing ambiguity to patients or the public.
Dr Dilip Bhanushali, National President, IMA, told TNIE that it is a “big victory” as not everyone can use the prefix ‘Dr’.
Dr Bhanushali, who had written a letter to Union Health Minister JP Nadda, Secretary Health, Punya Salila Srivastava, National Medical Commission (NMC), and others, flagging the issue, said the prefix ‘Dr’ could be misleading for the public and its use should be restricted.
In the letter, which was addressed to Dr Bhanushali, the DGHS said the directorate has received several representations and strong objections from various organisations, including the Indian Association of Physical Medicine and Rehabilitation (IAPMR), regarding the use of the prefix "Dr" and suffix "PT" by physiotherapists.
She said the IAPMR has informed that the issue arises from the Competency Based Curriculum for Physiotherapy Approved Syllabus 2025 published by the National Commission for Allied and Healthcare Professions under the Ministry of Health and Family Welfare on March 23.
In her letter, she listed the points of concern, stating that physiotherapists are not trained as medical doctors and, therefore, should not use the prefix "Dr" as it misleads patients and the general public, potentially leading to quackery.
“Physiotherapists should not be permitted primary care practice and should only treat referred patients, as they are not trained to diagnose medical conditions-some of which may worsen with inappropriate physiotherapy intervention,” the letter added.
"In this regard, it is stated that the above recommendation is contrary to legal pronouncements and advisory orders issued by various courts and medical councils in the country," Dr Sharma said.
She cited several court rulings in this regard, including a 2003 judgment of the Patna High Court that held that unless physiotherapists are enrolled in the State Medical Register, they cannot practise modern medicine or use the prefix "Dr". Also, a Tamil Nadu Medical Council Advisory has also warned physiotherapists against using the prefix "Dr," terming them paramedics or technicians.
A Bengaluru court ruling of 2020 prohibited physiotherapists or occupational therapists from using the prefix "Dr" and emphasised that they must work under physician supervision.
The Madras High Court upheld the prohibition on physiotherapists using the prefix "Dr," reiterating that they are not recognised as "doctors" under the IMC Act.
It is pertinent to mention that the Ethics Committee of the Council Bill, 2007 had earlier decided that the title "Doctor" may only be used by registered practitioners of Modern Medicine, Ayurveda, Homoeopathy and Unani, she added.
No other category of medical professionals, including nursing and paramedical staff, is allowed to use the title, the letter added.
The general body had also obtained a legal opinion, which stated that any physiotherapist using the title "Doctor," without holding a recognised medical qualification, would be violating provisions of the Indian Medical Degrees Act, 1916. Such a violation attracts action under section 7 of the Act for the contravention of sections 6 and 6A, the letter added.
"This legal opinion was adopted by the council at its meeting held on March 23, 2004. Accordingly, the ethics committee of the council reiterated that persons with qualifications in physiotherapy are not entitled to use the prefix "Dr" under any circumstances whatsoever," the letter said.
"It is hereby directed that the usage of the prefix 'Dr' for physiotherapists in the Competency Based Curriculum for Physiotherapy Approved Syllabus 2025 be removed forthwith," the letter added.