Defamation Letter to Dr. S.S.Agarwal and Dr.K.K. Aggarwal

Letter to Dr. S.S.Agarwal and Dr.K.K. Aggarwal for Defaming Physiotherapy Profession

March 30th  , 2016
To
1.Dr S.S Agarwal,IMA National President 
2. Dr K.K Aggarwal,IMA National Secretary

I have received the following E-mail forwarded to me  with the titled “ IMA White Paper: Physiotherapists Cannot Use the Prefix “Dr” dated 19th March,2016  authored by both of you.

I have also read the same contents in following links. 
http://www.ima-india.org/ima/left-side-bar.php?scid=476
http://blogs.kkaggarwal.com/2016/03/19/
http://onlinefamilyphysician.blogspot.in/

I find the article completely intended to tarnish and defame the Physiotherapists of India with false, fabricated and irrelevant documentations and logic  ad absurdum. Hence strongly condemn abusive, obnoxious , fraudulent and defaming statements against the Physiotherapists.

In following is our reply from The Indian Association of Physiotherapists( IAP)
You mention the following in Para 1 of your dubious article
The Rehabilitation Council of India Act, 1994 (hereinafter referred to as “RCI Act”) is enacted to provide for the constitution of the Rehabilitation Council of India for regulating the training of rehabilitation professions and the maintenance of a Central Rehabilitation Register and for matters connected therewith or incidental thereto. 

Our reply : As per records of Rehabilitation Council of India there is no such act  of Rehabilitation Council of India Act, 1994 quoted by both of You. There are only Two Acts of RCI of 1992 and amendment in 2000 ( Attached for your reference). Thus you are creating and quoting acts framed by your own which never existed which itself is offence according to IPC sections 463, 464,465, 466, 468,469 and 471. Herewith I challenge both of you to submit The Rehabilitation Council of India Act, 1994.

 You mention the following in Para 2 of your article
According to Section 2(i)(n)(xvii) of RCI Act, the term “physiotherapist” means a Rehabilitation professional. Thus, the physiotherapists in India are regulated by the provisions of RCI Act and its Rules and Regulations and not by any other Act or law in India.

Our reply : There is no such section 2(i)(n)(xvii) of RCI Act in both the RCI acts of 1992 and amended RCI act of 2000. The RCI clearly mentions 16 professionals included under them and mentions very clearly that professionals like Physiotherapists and Occupational Therapists are not covered under the RCI act. The following are the link.

http://www.rehabcouncil.nic.in/forms/list.aspx?id=41

I am also attaching the screen shot taken from the RCI site. Our inference is both of you are wrongly quoting the respected Rehabilitation Council of India for critical reasons known to both of you. I am sure RCI will definitely initiate required disciplinary proceedings against  both of you for wrongly quoting and involving RCI and trying to  threat  and spoiling reputation of respectable Physiotherapy professionals.

You mention the following in Para 3 of your dubious article
Section 13(2) of RCI Act mandates that no person other than a rehabilitation professional, who possesses a recognized rehabilitation qualification and is enrolled in the register shall practice as a rehabilitation professional anywhere in India. Thus for a physiotherapist to carry out his occupation as physiotherapist, it is mandatory that the physiotherapist should possess a recognised qualification as per the RCI Act and should also be registered as per the provisions of RCI Act  with the Rehabilitation Council of India, or else as per section 13(3) the said physiotherapist without registration with Rehabilitation Council of India shall be punished with imprisonment for a term which may extend to one year or with fine which may extend to Rs.1,000/- or with both.

Our reply : While RCI clearly mentions that Physiotherapists are not covered under RCI act in above you have again misquoted Section 13(2) and Section 13(3) of the RCI Act of 1992. Both of you also dare to declare punishment of imprisonment and a term of one year. I just want to ask are you truly representatives of 2.6 lakh members of your association IMA or you are Psychopaths trying to defame and intimidate Physiotherapy professionals qualifying from several reputed Universities of this great nation. You both misquote Govt Acts and declare punishments are you both in sound frame of mind, the act is really pathetic and punishable under various section of IPC 191, 192, 196, 415, 416, 418, 419 and 420. I am sure the courts will decide much more severe punishment for citing wrong Acts and against near to 60,000 qualified Physiotherapists.
 
In Para 4 you mention
Thus, the physiotherapists are rehabilitation professionals who are registered with the Rehabilitation Council of India.
 
Our reply : Again you give a fabricated and dubious statement in contrary to the RCI Act that Physiotherapists are to register under RTI in your statement.
 
