Strategies of CAM to cam'isise health-care in Portugal: The case of acupuncture and homeopathy

Recent sociological research has shown that complementary and alternative medicine (CAM) has enacted a number of strategies of inclusion and demarcation to achieve occupational closure and therefore legitimacy within mainstream health-care worldwide. The proposed paper reports on research conducted in Portugal about the strategies used by CAM in order to achieve occupational closure within health-care. It aims to answer the following research question: What have been the main strategies of CAM to promote alternative conceptualisations of healing within mainstream health-care in Portugal? Through an analysis informed by a social closure framework and Abbott's system of professions, this study identifies main closure strategies of two CAM therapies, acupuncture and homeopathy, to acquire legitimacy and occupational closure within the mainstream health-care system in Portugal.

Data are derived from in-depth interviews with 10 traditional acupuncturists and 10 traditional homeopaths, and also from documentary search. Three similar multi-level strategies where identified in both CAM therapies: expressing countervailing values, professionalising and allying with the biomedical science. A new concept is introduced in this analysis to highlight the desirable outcome of CAM’s recent strategies of closure in the country. This concept is CAM’isation, and refers to the process of promoting CAM treatments and solutions to everyday human problems (either previously medically or non-medically defined problems). At a definitional level, this process is similar to that of medicalisation (Conrad, 2007), in that it offers a treatment framework for everyday human problems. Although at the moment CAM’isation seems to run more in parallel rather than in an opposite direction to medicalisation, this process can have as a consequence the reverse of medicalisation, i.e. demedicalisation. Having said this, recent strategies used by CAM in order to ‘CAM’isise’ health-care in Portugal will be analysed in this paper.