Professions, democracy and marginality: Orthodox medicine and complementary and alternative medicine

This paper considers how far professional groups in modern liberal democratic societies themselves form democracies, particularly in relation to groups of practitioners defined as at the margins of orthodoxy. It is illustrated with particular reference to health care - and specifically the position of practitioners of complementary and alternative medicine in the professional pecking order. The ideology of professions is typically that they are collegial groups, consisting of communities of equals serving the public good. However, it is argued that persisting hierarchies of income, status and power both within and between professions suggest that such groups may be operating in an undemocratic manner – as epitomised by the case of health care in the Anglo-American context. This is exemplified most starkly by the relationship between orthodox medicine and marginal health professional groups at the edges of orthodoxy. An analysis of the group interests involved from a neo-Weberian perspective indicates that professions may be far from democracies when it comes to decision making - and also raises issues regarding the extent to which professions serve the public interest.