Students: Dissertation: Richard Lockwood

ABSTRACT

Integrative medicine (IM) has become a new area of specialization in mainstream health care.  The impetus for the development of IM was the general popular demand for the wide range of treatments and therapies known collectively as Complementary and Alternative Medicine (CAM).  Dramatic changes occurred in the institutions of science, medicine and public policy in reaction to a few highly publicized prevalence studies on CAM utilization in the early 1990’s.  The Medical Expenditure Panel Survey measured CAM utilization and professional service provision during the years 1996 and 1998 (N=39,314), but never since.  These studies provide a unique window into the emergence of IM, long before the policy debates took up the issue.

This dissertation describes this early form of integration through close examination of a subpopulation who received CAM services from their mainstream physicians (MDCAM).  Through the lens of Abbott’s theory of a system of professions, MDCAM represents a professional strategy of borrowing specific CAM therapies to enact a process of client differentiation, the early stages of professional specialization.

Nearly one million Americans received CAM therapies from their physicians during the period, and this professional behavior was found in every region of the country.  Services provided by physicians included spiritual healing, massage and acupuncture; national population prevalence estimates are provided.  This is all the more meaningful because physicians, at the time, were at risk for disciplinary action for providing CAM.

While the MDCAM subpopulation was similar to those who used both conventional and CAM services, this group reported much higher average number of prescription medication use.  Further, the demographic profile of MDCAM was more similar to frequent consumers of health care services, than infrequent consumers.  The MDCAM group is distinguished by the use of the following services: nutritional advice, biofeedback and meditation, over and above other CAM therapies.  This group is characterized by diagnoses of chronic illness.  MDCAM recipients received mainstream medicine, yet employed the services associated with disease management offered by the CAM domain.

June 3, 2008

DISSERTATION COMMITTEE

Grant Farr, Chair
Matthew Carlson
Heather Hartley
Martin Zwick
Sherril Gelmon, Graduate Studies Rep.