Doctors will soon get a template for treatment ... You may call it a prescription of sorts for doctors. The Union ministry of health and family welfare has begun drafting a set of standard treatment guidelines (STG) at the national level in an attempt to bring uniformity in medical care across the country. Among other crucial directives, it will tell doctors which drugs to prescribe and which not to for various diseases. And in a bold move, it will recommend that doctors follow a line of treatment that doesn't involve prescribing drugs when medication is unecessary. This intervention, even if it causes pharmaceutical firms and doctors more than a few moments of anxiety, will hopefully restore some order into a market that's marked by irrational combinations of drugs and paranoid pill-popping sustained by strategic marketing. About 25 per cent of drugs being sold in India are believed to be irrational and have a market value of around Rs 8,000 crore. The STG, on the contrary, seeks to assist medical practitioners in identifying the best and cheapest available line of treatment. Wrong drug choice, overdosing and needless prescribing of costly drugs will be dealt with. The guidelines will also offer a way out of 'polytherapy', where as many as six drugs are prescribed when none may be required. Like in acute viral gastroenteritis for which only oral rehydration therapy is effective, or common cold where steam inhalation suffices. The STG will also deal with other common problems such as incorrect drug choices, overdosing, underdosing, and the choice of more expensive drugs when less expensive ones are equally or more effective. While there have been varying treatment guidelines framed by certain states and other bodies, this is the first attempt to come up with a national guideline. The move, supported by WHO, comes after a similar exercise last November for certain medical conditions by the Armed Forces Medical College, Pune. Some of the 35 medical conditions that were covered included diabetes, cholera, schizophrenia, anaemia and dengue. "There is a real need at the national level for treatment not based on the perception and experience of individual doctors, but one that is codified and published in reputed journals," says Chandra M. Gulhati, editor of Monthly Index of Medical Specialities and one of those being consulted for the STG draft. It will also include references as resource material and cost of the treatment involved. This is because the primary interest of the ministry is to ascertain the cost of treatment by establishing a set of STG to help it with health budgeting. The Indian Medical Association (IMA) has reacted cautiously to this move. "We welcome the initiative as it will mean that doctors will not have to remember the entire range of medicines," says S.N. Misra, IMA's honorary secretary-general. "But this is something that has to done scientifically with guidelines that are practically usable. And IMA has to be part of such an exercise," he adds. The guidelines will also result in spin-off implications such as insurance-related decisions about what kind of monies to reimburse for a particular disease. More importantly, the STG will also help consumers avoid malpractice. "Presently, patients lose 80 per cent of the cases filed by them against doctors, not because they are wrong, but because of lack of evidence. These guidelines will serve as crucial proof of what ought to have been done in a particular case," says Gulhati. The compilation of the guidelines, likely to take over a year, will come as a sure stimulant for patient rights.