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Book Reviews > Borderland Practices: Regulating Alternative Therapies in New Zealand
By Kevin Dew

This new book that examines the changing nature of 'orthodox' and 'alternative' practice. The author looks at recent medical history from a social scientist's perspective and asks how primary health care can be regulated when the boundaries between what is orthodox and what is alternative are continually shifting.

Every day thousands of New Zealanders consume an array of vitamin pills or visit alternative therapists of one kind or another. Doctors themselves may prescribe or administer 'alternative' remedies such as St John's Wort or acupuncture. What is going on in primary health care?

Modern societies regulate medical care to maintain patient safety, but where there has been regulation there has also been limitation. Medical practice has become more standardised and controlled, and some therapeutic practices have been deemed acceptable while others have not. Medical doctors who have ventured too far down the 'alternative' path have been struck off, and therapies such as homeopathy are excluded from state funded care.

Kevin Dew argues that terms such as 'science', 'unorthodoxy' and 'incompetence' have tended to change in meaning over time and place. Some of the challenges to orthodox medicine in the twentieth century, such as chiropractic and acupuncture, are now accepted practice. The New Zealand health reforms attempted to define a 'core' of health services that would be validated by science and provided to everyone, but solutions to the problems varied with the different patient populations seen by practitioners. And what were once acceptable concepts and practices in orthodox medicine are unacceptable now.

Health reforms have led to efforts to develop formulae that will guide the therapeutic actions of medical practitioners, but individual practitioners make their own judgements about patient care. How the delivery of care is regulated and funded are questions that don't go away, and the author concludes his discussion of these issues by looking at three possible models of regulation. These models take into account relations between medical knowledge, the role of the practitioner and the role of the profession in policing what practitioners, whether orthodox or alternative, are allowed to do.

Borderland Practices: Regulating Alternative Therapies in New Zealand
This timely publication is from The University of Otago Press.

Kevin Dew is a senior lecturer *In the Department of Public Health at the Wellington School of Medicine and Health Sciences, University of Otago. He has co edited Health and Society in Aotearoa New Zealand with Peter Davis, and Sociology of Health in New Zealand with Allison Kirkman.

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