INDIA

Medical Impersonation And The Appearance Of Legitimacy – Analysis

April 18, 2026 
Observer Research Foundation
By K.S. Uplabdh Gopal


India’s quackery problem is unusually hard to describe with precision because the state does not seem to maintain a usable national count of such unqualified medical providers. It does not appear to be able to say, with confidence, how many such practitioners it is dealing with, where they are concentrated, or what mechanism is being used to identify them systematically. In a 2018 Lok Sabha question on fake doctors and quacks, members asked for the mechanism used to identify them, the number identified across states over time, why that was happening, and what steps were being taken. The answer dealt with a specific disease incident in Uttar Pradesh, but for parts (b) to (e) of the question, it fell back on a generic statement that section 15 of the erstwhile Indian Medical Council Act 1956 prohibited unregistered practice and that health is a State subject. A late 2025 Lok Sabha reply was even more direct. Complaints, it stated, are forwarded to the relevant State or Union Territory, while details of such complaints and subsequent action are not maintained centrally.

In this vacuum sit two numbers that are cited constantly but are not equally sturdy. The first is the controversial World Health Organisation (WHO)-cited figure stating that 57.3 percent of allopathic practitioners in India do not have a medical qualification. The underlying WHO publication, The Health Workforce in India, was based on specially extracted district-level data from the 2001 Census, not on a live registry of current practitioners, and the government later dismissed the claim as “erroneous” on the ground that all registered doctors necessarily hold recognised qualifications. The second number is the Indian Medical Association (IMA) estimate that about 10 lakh quacks practise allopathic medicine, including 4 lakh practitioners of Indian medicine, although this figure appears on an advocacy page of IMA’s anti-quackery wing without any visible methodological note or source explanation. It is therefore an important institutional claim, but not a transparent prevalence estimate.

The NCRB’s 2023 ‘Crime in India’ report does not provide a public-facing national line-item for quackery or medical impersonation from which a reliable national count can be discerned. In the state of Delhi, a Right-to-Information (RTI)-based report found that only one case was registered against a quack doctor in 2025, none was forwarded in 2024, and the Delhi Medical Council (DMC) stated that it does not conduct anti-quackery raids or inspections, leaving action to district-level health officers. A Comptroller and Auditor General (CAG) audit of Delhi’s health regulatory mechanisms found that, out of 928 complaints received between February 2017 and January 2022, no survey or inspection was carried out in 14 cases despite delays ranging from 126 to 2,289 days, and that between 2016 and September 2022, police registered First Information Reports (FIRs) against only 40 of 335 persons found practising medicine without the required qualifications; the audit also noted that the DMC did not actively pursue cases where police action was not initiated.

The combination of uncertain prevalence and thin enforcement leaves India facing a more difficult policy question. If unqualified practitioners continue to occupy the space between legal medicine and available medicine, should the state continue with its current approach, or enter into a more Faustian accommodation by absorbing parts of this informal workforce into a tightly limited system of training, supervision, and referral? This issue was raised a decade ago in the British Medical Journal (BMJ), asking whether India’s quacks might be trained to deliver safer basic care, and China’s barefoot doctor system in the 1960s and 1970s shows that states have, in other settings, tried to convert informal rural healing labour into a supervised lower-tier workforce rather than leave it entirely outside the system.

Access Gaps and the Demand for Informal Care

The debate over quackery persists because it reflects a real gap in access. In many parts of rural India, patients turn first to the provider who is available nearby and willing to act, rather than the one who is formally qualified. A study published in 2022 using evidence from 2009 for 1,519 villages across 19 states found that most providers in rural primary-care markets were private, and that informal providers accounted for 68 percent of the total provider population; a 2016 BMJ feature framed the issue by asking whether some form of training for these practitioners in basic care might be better than leaving them wholly outside the regulatory framework. The responses to that piece laid out the central divide. One position holds that training quacks would formalise a lower standard of care for poorer patients, devalue medical training, and allow the state to postpone the harder tasks of rural deployment, doctor retention, and functioning primary care. The competing position holds that, where informal providers already serve as the de facto first point of contact, bounded training, referral protocols, and supervision may reduce harm more effectively than denunciation alone.


