INFORMATION TO USERS This manuscript has been reproduced from the microfilm master. UMI films the text directly from the original or copy submitted. Thus, some thesis and dissertation copies are in typewriter free, while others may be from any type of computer printer. The quality of this reproduction is dependent upon the quality of the copy submitted. Broken or indistinct print, colored or poor quality illustrations and photographs, print bleedthrough, substandard margins, and improper alignment can adversely affect reproduction. In the unlikely event that the author did not send UMI a complete manuscript and there are missing pages, these will be noted. Also, if unauthorized copyright material had to be removed, a note will indicate the deletion. Oversize materials (e.g., maps, drawings, charts) are reproduced by sectioning the original, beginning at the upper left-hand comer and continuing from left to right in equal sections with small overlaps. Each original is also photographed in one exposure and is included in reduced form at the back of the book. Photographs included in the original manuscript have been reproduced xerographically in this copy. Higher quality 6” x 9” black and white photographic prints are available for any photographs or illustrations appearing in this copy for an additional charge. Contact UMI directly to order. UMI A Bell & Ifowell Infonnation Company 300 North Zeeb Road, Ann Arbor MI 48106-1346 USA 313/761-4700 800/521-0600 EXPLAINING THE SUCCESS OF THE ALTERNATIVE HEALTH CARE MOVEMENT: HOW INTEGRATIVE MEDICINE IS EXPANDING WESTERN MEDICINE DISSERTATION Presented in Partial Fulfillment of the Requirements for the Degree Doctor of Philosophy in the Graduate School of The Ohio State University By Melinda Ann Goldner, B.A., M.A. The Ohio State University 1998 Dissertation Committee: Approved by Professor Verta Taylor, Adviser Professor J. Craig Jenkins A dviser Professor Robert Kaufman Department of Sociology UMI Number: 9833984 Copyright 1998 by Golc^er, Melinda Ann All rights reserved. UMI Microform 9833984 Copyright 1998, by UMI Company. All rights reserved. This microform edition is protected against unauthorized copying under Title 17, United States Code. UMI 300 North Zeeb Road Ann Arbor, MI 48103 Copyright by Melinda Ann Goldner 1998 ABSTRACT Alternative medicine is attracting public attention at the same time that it is expanding the practice of Western medicine. More consumers are using and practicing alternative techniques such as acupuncture and yoga. As they empower themselves and make the necessary personal changes, they influence their friends and family. These activists also influence society by educating the public, lobbying financial and governmental agencies, and spending their own money on these techniques. These personal and political actions have collectively caught the attention of insurers, physicians, governmental agencies and the media. Researchers typically conceptualize alternative medicine as a set of techniques or beliefs. Instead, I argue that we need to examine alternative medicine as a social movement, because it is this collective effort that has led to these recent changes. Through interviews with forty alternative health care practitioners and clients, and observations of five alternative health care organizations in the San Francisco, California Bay area, I found that most practitioners and clients identify with an alternative health care movement and define their participation as activism. Though their resistance to Western medicine often involves individual acts, collectively they are forming an alternative ideology and structure, and having a larger impact 11 since they identify with a seemingly cohesive social movement that challenges Western medicine collectively. Since the alternative health care movement has diverse participants, strategies and organizations, I argue for a synthesis between resource mobilization and new social movement theories. The authority and dominance of Western medicine are beginning to dismantle, whereby power has moved away from the physicians to financing and regulatory agencies. These political changes have led to a newer trend toward integrative medicine, which combines Western and alternative medicine. Though integrative medicine signals movement success, I use institutional theories to explore how Western medicine can respond to this threat. Though some physicians are incorporating alternative medicine, they still have more power than alternative practitioners. In this study I specify the dynamic relationship between the political opportunity structure, a movement and their opposition. I argue that activists need to control holistic ideology to prevent Western medicine from co-opting their personnel and techniques. Ill Dedicated to Jeff IV ACKNOWLEDGMENTS I wish to thank my adviser Verta Taylor for her insight and patience throughout my graduate career at Ohio State. The other members of my committee, Craig Jenkins and Bob Kauhnan, also provided great suggestions and graciously worked around my tight schedule. Members of the Sociology department at the University of San Francisco went out of their way to provide comments and support, especially Jenny Turpin and Mike Webber. I thank all of my friends who genuinely seemed interested when I told them about my research. A special thanks to Dan Ardia for sending me Dr. Andrew Weil's book that led to this research idea, and Jo Reger and Nancy Whittier who sat with me at the American Sociological Association's Meetings in Washington, D C. to turn this idea into a research question. I am especially grateful to Steve Scanlan and Deb McBrier who gathered signatures, handed in forms, and delivered documents at Ohio State while I lived in California. I am grateful to the people who allowed me to interview and observe them. They were always generous with their time, and their perspective forced me to rethink many of my ideas. I would like to thank Robert Anderson who did not hesitate to share his ideas and data with me despite our similar research interests. Richard Miles was always willing to introduce me to people within the movement, and invite me to important events. Finally, I want to thank my family. My sister Pam and her husband Don let me live rent-free in California so that I could conduct my research. My sister constantly shared her experiences with alternative medicine, and answered my questions on anything from Sanskrit to Deepak Chopra's work. I would not have made it through high school, let alone graduate school, without the constant generosity and support of my parents. They found the balance between supporting me and resisting the ever present question on everyone's mind — "when was I going to finish?" Finally, I want to thank my husband, Jeff Feldman. He was an editor, confidant and sounding board for my research. Yet, he also knew when to take me away from the computer so that I could maintain a balanced life. VI VITA April 30,1968........................................... Bom - Wooster, Ohio 1990.............................................................B.A., Tufts University, Medford, Massachusetts 1993.............................................................M.A., Washington State University, Pullman, Washington FIELDS OF STUDY Major Field: Sociology Studies in: Medical, Social Movements, Gender Vll TABLE OF CONTENTS A bstract ................................................................................................................ ii D edication........................................................................................................... iv Acknowledgments ............................................................................................. v \ ^ t a ......................................................................................................................... vii List of Tables ......................................................................................................... x List of Figures...........................................................................................................xi Chapters: 1. Introduction.............................................................................................. 1 Alternative Medidne as a Social Movement........................ 9 Integrative Medidne.................................................................... 24 Chapter Outline........................................................................... 32 2. Methodology ............................................................................................. 36 D ata....................................................................................................38 Data Analysis ................................................................................ 54 Summary and Limitations .......................................................... 55 3. Defining Alternative Medidne............................................................... 58 Alternative Techniques.................................................................. 59 Alternative Beliefs........................................................................ 63 Health is Well-Being...........................................................66 Individual Responsibility for H ealth........................... 71 Health Education.................................................................73 The Use of Natural Remedies........................................ 75 Sodal & Environmental Determinants of Health . 77 C on dusio n....................................................................................