Hans A. Baer

The American dominative medical system as a reflection of social relations in the larger society.

Expanding upon Navarros analysis of the American biomedical sector, I argue that the phenomenon of medical pluralism has historically and continues to reflect class, racial/ethnic, and gender relations in American society. The evolution of the American medical system is traced from a relatively pluralistic one in the nineteenth century to a dominative one in the twentieth century. While legitimation and even professionalization of various alternative medical systems supports the assertion that the dominance of biomedicine is delegated rather than absolute, these processes reflect the growing accommodation on the part of alternative practitioners to the reductionist disease theory which is compatible with capitalist ideology.

Introduction - taking stock of integrative medicine: broadening biomedicine or cooption of complementary and alternative medicine?

Abstract In response to the emergence of the holistic health movement in the early 1970s and the rising popularity of complementary and alternative therapies, a growing number of biomedical physicians and institutions have embraced complementary and alternative medicine (CAM), often under the guise of integrative medicine. Whereas alternative medicine is often defined as functioning outside biomedicine and complementary medicine beside it; integrative medicine purports to combine the best of both biomedicine and CAM. Some social scientists have argued biomedicine has become more holistic as a result of this development, whereas others suggest it has embarked upon a subtle process of absorbing or co-opting CAM. This special issue consists of six articles that address changes in the health care sectors of four Anglophone societies, namely the United States, Great Britain, Australia, and New Zealand, associated with the adoption of integrative medicine or CAM. The authors examine some of the causes and consequences of this development. Is this a reframing of biomedicine itself, an erosion of medicine’s political, economic, and social authority, a response to managerialism and the demands of consumers or market pressures, an expression of rising legitimacy for CAM, or a new professional strategy for biomedicine? And finally, where might the push for evidence-based medicine fit into this equation?

The holistic health movement in the San Francisco Bay Area: Some preliminary observations

This essay presents a preliminary overview of the holistic health movement in the San Francisco Bay Area. In part drawing upon ethnographic data, it examines the juxtaposition of the drive for professionalization and resistance to professionalization on the part of various alternative healers. It also considers the growing interest of biomedical physicians, corporations and government policy makers in holistic health. Despite the frequent claim that the holistic health movement constitutes a counterhegemonic effort that challenges the basic premises of biomedicine, we argue that the holistic health movement exhibits strong hegemonic attributes in that it tends to offer individualistic solutions rather than social structural ones in addressing health problems.

The potential rejuvenation of American naturopathy as a consequence of the holistic health movement

Naturopathy is a heterodox professionalized medical system which, in contrast to osteopathy and chiropractic, has received little attention from social scientists, particularly in the United States. This article is an attempt to correct that situation. It focuses on the history of this healing tradition by discussing three stages in the development of American naturopathy: 1) its emergence around the turn of the century; 2) its decline beginning in the late 1930s; and 3) its recent potential rejuvenation, particularly in the Pacific Northwest. The essay concludes that as a consequence of its philosophical and therapeutic eclecticism, naturopathy found itself pre-adapted to the holistic health movement that emerged in American society during the 1970s.

The drive for professionalization in British osteopathy

This article examines the drive by osteopaths for professionalization in Great Britain. Whereas osteopathy evolved into osteopathic medicine and became part of the medical mainstream in the United States, osteopathy diffused from America to Britain around the turn of the century where it continues to function as a marginal profession. In an effort to overcome their marginality osteopaths have established associations and schools, lobbied for state recognition, created an umbrella organization to transcend intraprofessional rivalries, formed voluntary registers and redefined the scope of their practice. In addition to presenting an overview of these strategies for professionalization, I argue that the ability of osteopaths to obtain legitimacy depends upon convincing political and economic elites that they are useful in compensating for contradictions of capital-intensive, high technology medicine.

Prophets and advisors in black spiritual churches: therapy, palliative, or opiate?

