Redefining Medicine: Boundary Work and Legitimating Claims AmongAcupuncturists and Physicians Pubblico
Crabtree, Charity (2009)
Published
Abstract
In this study I interview physicians, licensed acupuncturists, and medical acupuncturists (physicians who are licensed to practice acupuncture as well) in order to clarify the types of boundary work and legitimating claims used to maintain distinctions between acupuncture and conventional medicine in an increasingly "diverse" medical field. All practitioners use social and symbolic boundary work to some extent; where social boundaries are weak, often symbolic boundaries become increasingly important to physicians trying to maintain professional dominance. They are also important to acupuncturists concerned with highlighting their distinctiveness from this institutionalized (and seemingly flawed or inadequate) healing modality. The fluid nature of these types of boundaries hints at the legitimation process undergone by exotic or unusual cultural elements in our society. Moral and cognitive legitimacy are valuable tools for overcoming social boundaries, and claims of such are vehemently made (and challenged) by advocates (and adversaries). As more patients are seeking out alternative treatments, results indicate that physicians tolerate and even welcome alternative perspectives but use symbolic means of distinguishing between good medicine and false hopes. Evidence also indicates that acupuncturists have adapted explanations of acupuncture to fit the current medical landscape, as a result contributing to an understanding of acupuncture as a type of medicine that has the potential for filling in the "gaps" left by conventional forms. Results suggest that the success of other types of healing in entering the medical field depends on collecting a body of scientific research supporting the claims of the alternative healers and developing explanations of their medicines that make sense in the current medical landscape, as well as making an argument that they are able to do things conventional medicines cannot.
Table of Contents
Table of Contents:
Chapter One: Introduction 1
Chapter Two: The Science and Culture of
Biomedicine and Acupuncture 12
Chapter Three: Theoretical Background/Complementary
and Alternative Medicine as a Social Movement 42
Chapter Four: Research Design/
Question, Methods, and Data 57
Chapter Five: Social and Symbolic Boundaries/
Working Together, Working Apart 93
Chapter Six: Legitimating Claims/
Cognitive, Moral, and Pragmatic 120
Chapter Seven: Conclusion/
Redefining "Medicine" 147
Epilogue: Machine or Garden?
Enchantment and Integrative Medicine 159
Bibliography 164
Appendices 1-8 173
Tables and Diagrams:
Table One: Types of Practitioners 57
Diagram One: General Model 58
Diagram Two: Training, Interactions, and Practice 59
Table Two: Hypotheses: Boundary Work 63
Table Three: Hypotheses: Legitimating Claims 71
Diagram Three: General Model 72
Diagram Four: Training, Interactions, and Practice 73
Diagram Five: Boundary Work/Integrative Practitioners 74
Diagram Six: Boundary Work/Non-Integrative Practitioners 74
Diagram Seven: Legitimating Claims 75
Table Four: Respondents 84
Table Five: Hypotheses: Boundary Work 94
Table Six: Hypotheses: Legitimating Claims 121
Diagram Eight: Legitimating Claims 145
Diagram Nine: Boundary Work/Integrative Practitioners 149
Diagram Ten: Boundary Work/Non-Integrative Practitioners 149
Diagram Eleven: Legitimating Claims 151
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