Choosing a practitioner: what to look for and what to ask

The quality of Ayurvedic care varies enormously, and in many countries there is no legal barrier to describing yourself as an Ayurvedic practitioner.

This article sets out what to check.

Qualifications

In India, the recognised qualification is the BAMS — Bachelor of Ayurvedic Medicine and Surgery — a degree of five and a half years including a compulsory internship, followed by registration with a state or national council. Postgraduate qualifications exist in specialties.

Practitioners with this background have studied anatomy, physiology, pathology and modern diagnostics alongside classical texts, and they are trained to recognise conditions requiring conventional referral.

Outside India, the picture varies. Some countries have registration schemes for practitioners of traditional medicine; many have none. Training programmes range from multi-year courses to short certificates.

A weekend course does not qualify anyone to give clinical advice, and there is no shortage of people with such training practising.

The questions worth asking

What is your training, and where? Duration, institution, and whether it included clinical training with supervised patient contact.

Are you registered with anything? With whom, and does it have a complaints procedure and require indemnity insurance?

Do you carry professional indemnity insurance? A practitioner without it is a practitioner you have no recourse against.

How do you decide when to refer to a doctor? This is the most informative question. A well-trained practitioner will answer it readily and will describe specific circumstances. Someone who suggests referral is rarely necessary has told you something important.

What will you prescribe, and can I see the full ingredient list? You are entitled to know exactly what you are taking. A practitioner who will not tell you should not be treating you.

Are your preparations tested for heavy metals? A serious practitioner will know where their preparations come from and whether they are tested.

Do you use rasa shastra preparations? If yes, whether they monitor blood levels. Our position on these is set out elsewhere on this site.

The warning signs

Advising you to stop prescribed medication. The clearest one. No competent practitioner adjusts another clinician's prescription without involving them. If this happens, leave, and speak to your doctor.

Discouraging you from seeing a doctor, or from investigating a symptom.

Discouraging you from telling your doctor what you are taking.

Claiming to treat serious disease. Claims to cure cancer, reverse diabetes without medical involvement, treat autoimmune disease definitively, or manage serious mental illness alone.

Not taking a medical history. A practitioner who does not ask about your conditions, medications, allergies and pregnancy status is not practising safely.

Diagnosis by pulse alone, presented as detecting specific diseases. Pulse examination is part of traditional assessment; it does not diagnose conditions that require investigation, and claims that it does are not supportable.

Selling large quantities of their own products, particularly expensive packages purchased in advance.

Pressure and urgency, particularly around large payments.

Refusal to provide written information about what you are taking.

The good signs

Takes a full history including medications, conditions and allergies.

Asks whether you are under medical care and offers to communicate with your doctor.

Explains what they are recommending and why, in terms you understand, and is clear about which parts are traditional practice and which have evidence.

Gives you a written list of what you are taking.

Refers when appropriate, and can describe when they would.

Is comfortable saying they do not know, or that a condition is outside their scope.

Does not object to you telling your doctor.

Retreats and residential programmes

A specific caution, because these are heavily marketed and vary enormously.

Some are run by qualified clinicians with proper assessment and medical oversight. Some are wellness businesses with therapists rather than practitioners.

Ask specifically: who conducts the initial assessment and what are their qualifications, what procedures are involved, what happens if someone becomes unwell, and how far the nearest hospital is.

Procedures involving emesis, purgation, enemas or fasting are medical procedures. Undergoing them somewhere without medical oversight, in an unfamiliar country, is a risk worth weighing.

What to do about your own care

Tell your doctor you are seeing an Ayurvedic practitioner and what you are taking. Most doctors are not hostile to this and want the information for interaction reasons.

Keep taking prescribed medication.

Keep attending monitoring appointments.

Get new symptoms investigated conventionally.

And if something feels wrong about a practitioner, that instinct is worth acting on. There are good practitioners and you are not obliged to stay with one you doubt.

Never stop prescribed medication on a practitioner's advice without speaking to the prescriber. Report concerns about a practitioner to the relevant registration body where one exists.