Mainstream marginality: professional projects and the appeal of complementary and alternative medicines in a context of medical pluralism.

This narrative critically reviews my contribution to the development and maturation of a sociology of complementary and alternative medicine (CAM).

Through the application of qualitative methodologies, my work has documented the emergence of a ‘new’ medical pluralism, focussing on the professional development of CAM as practiced by non-medically qualified practitioners and nurses and midwives, and has provided an understanding for the groundswell of appeal of CAM to both users and practitioners.

With reference to neo-Weberian, Foucauldian and feminist theories of occupational formation, the research has provided insight into CAM ‘professional projects’, detailing the attempts to secure market share, broker trust relations, and discipline work conduct.

My work has also revealed the enduring capacity of (patriarchal) biomedicine to shape CAM practice and health care delivery. As a consequence, CAM is described as being situated in a position of ‘mainstream marginality’ – popular, but peripherally located in state-sanctioned health care, with an appeal to groups of users and practitioners who themselves feel marginalised. As such, my work has contributed to an appreciation of the attractions of CAM and its empowering potentials, and the dynamics of biomedical power, professionalisation and professionalism in relation to jurisdictional battles for market share.

Through critical reflection on my work, however, I note there is space for further exploration into: the opportunities for affective change and collaboration that can be fostered in integrated/integrative clinics; the ways in which biomedical dominance might be mutating; the different ways in which wellbeing, efficacy and evidence might be conceptualised; the possibility of integrating post-colonial theory and anthropology with sociology to produce a globalised analysis of medical pluralisms.