Further you both have cited judgement of  Hon’ble Supreme Court of India  “Poonam Verma versus Ashwin Patel, CA No. 8856/1994 dated 10.05.1996.

The Hon’ble Supreme Court of India, in the matter titled as  has held that:“A person who does not have knowledge of a particular System of Medicine but practices in that System is a Quack and a mere pretender to medical knowledge or skill, or to put it differently, a Charlatan.”

Our Reply:  It seems both of you both have not gone through/understood  the contents of the judgement of the Hon’ble Supreme Court of India in case of Poonam Verma and Ashwini patel. The judgement was related to practice of Allopathic drugs by a person named Dr. Ashwin Patel qualified in DHMS (Diploma in Homoeopatnic Medicines and Surgery)  in 1983. Dr. Ashwin Patel prescribed Allopathic Medicines (cap. Ampicillin, Tab. Paracetamol, Tab. Diavol, Tab. Quintor, Tab. Ibuflamor,  injection Diclonac)   on Mr. Pramod Verma, a  35 year old patient and subsequently Mr. Pramod died on 14th July, 1992. The case was filed by Mrs.Poonam Verma  wife of diceased  and Honorable Supreme Court gave the verdict quoted by you by bench of Justice Ahmad saghir S. And Justice Kuldip Singh. 
 
Why you both have quoted the above Judgement in relation to Physiotherapy. Physiotherapists are practising the profession of Physiotherapy. What is the problem with both of you if a qualified Person of Physiotherapy is practising Physiotherapy profession?

As a law abiding citizen you must note that a Physiotherapist is not a quack. The word "quack" is an onomatopoeia used for the noise made by many ducks. In the Middle Ages the word quack meant "shouting". Quackery is a derogatory term used to describe the promotion of unproven or fraudulent medical practices. Random House Dictionary describes a "quack" as a "fraudulent or ignorant pretender to medical skill" or "a person who pretends, professionally or publicly, to have skill, knowledge, or qualifications he or she does not possess; a charlatan.
 
A Physiotherapist qualifies from U.G.C recognized University with U.G. C recognized qualification as specified on 11thNovember 2009 B.P.T specified at serial 55 ,MPT   specified at serial 104 and PhD mentioned at Serial No 110 ( Letter No: D.O.No.F.1-10/2004 Pt.(CPP-II) sent by Dr.Dev Swarup, Joint Secretary. There are 163 degrees recogised by U.G.C in total( Notification attached in this mail).

There is also a notification from U.G.C dated 30th June, 2010 Ref No: F-3-1/2009 stating the Teaching Requirement of Physiotherapy Colleges in section 4.4.4( document attached in mail).

According to your statements it looks that you have no respect for the highest authority for approving the degrees i.e University grants Commission. If someone is practising Physiotherapy after B.P.T/ M.P.T/ PhD what is your problem? If he/she will not practice Physiotherapy then what will they practice? For what reason you have this interference to someone's constitutional right to practice profession. It is clearly evident from your statements that you want to deliberately defame the Physiotherapy profession condemnant quod non intellegunt.
 
The sovereign constitution of India according to Article 19 provides freedom to practice any profession at any part of India. It is equally evident that you have questioned the constitutional right as a citizen of this great nation. I am remembered of Gurudev Rabindranath Tagore's statement that " Where the mind is without fear and the head is held high,into that heaven of freedom, my father, let my country awake". You being in noble healthcare profession trying to unnecessary intimidate fellow healthcare professionals is against the spirit of my Republic of India. Your statement is also "au contraire" to the one in Hippocratic Oath, Geneva Declaration of World Medical Association( Amended uptil 2006).

You both with mischief known to you  believe that by quoting judgements improperly you will scare fellow health care professionals or you both assume you are street smarts trying to quote something else to make physiotherapists scare. I strongly warn you both and individuals of your mindset to refrain interfering with our fundamental rights to practice our noble Physiotherapy Profession as guaranteed by Article 19 and 21 of Indian Constitution. Highly condemnable act by both of you being the current President and Secretary of Indian Medical Association. Really Shameful and unpardonable act by both of you. 

You both have mentioned in your article that
 The Hon’ble Supreme Court in the matter titled as “Dr. Mukhtiar Chand versus The State of Punjab, 1998 (7) SCC 579,” has held that:
“Section 15(2)(b) of the 1956 Act prohibit all persons from practising modern scientific medicine in all its branches in any State except a medial practitioner enrolled on a State Medical Register.

Our Reply: Again you have cited the judgements related to practice of Allopathic medicine not related to Physiotherapy practice. Do note that the Physiotherapists practice  the Physiotherapeutic method of treatment.