The argument becomes more complicated once attention shifts to the appearance of legitimacy. Medical authority is often inferred from visible cues by patients, long before it is verified through registration or specialist records. The white coat, framed certificates, specialist titles, clinic boards, hospital affiliations, medical jargon, the prefix “Dr.”, social media reels, and before-and-after images all operate as signals that a lay patient may reasonably read as proof of competence. A 2025 editorial described quackery in dermatology as extending to both people without formal medical training and professionals acting beyond the scope of their expertise, and it identified short certification courses, unregulated aesthetic procedures, and false claims on social media as key drivers of the problem. Recent reporting from Maharashtra shows the same pattern in operational form, with regulators and professional bodies warning that unqualified and unregistered individuals increasingly present themselves as ‘skin specialists’, ‘trichologists’, or ‘aesthetic physicians’, while offering lasers, fillers, botulinum toxin, hair transplants, and chemical peels in ways that the public cannot easily interpret.

Reducing the Room for Impersonation

The policy response has to address various linked problems at once. The state still lacks a clear picture of the scale and distribution of medical impersonation or quackery, and formal care remains uneven enough that unqualified practitioners continue to find room in the market. The first recommendation is long overdue. The Union government should work with states to build a shared picture of the problem before promising to solve it. That means a standard reporting architecture for complaints, FIRs, prosecutions, and case outcomes, ideally disaggregated by district and by type of impersonation or unlawful practice. A joint Centre-state dashboard would not solve quackery by itself, but it should give policy something firmer to work with.


The second task should be to shift the patient-facing front end of practice from trust by appearance to trust by verification. Maharashtra’s Know Your Doctor (KYD) platform is one of the more useful recent attempts to do this. Its February 2025 notification asked registered practitioners to display a QR code-based KYD card at their practice locations so that patients could instantly view verified information on authenticity, credentials, and speciality. The broader principle is sound and could be taken further. Indian regulations already require registered businesses to display their Goods and Services Tax (GST) registration certificateprominently and GST Identification Number (GSTIN) on the name board at the entrance of the establishment. A similar rule for modern medical practice should be administratively feasible. Clinics and hospitals could be required to display the practitioner’s registration number, council, qualification, and a scannable verification code at the entrance, on prescriptions, and on digital appointment pages. The limitations are also clear. Such a system only works if the underlying records are current. The National Medical Commission’s (NMC) Indian Medical Register notes that its published data is being updated and, on the page currently visible, only reflects State Medical Council data up to 2021, with some state gaps.

A third reform is needed in the digital and institutional spaces. The NMC’s 2023 Professional Conduct Regulations expressly contemplate guidelines on advertising and social media conduct for registered medical practitioners. Those provisions should now be operationalised in a far more specific way. Any paid or public-facing digital promotion for clinical services should carry standardised disclosures of degree, recognised speciality, council, registration number, and active registration status, in a format that is difficult to obscure or stylise away.

The fourth priority is for hospitals, platforms, and employers. Hospitals, telemedicine platforms, and contractor agencies should be required to run direct verification against council records before onboarding practitioners and at fixed intervals thereafter. Over time, India could build a more integrated digital verification layer for medical education and registration, drawing on the broader direction of travel in higher education, where digital credential frameworks such as the Academic Bank of Credits already exist.

None of this reduces the importance of expanding access through the formal system. The government’s recent increase in 48,563 MBBS seats and 29,080 postgraduate seats between academic years 2020–21 and 2025–26, along with approval of another 10,023 seats under centrally sponsored schemes, points in the right direction. This momentum now needs to be joined with deployment, retention, verification, and a stronger public culture of confidence in evidence-based medicine. If those pieces begin to move together, the country may finally narrow the space in which quackery survives by being available when the formal system is not.

About the author: K.S. Uplabdh Gopal is an Associate Fellow with the Health Initiative at the Observer Research Foundation.

Source: This article was published by the Observer Research Foundation.
ORF was established on 5 September 1990 as a private, not for profit, ’think tank’ to influence public policy formulation. The Foundation brought together, for the first time, leading Indian economists and policymakers to present An Agenda for Economic Reforms in India. The idea was to help develop a consensus in favour of economic reforms.