IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v62y2006i3p731-744.html
   My bibliography  Save this article

Uncharted ground: Patterns of professional interaction among complementary/alternative and biomedical practitioners in integrative health care settings

Author

Listed:
  • Hollenberg, Daniel

Abstract

The development of "integrative health care" (IHC) settings combining various aspects of Western biomedicine and complementary/alternative medicine (CAM) is a relatively recent phenomenon among biomedical and CAM professions. While IHC is recognised internationally and occurs in many different contexts (e.g. clinic or hospital), patterns of interaction between biomedical and CAM practitioners, and the nature of IHC settings, are largely unknown. This paper presents findings from a research study of two newly established IHC settings in Canada. The main research question was: how are biomedical and CAM practitioners integrating or not integrating with each other at the level of professional interaction in IHC settings? Using a case study design, in-depth interviews were conducted with 13 biomedical and eight CAM practitioners during 2002-2003, and ethnographic observation and document analysis was conducted at each site. Drawing from closure theory of the professions, comparative analysis of the sites revealed that biomedical practitioners enact patterns of exclusionary and demarcationary closure, in addition to the use of "esoteric knowledge", by: (a) dominating patient charting, referrals and diagnostic tests; (b) regulating CAM practitioners to a specific "sphere of competence"; (c) appropriating certain CAM techniques from less powerful CAM professions; and (d) using biomedical language as the primary mode of communication. CAM practitioners, in turn, perform usurpationary closure strategies, by: (a) employing their own "esoteric knowledge" in relation to biomedicine and other CAM professions; (b) appropriating biomedical language and terminology; (c) increasing their professional status by working with biomedicine; and (d) referring among CAM practitioners to increase patient flow. The findings suggest that when attempts are made to integrate biomedicine and CAM, dominant biomedical patterns of professional interaction continue to exist. Despite continued patterns of social closure, biomedical and CAM practitioners continue to provide a certain form of integrative care that may be of benefit to patients, albeit not as integrative as current models of integration would prefer.

Suggested Citation

  • Hollenberg, Daniel, 2006. "Uncharted ground: Patterns of professional interaction among complementary/alternative and biomedical practitioners in integrative health care settings," Social Science & Medicine, Elsevier, vol. 62(3), pages 731-744, February.
  • Handle: RePEc:eee:socmed:v:62:y:2006:i:3:p:731-744
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277-9536(05)00315-1
    Download Restriction: Full text for ScienceDirect subscribers only
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Shuval, Judith T. & Mizrachi, Nissim & Smetannikov, Emma, 2002. "Entering the well-guarded fortress: alternative practitioners in hospital settings," Social Science & Medicine, Elsevier, vol. 55(10), pages 1745-1755, November.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. van der Sijpt, Erica, 2010. "Marginal matters: Pregnancy loss as a social event," Social Science & Medicine, Elsevier, vol. 71(10), pages 1773-1779, November.
    2. Hök, Johanna & Wachtler, Caroline & Falkenberg, Torkel & Tishelman, Carol, 2007. "Using narrative analysis to understand the combined use of complementary therapies and bio-medically oriented health care," Social Science & Medicine, Elsevier, vol. 65(8), pages 1642-1653, October.
    3. Josyula, K. Lakshmi & Sheikh, Kabir & Nambiar, Devaki & Narayan, Venkatesh V. & Sathyanarayana, T.N. & Porter, John D.H., 2016. "“Getting the water-carrier to light the lamps”: Discrepant role perceptions of traditional, complementary, and alternative medical practitioners in government health facilities in India," Social Science & Medicine, Elsevier, vol. 166(C), pages 214-222.
    4. Keshet, Yael & Simchai, Dalit, 2014. "The ‘gender puzzle’ of alternative medicine and holistic spirituality: A literature review," Social Science & Medicine, Elsevier, vol. 113(C), pages 77-86.
    5. Gaboury, Isabelle & Bujold, Mathieu & Boon, Heather & Moher, David, 2009. "Interprofessional collaboration within Canadian integrative healthcare clinics: Key components," Social Science & Medicine, Elsevier, vol. 69(5), pages 707-715, September.
    6. Patel, Gupteswar & Brosnan, Caragh & Taylor, Ann & Garimella, Surekha, 2021. "The dynamics of TCAM integration in the Indian public health system: Medical dominance, countervailing power and co-optation," Social Science & Medicine, Elsevier, vol. 286(C).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Ben-Arye, Eran & Karkabi, Khaled & Karkabi, Sonia & Keshet, Yael & Haddad, Maria & Frenkel, Moshe, 2009. "Attitudes of Arab and Jewish patients toward integration of complementary medicine in primary care clinics in Israel: A cross-cultural study," Social Science & Medicine, Elsevier, vol. 68(1), pages 177-182, January.
    2. Hsiao, An-Fu & Ryan, Gery W. & Hays, Ronald D. & Coulter, Ian D. & Andersen, Ronald M. & Wenger, Neil S., 2006. "Variations in provider conceptions of integrative medicine," Social Science & Medicine, Elsevier, vol. 62(12), pages 2973-2987, June.
    3. Patel, Gupteswar & Brosnan, Caragh & Taylor, Ann & Garimella, Surekha, 2021. "The dynamics of TCAM integration in the Indian public health system: Medical dominance, countervailing power and co-optation," Social Science & Medicine, Elsevier, vol. 286(C).
    4. Shuval, Judith, 2006. "Nurses in alternative health care: Integrating medical paradigms," Social Science & Medicine, Elsevier, vol. 63(7), pages 1784-1795, October.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:62:y:2006:i:3:p:731-744. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.