We live in era of evidence based medicine. As per Pubmed there are 2,92,263 research articles with search Physical Therapy and 1,39,211 research articles with search Physiotherapy proving the efficiency of Physiotherapy as a method of treatment for various mechanical problems, Neurological Conditions, Sports Injuries, Musculoskeletal problems , Pediatric conditions, Geriatric conditions and   Cardiorespiratory Conditions. You may take the following links for the Pubmed.

http://www.ncbi.nlm.nih.gov/pmc/?term=Physical+Therapy
http://www.ncbi.nlm.nih.gov/pmc/?term=Physiotherapy
 
You both have mentioned in the last second paragraph that
Thus, the physiotherapist by claiming to be a medical consultant among the general public by prefixing the word “Dr” with their name and by running a pain and rehabilitation clinic without sufficient registration, are committing the offence of cheating the general public by faking certificate of an Association to be that of a statutory body. Also, the said persons have also committed an offence under section 336, 417, 418, 419, 425, 469 read with section 471 of Indian Penal Code. The act of the physiotherapists by running a pain and rehabilitation clinic and treating patients on their own without medical supervision and the required registration with the respective councils is dangerous to the life of the general public.

Our Reply: Both of you have habit of writing abusive, obnoxious , fraudulent and defaming statements against the Physiotherapists. We take a very strong objection to your above statements. Just  explain why a Physiotherapists can’t run a Pain and Rehabilitation Clinic using Physiotherapy modalities like Exercises, Manipulation, Short Wave Diathermy, Traction, TENS, Ultrasound, LASER, Shock Wave Therapy and many others. In following I give the reference of the Model Curriculum Handbook for Physiotherapists available in the website of Ministry of Health and Family Welfare, Govt of India. Following is the link.

http://www.mohfw.nic.in/WriteReadData/c08032016/Model_Curriculum_Handbook_Physio.pdf

The following is mentioned in Page No.25 of the Physiotherapy Curriculum

About Physiotherapy
Physiotherapists are health care professionals with a significant role in health promotion and treatment of injury and diseases. They combine their in-depth knowledge of the body and how it works with specialized hands-on clinical skills to assess, diagnose and treat symptoms of illness, injury or disability.

Scope of practice
Physiotherapists plan and administer physiotherapy/ rehabilitation treatments independently and also being a part of the multidisciplinary team. The minimum education requirement is often a baccalaureate degree or postgraduate degrees in Physiotherapy.
 
Chapter 3: Background of the profession  Page 25.
Statement of Philosophy– Why this profession holds so much importance

Physiotherapy practice spans the continuum from health promotion to prevention to rehabilitation for individuals and populations throughout the lifespan. Physiotherapy diagnoses movement dysfunctions based on skillful examination and evaluation regardless of the cause or etiology and provide skilled therapeutic intervention to foster improvement in physical functioning and maximizing overall quality of life. Physiotherapists provide the initial access into the health care system for persons with impairments and functional limitations amenable to physiotherapy and engage in collegial referral relationships with other health care professionals.
 
Physiotherapy is an essential part of the health and community/welfare services delivery system. Physiotherapists practice independently of other health care/service providers and also within multidisciplinary rehabilitation/habilitation programmes to prevent, gain, maintain or restore optimal function and quality of life in individuals with loss and disorders of movement.

The World Health Organisation, International Labour Organisation, The Delhi Council for the Physiotherapy & Occupational Therapy Act, 1997 (Delhi Act No.7 of 1997) , Maharashtra State Council for Occupational & Physiotherapy Act, 2002(Mah.II of 2004) and Gujarat State Council for Physiotherapy Act (Act 18, 2011) in the definition clearly defines the independent nature of Physiotherapy practice. 
 
Definition of Physiotherapy by WHO ( ISCO Code 2264) 
Physiotherapists assess, plan and implement rehabilitative programs that improve or restore human motor functions, maximize movement ability, relieve pain syndromes, and treat or prevent physical challenges associated with injuries, diseases and other impairments. They apply a broad range of physical therapies and techniques such as movement, ultrasound, heating, laser and other techniques. They may develop and implement programmes for screening and prevention of common physical ailments and disorders.    
 
The Delhi Council for the Physiotherapy & Occupational Therapy Act, 1997 (Delhi Act No.7 of 1997).
“Physiotherapy” means physiotherapeutic system of medicine which includes examination, treatment, advice and instructions to any person preparatory to or for the purpose of or in connection with movement dysfunction, bodily malfunction, physical disorder, disability, healing and pain from trauma and disease, physical and mental conditions using physical agents including exercise, mobilization, manipulation, mechanical and electrotherapy, activity and devices for diagnosis, treatment and prevention.
 
