The Challenges of Integrating Alternative and Complementary Medicines into Care Systems: Professional Regulations in the in-between

Worldwide, the growth of Alternative and Complementary Medicines (CAM) has led to a reconfiguration of the health field. Despite very different socio-political contexts and healthcare systems, in Argentina and in France, the near absence of regulations concerning these practices has resulted in a significant heterogeneity in practitioners' backgrounds and educational trajectories. The analysis suggests that the internal segmentation of this CAM market makes recognition procedures complex.

This presentation is based on two sociological theses’ fieldwork: Josefina Avelin's study of Argentine CAM practitioners, and Fanny Parent's research on Chinese medicine professionals in France. We explore the positions they take regarding potential regulation and integration into the formal health system, identifying two key aspects that emerge from this regulatory void.

Firstly, professionals with conventional health-related degrees (such as biomedical doctors), who already possess the necessary credentials, prioritize maintaining autonomy over seeking state legitimization. In Argentina, many professionals embraced heterodox approaches to health after recognizing the limitations of the system they were trained in, and thus are reluctant to reintegrate into it. A similar situation can be observed in France with biomedical doctors integrating Chinese medicine into their practice. However, since acupuncture is recognized as a medical act, acupuncturist doctors’ organizations are trying to maintain their monopoly and reinforce the practice's legitimacy in the medical field.

Secondly, practitioners without conventional degrees often display ambiguous strategies to assert their expertise. The holistic approach allows them to navigate among the fields of health, religion and sports; emphasizing their proximity to professional codes of biomedicine or the cultural dimensions of their practices according to the context they are in. In this movement, different competition and alliances are formed with CAM practitioners from medical professions. Taking these dynamics into account is essential to understanding the tensions that arise when attempting to incorporate CAM into official health systems.