In (post)modern society, there is a return to alternative medicine practices, which puts researchers to explain this phenomenon and determine its consequences, and state systems health care are encouraged to establish control over activities of alternative healers, taking into account the interests of patients and ensuring their safety. The World Health Organization defines traditional medicine as “the sum total of the knowledge, skill, and practices based on the theories, beliefs, and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness “(World Health Organization a, para.1). Alternative or complementary medicine, in turn, is defined by WHO as “a broad set of health care practices that are not part of that country’s own tradition or conventional medicine and are not fully integrated into the dominant healthcare system” (World Health Organization a para. 2). It is generally accepted that alternative medicine is a set of knowledge, skills, and abilities based on practice and observation, transmitted from generation to generation orally or in writing, not always having scientific justification and logical explanation, used in the prevention, diagnosis, treatment of diseases and in medical rehabilitation.
However, based on the WHO definition, traditional medicine also does not always imply an evidence-based basis and, in reality, is simply the dominant institutionalized way of managing the disease in a particular health system. Alternative medicine is thus a counter-examination to established medical practice. WHO includes in the list of alternative medical approaches and methods of their application such practices as homeopathy, anthroposophic medicine, applied kinesiology, Kirlian photography, reflexology, osteopathy, chiropractic, Rolfing breathing, psionics, radiesthesia, treatment using radio electronics, pyramidal therapy, naturopathy, dianetics aroma and flower therapy, herbal medicine, biochemical, orthomolecular methods, bioenergy, and others (World Health Organization a). However, based on the definitions above, for many countries in Southeast Asia (South Korea, China, Taiwan, Singapore), many of these practices are part of the institutionalized health care system and are covered by insurance, and thus are traditional medicine, not alternative medicine (Bodeker & Kronenberg).
For Western countries, alternative medicine is starting to gain popularity. Due to significant scientific advances, the market for innovative biomedical technologies is rapidly expanding. As a result, significant changes occur in the relationship between doctor and patient. The market laws invade this private space, medical services are implemented according to the criteria of price and quality, and the patient becomes a client. The rise of technocratism and commercialization is causing discontent among consumers, who are increasingly turning to alternative treatments. For example, according to the American Medical Association, four out of ten Americans seek some form of alternative therapy.
If earlier medical professionals and the scientific community viewed alternative medicine as a threat both to their profession and to the patient’s life and health, now views are beginning to change. The world scientific community is moving to the concept of integrative medicine, which involves the scientifically grounded combination of both approaches within the framework of a new standard – evidence-based medicine.
Literature review
Sociological issues of alternative medicine were mainly formed at the intersection of two disciplinary fields. The study of alternative medicine as such belongs to the field of the sociology of medicine, which considers the social factors of the growing interest of patients and doctors in various traditional and folk healing practices and how the latter interact with the modern healthcare system (Ross). On the contrary, in the sociology of professions, the demand and processes of institutionalization of certain types of alternative treatment are of interest to scientists only indirectly, as conditions for a more important professionalization process of specialists in alternative medicine (Brosnan & Cribb). In this stream of research, alternative medicine doctors as a professional group do not quite fit into the subject field of the classical sociology of the profession, which traditionally considered occupations with high status and prestige. Although medicine, in general, has always been one of these occupations, various types of alternative medicine were the exception, as they differed in more or less marginalized positions in health care in most developed countries.
Making a large-scale transition to an integrated model of healing in conditions when chronic diseases became the leading causes of death, doctors were faced with the need for a complete understanding of the cultural and socio-economic factors of ill health. Knowledge in the field of risk factors associated with patients’ lifestyle, depending on their belonging to a particular socio-ethnic group of the population, has acquired particular relevance. The need to conduct such a complex social analysis in the interests of medicine, understanding the behavioral models of not only patients but also medical personnel, predicting the directions and forms of cultural changes in a new scientific direction – medical anthropology (Ross).
In the new technological take-off, it has become necessary to know how people in different cultures and social groups explain the causes of ill health, the forms of treatment they trust, and whom they turn to when they become sick. A stream of research has emerged that studies people’s perception of their physical and mental suffering and the steps people take to explain and reduce this suffering (Karvonen et al.). There is an understanding that alternative medicine, along with the introduction of the latest technologies, will have to go through the path of overcoming the increasing alienation between doctor and patient. In this direction, significant innovations are needed to organize medical care in all countries at different stages of national health systems development.
Analysis of the problem and evidence
Today, there are significant variations in the social status of various alternative medicine specialists all over the world. First of all, this is due to the different level of institutionalization of alternative methods of treatment in different countries, depending on the cultural, social, and historical conditions in which these methods developed and exist in their current state. Some methods remain unrecognized by official health care, and many have received this recognition only recently. The level of institutionalization of one or another type of alternative medicine in a particular country is determined depending on its place in the system of training medical specialists, the position in the medical services market, the nature and degree of integration in the public health sector, and the possibilities for self-regulation (through professional associations).
