Making sense of "alternative", "complementary", "unconventional" and "integrative" medicine: exploring the terms and meanings through a textual analysis.

Jeremy Y Ng,Cynthia R Whitehead,Alison K Thompson,Heather S Boon

doi:10.1186/s12906-016-1111-3

Jeremy Y Ng, Cynthia R Whitehead + Show 2 more

Open Access

https://doi.org/10.1186/s12906-016-1111-3

Copy DOI

Abstract

BackgroundMedical pluralism has flourished throughout the Western world in spite of efforts to legitimize Western biomedical healthcare as “conventional medicine” and thereby relegate all non-physician-related forms of healthcare to an “other” category. These “other” practitioners have been referred to as “unconventional”, “alternative” and “complementary”, among other terms throughout the past half century.MethodsThis study investigates the discourses surrounding the changes in the terms, and their meanings, used to describe unconventional medicine in North America. Terms identified by the literature as synonymous to unconventional medicine were searched using the Scopus database. A textual analysis following the method described by Kripendorff 2013 was subsequently performed on the five most highly-cited unconventional medicine-related peer-reviewed literature published between 1970 and 2013.ResultsFive commonly-used, unconventional medicine-related terms were identified. Authors using “complementary and alternative”, “complementary”, “alternative”, or “unconventional” tended to define them by what they are not (e.g., therapies not taught/used in conventional medicine, therapy demands not met by conventional medicine, and therapies that lack research on safety, efficacy and effectiveness). Authors defined “integrated/integrative” medicine by what it is (e.g., a new model of healthcare, the combining of both conventional and unconventional therapies, accounting for the whole person, and preventative maintenance of health). Authors who defined terms by “what is not” stressed that the purpose of conducting research in this area was solely to create knowledge. Comparatively, authors who defined terms by “what is” sought to advocate for the evidence-based combination of unconventional and conventional medicines. Both author groups used scientific rhetoric to define unconventional medical practices.ConclusionsThis emergence of two groups of authors who used two different sets of terms to refer to the concept of “unconventional medicine” may explain why some journals, practitioner associations and research/practice centres may choose to use both “what is not” and “what is” terms in their discourse to attract interest from both groups. Since each of the two groups of terms (and authors who use them) has different meanings and goals, the evolution of this discourse will continue to be an interesting phenomenon to explore in the future.

Highlights

Medical pluralism has flourished throughout the Western world in spite of efforts to legitimize Western biomedical healthcare as “conventional medicine” and thereby relegate all non-physician-related forms of healthcare to an “other” category
Many included a call for increased research and funding to be devoted to the study of this subject area, to ensure that unconventional medicines met a certain standard of safety and efficacy: “In light of these observations, we suggest that federal agencies, private corporations, foundations, and academic institutions adopt a more proactive posture concerning the implementation of clinical and basic science research, the development of relevant educational curricula, credentialing and referral guidelines, improved quality control of dietary supplements, and the establishment of postmarket surveillance of drug-herb interactions.” ([37], p. 1575)
We have demonstrated that scientific rhetoric is evident in the discourses of both “what is not” and “what is” author groups, which demarcate their work within a conventional medicine framework from that of work performed by members of unconventional medicine

Summary

Introduction

Medical pluralism has flourished throughout the Western world in spite of efforts to legitimize Western biomedical healthcare as “conventional medicine” and thereby relegate all non-physician-related forms of healthcare to an “other” category These “other” practitioners have been referred to as “unconventional”, “alternative” and “complementary”, among other terms throughout the past half century. Medical pluralism has flourished despite efforts to legitimize Western biomedical health care as “conventional medicine”, thereby relegating non-physician forms of healing to an “other” category. These “other” practitioners have been labelled as “unorthodox”, “unconventional”, “alternative” and “complementary”, among other terms throughout history [1, 2]. For the purpose of this study, “conventional medicine” is defined as “medical interventions that are taught extensively at US [and Canadian] medical schools and generally provided at US [and Canadian] hospitals” ([5], p. 246)

Objectives

Methods

Results

Discussion

Conclusion