Maharashtra State Council for Occupational & Physiotherapy Act, 2002(Mah.II of 2004)
“Physiotherapy” means a branch of modern medical science, which includes examination, assessment, interpretation, physical diagnosis, planning and execution of treatment and advice to any person for the purpose of preventing, correcting, alleviating and limiting dysfunction, acute and chronic bodily malfunction including life saving measures via chest Physiotherapy in the intensive care units, curing physical disorders or disability promoting physical  fitness, facilitating healing and pain relief and treatment of physical and psycho-somatic disorders through modulating physiological and physical response using physical agent, activities and devices using exercises, mobilization, manipulations, therapeutic ultra-sound, electrical and thermal agents and electrotherapy for diagnosis, treatment and prevention.
 
Gujarat State Council for Physiotherapy Act (Act 18, 2011) Gujarat State Govt Gazette Extraordinary Thursday April 28th, 2011
 
"Physiotherapy" means a branch of modern medical science which includes examination, assessment, interpretation, physical diagnosis, planning and execution of treatment and advice to any person for the purpose of preventing, correcting, alleviating and limiting dysfunction. acute and chronic bodily malfunction, including life saving measures via chest physiotherapy in the
intensive care units, curing physical disorders or disability, promoting physical fitness, facilitating healing and pain relief and treatment of physical and psychosomatic disorder through modulating physiological and physical response using exercises, physical agents, activities and devices including mobilization, manipulations, mechanical, electrical, and thermal agents, including therapeutic ultrasound and therapeutic LASER, and electrotherapy including electrophysiology for diagnosis, treatment and prevention.
 
Do take the following link to see the Message of the present Prime Minister Shri. Narendra Modi ji ( Gujarat CM then in 2011) in his twitter account on April 7th, 2011 on formation of Gujarat Physiotherapy Council. His posting “Gujarat forms Physiotherapy council. It will give Physiotherapy its due professional status in the Medical Fraternity”.
 
https://twitter.com/narendramodi/status/55932219662929920

Your statement that the Physiotherapist can practice only with medical supervision is a false and fabricated statement with sole intention to misguide public at large, hence defaming the noble Physiotherapy profession.  
 
Without a Physiotherapists certification in any elite sports the player can’t play. It applies to  Mahendra Singh Dhoni and also to the player in form Virat Kohli. Do You mean to state that ICC, BCCI and other sports agencies are doing unethical practice?
 
Thus your statement “The act of the physiotherapists by running a pain and rehabilitation clinic and treating patients on their own without medical supervision and the required registration with the respective councils is dangerous to the life of the general public” mentioned in last second paragraph of your article contradicts the documentary statements and evidences of World Health Organisation (WHO), International Labour Organisation, Ministry of Health and Family Welfare, Govt of India, Delhi Council of Physiotherapy and Occupational Therapy, Maharashtra Council of Occupational Therapy and Physiotherapy and Gujarat State Council of Physiotherapy.   
 
You both have mentioned in the last paragraph that
In view of the above discussions, it is opined that the physiotherapists are not allowed to portray themselves as registered medical practitioners by prefixing the word “Dr” with their name. If any physiotherapist prefixes the word “Dr” with his/her name, then he/she shall be treated as quack as mentioned by the Hon’ble Supreme Court and all laws as applicable on any quack shall be also applicable on said physiotherapists who is prefixing “Dr.” with the name and who is portraying as the medical practitioner/medical consultant.

Our Reply:

The Hon’ble Supreme Court of India on 10 March, 1995 , SC 2348 observed the following in case “In Re: Vinay Chandra Mishra (The ... vs Unknown on 10 March, 1995 )

The judiciary is not only the guardian of the rule of law and third pillar but in fact the central pillar of a democratic State. If the judiciary is to perform its duties and functions effectively and true to the spirit with which they are sacredly entrusted to it, the dignity and authority of the courts have to be respected and protected at all costs. Otherwise the very corner-stone of our constitutional scheme will give way and with it will disappear the rule of law and the civilized life in the society. It is for this purpose that the courts are entrusted with extraordinary powers of punishing those who indulge in acts, whether inside or outside the courts, which tend to undermine the authority of law and bring it in disrepute and disrespect by scandalizing it.

Related to the Prefix " Dr" by Physiotherapists.
 
Let me mention here that in India the use of word Doctor is a matter of convention and tradition ( MCI Letter dated 24/08/1993 attached).
 
