ABSTRACT
Consideration of the position of the alternatives to medicine is of much interest not only because of its topicality, but also because it raises the question of the extent to which popular, consumer-based demand in an increasingly market-oriented society can diminish established patterns of professional dominance. The centrality of this question is highlighted by ongoing debates in the social sciences about possible trends towards the proletarianisation and deprofessionalisation of the medical profession in the Anglo-American context – which focus, amongst other things, on how far the occupational control and cultural authority of the medical profession have been eroded in recent times (see, for instance, McKinlay and Arches 1985; Coburn 1999; Saks 2003a). In exploring the fate of professional dominance in relation to the alternatives to medicine, this chapter will also address such related issues as the occupational strategies employed by the medical profession in defending its position against external competitors and the degree to which the medical response to this challenge has been imbued with the sense of public responsibility suggested by its professional ideology. In so doing, the chapter takes a neoWeberian perspective on the professions in general and the health professions in particular that defines such groups as monopolistic bodies seeking to regulate market conditions in their favour in face of competition from outsiders (Saks 1998). One of the more intriguing contemporary aspects of the challenge to the orthodox medical profession comes from the external competition posed by the escalating consumer support for the alternatives to medicine, to which the discussion now turns.