In some countries, alternative methods are in the hands of professional doctors; in others, access to them is allowed to a broader range of practitioners. For example, in Denmark, in order to use acupuncture (reflexology) for therapeutic purposes, a medical diploma is not required, while in countries such as Spain, Bulgaria, Greece, the Czech Republic, Hungary, and Latvia, only qualified doctors are allowed to use this method (Peltzer & Pingpid). In Europe, about 25–40% of general practitioners without special training in homeopathy prescribe homeopathic medicines (Michaux).
To promote the professional scientific integration of biomedical approaches, through the efforts of specialists in the field of various medical schools and areas, the WHO Traditional Medicine Strategy 2014–2023 was developed (World Health Organization b). The strategy aims to support the Member States of the World Health Organization in developing policies and implementing action plans that will strengthen the role of complementary medicine in maintaining public health. Building on the work done in previous projects, priority areas for health services and systems have been identified, including traditional and complementary medicines, and the inclusion of alternative medicine in physicians’ practice until 2023.
The World Health Organization is doing significant work with countries to develop policies that are most appropriate to the level of development of their national systems. In order to provide information, a constant collection of information has been established both from the WHO member countries and from international professional organizations uniting doctors practicing alternative methods of treatment (such as the World Federation of Chiropractic, The International Council for Homeopathy, the World Federation of Acupuncture Societies, and others) (World Health Organization b). At present, national systems for regulating the interaction of various forms of medicine are quite different, as evidenced by the data from a review of the legal status of traditional and complementary medicine worldwide, published by WHO specialists.
Discussion
Similar factors have driven the growth in demand for alternative medicine in Western countries, but this has happened at different times. In the late 1960s and early 1970s, large-scale sociocultural changes took place in Europe and the United States, which led to the emergence of various counterculture types, including those related to a healthy lifestyle and medical culture (Zörgő et al.). Representatives of the medical counterculture in medicine were critical of the dominant medical system, pointing out the limitations of its reductionist approach to treatment and the negative consequences of treatment (side effects) for the patient’s body and psyche (Chaplin & Mooney). As a result, many doctors began to look for new ways of treatment, and patients became more critical in the choice of medical services.
At present, the problem has become actual since the implementation of personalized medicine has begun with the efforts of representatives of innovative business sectors, academia, and politicians. The basic principles of this area involve the individualization of the treatment process based on current medical technologies and the strengthening of the patient’s subjective motivated role in the prevention of possible diseases and the choice of treatment methods. This turn of development is in many ways the opposite of the world’s dominant healthcare systems and implies the need to develop an interdisciplinary scientific paradigm based on the foundations of practical medicine and biomedical, psychological, social, and economic knowledge.
On the other hand, in terms of the sociology of professions, the involvement of alternative medicine in a set of professional medical practices in the framework of the controlled institutionalized system can be seen as an attempt by the professional medical community to retain its jurisdiction over patient care and at the same time maintain control over existing counter-expertise. Since evidence-based medicine is currently the gold standard of life sciences and practice, both traditional and alternative approaches will be re-framed in accordance with new requirements and standards.
Works Cited
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Brosnan, Caragh, and Alan Cribb. “Professional identity and epistemic stress: complementary medicine in the academy.” Health Sociology Review, vol.28, no.3, 2019: 307-322.
Chaplin, Tamara, and Jadwiga E. Pieper Mooney. The Global 1960s: Convention, contest and counterculture. Routledge, 2017.
Karvonen, Sakari et al.. “Who needs the sociology of health and illness? A new agenda for responsive and interdisciplinary sociology of health and medicine.” Frontiers in Sociology, vol.3, no.4, 2018. Web.
Michaux, Geneviève. “Should Anthroposophic Medicinal Products Be Regulated in Europe?.” European journal of health law, vol.24, no.1, 2017: 46-66.
Peltzer, Karl, and Supa Pengpid. “Prevalence and determinants of traditional, complementary and alternative medicine provider use among adults from 32 countries.” Chinese journal of integrative Medicine, vol. 24, no.8, 2018: 584-590.
Ross, Anamaria Iosif. The anthropology of alternative medicine. Routledge, 2020.
World Health Organization, a. Traditional, Complementary and Integrative Medicine. Web.
World Health Organization, b. “WHO Traditional Medicine Strategy 2014-2023.” World Health Organization, 2013.
Zörgő, Szilvia, György Purebl, and Ágnes Zana. “A qualitative study of culturally embedded factors in complementary and alternative medicine use.” BMC complementary and alternative medicine, vol.18, no.1, 2018: 25-36.