The word Doctor (gen.: doctoris) means teacher in Latin. The word is originally an agentive noun of the verb docēre ('teach'). So it has nothing to do with any treatment etymologically. Even father of medicine name is mentioned as " Hippocrates and nowhere as Dr. Hippocrates".  
 
You both seem to be paranoid and obsessed with the prefix of Dr. Without knowing the exact etymology. Have you ever reflected of Dr. Bhimrao Ramji Ambedkar, Dr. Manmohan Singh, Dr. Sarvepalli Radhakrishnan and Dr. C. V. Raman. I believe with your belligerent attitude you will serve notice to them also mentioning some white paper.
 
You need to clearly understand the difference between “Doctor” and “Doctorate”. As per oxford dictionary and other standard International Dictionaries the title “Dr” is addressed for “Doctorate” only. Academic attainments of higher order i.e., PhD, D.Lit, L.L.D. or D.Sc. has the sanction to use the prefix ‘Dr.’ Only those who have done PhD and Doctorate in medicine or Surgery and or any other subject (need not be Medicine) are allowed to prefix “Dr”.
 
As per my RTI to U.G.C, MCI and Ministry of Health and reply there is no definition for the word “Doctor”.
 
The general body of IAP in 1984 (Lucknow Conference) had resolved that their members may prefix ’Dr’ with their names and suffix (Physiotherapist) or (PT) to denote their profession so as not to cause confusion with entity of physician, surgeon or dentist. If the rules are strictly followed even “MBBS” and “BDS” under graduates do not have rights to prefix “Dr”. This title is not awarded by the University nor their Council( Certificates of MBBS attached of Pune University and NTR University). As per communication with FRCS, Edinburgh the British Surgeons prefix Mr. to their names and not doctor( Document attached). The Britishers commenced the modern medicine in India and we follow the British system.  
 
It is a conventional practice in India that any professional who treats is addressed as Dr. The word Physiotherapy ( Physio means Physical methods; Therapy( Gk) means To treat. Going by definition as clearly mentioned about treatment the Physiotherapists use "Dr" and will continue to use " Dr" as a matter of tradition applicable for MBBS, BDS, BAMS, BHMS , Siddha, Naturopaths, Unani etc. Out of all The Indian Association of Physiotherapists(IAP) has made a rule that every Physio must prefix "Dr" suffixed with PT.  On March 28th, 2010 a Public Notice in Leading newspapers was published by Dr. Sanjiv Kumar Jha, General Secy, IAP related to the prefix of Dr. by Physios( attached). At this juncture I  would like to point out here that the State legislations “Maharashtra State, Delhi State Legislations and Gujarat State has defined Physiotherapy as “System of Medicine”. Hence it has become the practice for Physiotherapists also to follow the privilege of addressing or Prefixing “Dr” like other System of Medicine” practitioners. The Govt approved Maharashtra OT/PT council registration certificate prefixes Dr. For Physiotherapists registering in council.

The fundamental duties as per article 51A of Indian Constitution of any citizen as per our constitution is to obligate all Indians to promote the spirit of common brotherhood, protect the environment and public property, develop scientific temper, abjure violence, and strive towards excellence in all spheres of life. There is reference to such duties in international instruments such as the Universal Declaration of Human Rights and International Covenant on Civil and Political Rights.
 
Herewith in your  ex dolo malo article titled “ IMA White Paper: Physiotherapists Cannot Use the Prefix “Dr” you have challenged the documents and wisdom of Rehabilitation Council of India (RCI),  University Grants Commission(U.G.C), Ministry of Health and Family Welfare, Govt of India and Honorable Supreme Court of India.
 
Hence keeping all the legal aspects discussed elaborately we want you to extend an unconditional apology to Physiotherapy fraternity within 10 days of this open letter E-mailed to both of you. You both must publicly apologise in Electronic Media, Print media and in IMA site to Physiotherapy fraternity for intending to defame the Profession. We warn you to refrain yourself  further making such derogatory statements about Physiotherapy profession. Suo Jure we will initiate Civil and Criminal legal proceedings against you at your own cost for defaming Physiotherapy profession.

Prof.(Dr.)Umasankar Mohanty,
BPT,MPT(Manual Therapy), PhD,S.R.P(U.K),MIAP, MISEP,FAGE
President, The Indian Association of Physiotherapists (2014-2017)

E-Mail:umasankar_mohanty@yahoo.co.in
Web:www.mtfi.net, www.physiotherapyindia.org
Mob:00-91-9448104132, 00-91-9448696414
Ph:00-91-824-4254132