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Books
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?
Borderland
Practices: Regulating Alternative Therapies in New
Zealand, by Kevin Dew, is a 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.
Modem 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.
This timely publication is from University of Otago Press.
Click here to purchase
Borderland
Practices
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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