Alternative Health and the Challenges of Institutionalization

Abstract

Through a case study of a complementary medicine clinic in a major urban hospital this article explores the links between two levels of power in the alternative health movement -the institutional level and alternative health's 'submerged networks.' Alternative health is conceptualized as a 'new social movement' whose central goal has been to create and sustain a form of life outside of conventional codes and institutional arrangements. The strength of this movement has been its ability to create a cultural laboratory where patients and activists can experience new ideas, authority relations, and identities. Through interviews and observations with the clinic staff and patients, the article asks whether alternative health's growing success in achieving institutional recognition is coming at the price of alternative health's submerged networks and core identity. Overall it is argued that complementary medicine clinics located in hospitals have the potential of establishing fruitful links with the dominant health care system but there is a clear danger of becoming absorbed by that system. The other danger is that alternative health will remain marginalized and lose touch with the institutional direction of society as a whole. The article concludes by arguing that alternative health should remain a 'dual movement' with institutional links as well as maintaining a close connection to the lifeworlds of patients. ACKNOWLEDGEMENTS Many thanks to the staff at the complementary medicine clinic who were enthusiastic about this project and gave us many hours of their time. Special thanks to Dr Lewis Madronna for generously allowing us to interview him over many weeks and in a number of locations. Also, thanks to Sharon Nepstad who read and commented on a version of the manuscript and to Duquesne University for supporting this research.

The Sociology of Traditional, Complementary and Alternative Medicine

“…Others have discussed the management of tensions in the therapeutic encounter, such as the management of sexuality in bodywork (Oerton 2004 ), empathy (Ruusuvuori 2005 ) or discussion of evidence of the effectiveness of homeopathy (Chatwin 2008 ). There have been some early steps to explore practitioner social networks, such as therapist networks in Mexico (Nigenda et al 2001 ), the role of ‘informal networks’ in the UK (Gibson 2003 ), ‘submerged networks’ in the United States (Schneirov and Geczik 2002 ), and looking at practitioner identity in relation to wider cross-cultural medical social networks (Zhan 2001 ). Issues such as career expectations, career trajectories, transitions from education to (usually independent) practice, or the extent to which communities of practice (Lave and Wenger 1991 ) have developed have not been explored in depth to date.…”

“…I would argue that a key contribution of the activism ‘big picture’ approach is to challenge the assumptions sometimes implicit in the ‘integration’ concept, i.e. that being more like biomedicine is the goal and that formal networks are key (Brindle and Goodrick 2001 ; Gibson 2003 ; Schneirov and Geczik 2002 ). However, like any form of activism, there is often a tension between staying true to core values (and awaiting revolutionary change) and the potential for faster change through collaboration and compromise with those in power (Goldner 2001 ; Villanueva-Russell 2011 ).…”

The untenable boundaries of biomedical knowledge: epistemologies and rhetoric strategies in the debate over evaluating complementary and alternative medicine

“…Research in western countries indicates an increase in the number of people using CAM treatments (Eisenberg et al, 1998;Thomas et al, 2001;Goldstein, 2002;Shuval et al, 2002;Hanssen et al, 2005;Molassiotis et al, 2005;Pud et al, 2005;Scott et al, 2005;Tindle et al, 2005;Winnick, 2007). The growth of CAM popularity and its penetration into medical health care organizations (Schneirov and Geczik, 2002;Shuval and Mizrachi, 2004), raises a number of questions, such as: Does it work? Are CAM treatments effective and benefi cial?…”

From body‐talk to body‐stories: body work in complementary and alternative medicine

“…Wolkowitz (2002) points out that how far the ‘holism’ espoused by CAM practitioners is ‘actually realised in embodied interactions, rather than remaining at the level of discourse’ may be ‘influenced by conditions of employment, including the managerial philosophies, staffing policies and payment systems that have evolved in the context of custom and practice of different occupations’ (2002: 503). There are increasing drives for more ‘professionalism’ in the CAM field and for ‘integration’ of systems with conventional medicine, although these developments are not universally supported by CAM professionals (Schneirov and Geczik 2002). These changes are altering the demographics of the practitioner population and the way in which CAM practice is regulated, which will have an impact on power relations in the embodied interactions in the therapeutic encounter.…”