Towards the Camisation of Health? The Countervailing Power of CAM in Relation to the Portuguese Mainstream Healthcare System

摘要

The aim of the research reported here is to answer the following primary research questions: Is the relationship between CAM, the medical profession and the State changing in Portugal? If there has been a change, how and why has such a change occurred? Two CAM therapies, acupuncture and homeopathy, have been chosen as case studies. The main sources of data were in-depth individual interviews and documents. The research sample (n=41) was made of three groups of interviewees: (1) 20 traditional CAM practitioners, (2) 10 orthodox medical doctors not committed to CAM and (3) 11 orthodox medical doctors committed to CAM. This research draws on a neo-Weberian perspective of professions which emphasises the power relations between related occupational groups who seek to gain or maintain power and status in their field of work. This research also makes extensive use of the concept of ‘countervailing powers’ (Light, 2010), as it attempts to illuminate the influence of CAM practitioners on Portuguese healthcare, as well as the influence of other powerful players, such as the State, and major corporations, such as pharmaceutical and health insurance companies, on CAM’s relationship with the medical profession. On the basis of this research, I argue that the relationship between CAM, the medical profession and the State has changed in Portugal over the last 16 years. I suggest a concept that helps to explain CAM practitioners’ recent countervailing actions within the Portuguese mainstream healthcare. This concept is ‘camisation’, a process through which everyday human problems are transformed into health problems which are treated in CAM terms and within a CAM framework. Although the main drivers of camisation have been CAM practitioners, I also show how the Portuguese State, the medical profession and the pharmaceutical industry have all been active collaborators in this process, whilst maintaining different interests and constantly bargaining and negotiating to maximise their power and status within the field of healthcare.