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How far can complementary and alternative medicine go? The case of chiropractic and homeopathy

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  • Kelner, Merrijoy
  • Wellman, Beverly
  • Welsh, Sandy
  • Boon, Heather

Abstract

This paper examines the efforts of two complementary and alternative occupations, chiropractors and homeopaths, to move from the margins to the mainstream in health care in the province of Ontario. We use a variety of theoretical perspectives to understand how health occupations professionalize: the trait functionalist framework, social closure, the system of professions, and the concept of countervailing powers. The research traces the strategies that the leaders of the two groups are employing, as well as the resources they are able to marshal. These are analyzed within the context of the larger institutional and cultural environment. The data are derived from in-person interviews with 16 leaders (10 chiropractic and 6 homeopathic) identified through professional associations, teaching institutions and informants from the groups. The responses were analyzed with qualitative content analysis. We also used archival materials to document what the leaders were telling us. The data revealed four main strategies: (1) improving the quality of educational programs, (2) elevating standards of practice, (3) developing more peer reviewed research, and (4) increasing group cohesion. Although both groups identified similar strategies, the chiropractors were bolstered by more resources as well as state sanctioned regulation. The efforts of the homeopaths were constrained by scarce resources and the absence of self-regulation. In both cases the lack of strong structural support from government and the established health professions played an important role in limiting what was possible. In the future, it may be to the state's advantage to modify the overall shape of health care to include alternative paradigms of healing along with conventional medical care. Such a shift would put complementary and alternative medicine occupations in a better position to advance professionally and become formal elements of the established health care system.

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  • Kelner, Merrijoy & Wellman, Beverly & Welsh, Sandy & Boon, Heather, 2006. "How far can complementary and alternative medicine go? The case of chiropractic and homeopathy," Social Science & Medicine, Elsevier, vol. 63(10), pages 2617-2627, November.
    • Handle: RePEc:eee:socmed:v:63:y:2006:i:10:p:2617-2627
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    References listed on IDEAS

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    1. Kelner, Merrijoy & Wellman, Beverly, 1997. "Health care and consumer choice: Medical and alternative therapies," Social Science & Medicine, Elsevier, vol. 45(2), pages 203-212, July.
    2. Cant, Sarah & Sharma, Ursula, 1996. "Demarcation and transformation within homoeopathic knowledge. A strategy of professionalization," Social Science & Medicine, Elsevier, vol. 42(4), pages 579-588, February.
    3. Coburn, David & Biggs, C.Lesley, 1986. "Limits to medical dominance: The case of chiropractic," Social Science & Medicine, Elsevier, vol. 22(10), pages 1035-1046, January.
    4. Barry, Christine Ann, 2006. "The role of evidence in alternative medicine: Contrasting biomedical and anthropological approaches," Social Science & Medicine, Elsevier, vol. 62(11), pages 2646-2657, June.
    5. Kelner, Merrijoy & Wellman, Beverly & Boon, Heather & Welsh, Sandy, 2004. "Responses of established healthcare to the professionalization of complementary and alternative medicine in Ontario," Social Science & Medicine, Elsevier, vol. 59(5), pages 915-930, September.
    6. Frank, R., 2002. "Homeopath & patient-a dyad of harmony?," Social Science & Medicine, Elsevier, vol. 55(8), pages 1285-1296, October.
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    Cited by:

    1. Ijaz, Nadine, 2022. "The reluctant and the envious: Therapeutic subalternity and the practice of homeopathy in North America," Social Science & Medicine, Elsevier, vol. 311(C).
    2. Almeida, Joana & Gabe, Jonathan, 2016. "CAM within a field force of countervailing powers: The case of Portugal," Social Science & Medicine, Elsevier, vol. 155(C), pages 73-81.
    3. Chung, Vincent C.H. & Hillier, Sheila & Lau, Chun Hong & Wong, Samuel Y.S. & Yeoh, Eng Kiong & Griffiths, Sian M., 2011. "Referral to and attitude towards traditional Chinese medicine amongst western medical doctors in postcolonial Hong Kong," Social Science & Medicine, Elsevier, vol. 72(2), pages 247-255, January.
    4. 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).
    5. Cant, Sarah & Watts, Peter & Ruston, Annmarie, 2011. "Negotiating competency, professionalism and risk: The integration of complementary and alternative medicine by nurses and midwives in NHS hospitals," Social Science & Medicine, Elsevier, vol. 72(4), pages 529-536, February.
    6. Brosnan, Caragh, 2017. "Alternative futures: Fields, boundaries, and divergent professionalisation strategies within the Chiropractic profession," Social Science & Medicine, Elsevier, vol. 190(C), pages 83-91.
    7. Schupmann, Will, 2023. "“We are not the ethics police”: The professionalization of clinical ethicists and the regulation of medical decision-making," Social Science & Medicine, Elsevier, vol. 322(C).

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