This paper examines a variant of Black ethnomedicine in urban areas, namely the complex of prophets and advisors found within the Spiritual movement. Based upon fieldwork among Spiritual churches in several cities and intensive interviews with Spiritual mediums in Nashville, Tennessee, attention is given to the form of folk psychotherapy that these prophets and advisors provide the members of their congregations as well as other individuals. Although it is argued that the complex of mediums in Black Spiritual churches provides an important coping mechanism for certain Blacks, it is important, particularly in light of the recent interest in a cooperative relationship between indigeneous healers and representatives of cosmopolitan medicine, to note that the solutions provided by these therapists may tend to deflect attention from recognizing that the problems of their clients often emanate from the stratified and racist nature of American society.

The organizational rejuvenation of osteopathy: A reflection of the decline of professional dominance in medicine

Abstract Three distinct stages in the relationship between osteopathic medicine and allopathic medicine are discussed. Although it has often been predicted that osteopathy would be absorbed by ‘organized medicine’, it will be argued that its recent organizational rejuvenation must be viewed within the context of the political economy of medical care in the United States. Various ‘strategic elites’ in the past decade have turned to osteopathic medicine as one of several strategies for dealing with the contradictions inherent in capital-intensive medicine, particularly those which contribute to a shortage and geographical maldistribution of primary physicians.

The Drive for Legitimation by Osteopathy and Chiropractic in Australia: Between Heterodoxy and Orthodoxy

This article examines the drive for legitimation on the part of osteopathy and chiropractic in Australia. A brief history is presented of the development of these two manual medical systems down under, their respective drives for statutory registration and public funding of their training institutions (all of which are embedded in public universities), and their respective niches within the context of the Australian dominative medical system. Ironically, although osteopathy is politically strong in both the United States, where it has evolved in osteopathic medicine and a parallel medical system to biomedicine, and in Britain, where it remains primarily a manual medical system, chiropractic over time became politically stronger than osteopathy in Australia. The author argues that although chiropractic and osteopathy remain distinct and related systems in Australia, from the perspective of the Australian state, they essentially are one and the same.

The Drive for Legitimation in Chinese Medicine and Acupuncture in Australia: Successes and Dilemmas

This article examines the drive for legitimation on the part of Chinese medicine and more specifically acupuncture in Australia. It examines the development of Chinese medicine in Australia, the road to statutory registration of Chinese medicine in Victoria, and the niche of Chinese medicine within the context of the Australian plural medical system. Despite the opposition of organized medicine, the Victorian Parliament passed the Chinese Medicine Registration Act in May 2000, making Victoria the only Australian political jurisdiction to formally regulate Chinese medicine practitioners and acupuncturists. The legal status of Chinese medicine and acupuncture outside of Victoria resembles that of naturopathy and other natural therapies, such as Western herbalism and homeopathy, none of which has achieved statutory registration in any Australian jurisdiction. Chinese medicine has a distinct identity within the context of the Australian plural medical system. Conversely, acupuncture, as one of the modalities of Chinese medicine—and in Western societies its principal modality—has been incorporated into various other heterodox medical subsystems, particularly chiropractic, osteopathy, and naturopathy, as well as conventional systems, such as biomedicine and physiotherapy.

Kerr-McGee and the NRC: From Indian country to silkwood to Gore

By focusing upon the Nuclear Regulatory Commissions appraisal of the Kerr-McGee Corporations safety record in the Four Corners area and at two facilities in Oklahoma, this article examines the political economy of nuclear regulation in American society. Particular attention is given to the agencys response to intervenor groups which protested various operations at Kerr-McGee facility in Gore, Oklahoma, both prior to and following the accidental rupture of a cylinder containing uranium hexafluoride. Despite a consistent record of violations and nuclear mishaps by Kerr-McGee, the Nuclear Regulatory Commission permitted the company to essentially monitor its own activities. Rather than protecting workers and the public from the hazards of the nuclear industry, state regulation attempts to legitimize and defuse public opposition to its endeavors.