| Throughout most of the twentieth century, the profession of medicine has been dominated by allopathic or ‘regular’ practitioners. Theories of professionalization have identified educational reform, medical regulation, and control of the medical marketplace as primary structural factors contributing to the ascendancy of regular medicine and the demise of competing medical sects. Recently, however, irregular practices, now less pejoratively called alternative or ‘complementary’ medicine, have returned, engendering both public and professional interest in these therapies. This research investigates the established medical profession's reaction to the re-emergence of alternative medicine in order to test and expand existing theories of professionalization. Using quantitative and qualitative techniques to analyze state and national level data, I seek to determine whether the profession's interest is prompted by demographic and structural factors simultaneously impacting the established profession and threatening its dominance. Hypothesized correlates are patient consumerism, need for treatment, third-party support, bureaucratization, and competition from non-medical providers. State level analyses reveal that adoption of alternative therapies by some regular medical doctors (holistic practice) is primarily influenced by competition and patient need. Holistic practice is more likely in states with a large population of relatively healthy senior citizens and practicing alternative healers. HMO enrollment enhances holistic practice while private coverage tends to constrain it. Pooled time series analyses of a sample of documents from the medical literature over a thirty-five-year period (1965–1999) link national journal coverage of alternative therapies to competition from chiropractors and expanding third-party support, which has recently become an area of contested professional terrain since the inception of insurance equity laws. Qualitative content analyses of the documents show that editorial tone shifts over time from condemnation to a neutral, accepting tone, revealing growing tolerance of alternative therapies and willingness to expand treatment options. Patient consumerism is not a strong determinant of professional interest in these analyses, offering little support for the deprofessionalization hypothesis. Instead, these results suggest that attention to, or adoption of, alternative therapies by the regular medical profession is an adaptation to change occurring both within and outside the profession, representing ongoing and continuing professionalization. |
