Complementary and alternative medicine's occupational closure in Portuguese healthcare: Contradictions and challenges

This article analyses strategies of closure recently enacted by complementary and alternative medicine practitioners in order to achieve occupational control over work domains in healthcare, taking Portugal as an example. A combination of the neo-Weberian occupational closure theory of the professions and Abbott's jurisdictional vacancy theory is proposed as the framework for analysis. Acupuncture and homeopathy will be presented as case studies. Data are derived from in-depth interviews with 10 traditional acupuncturists and 10 traditional homeopaths. Data analysis suggests that (1) professionalisation, (2) alignment with biomedical science and (3) expressing 'legitimating values' of a countervailing nature have been three significant strategies complementary and alternative medicine practitioners have used in an attempt to achieve market closure. It is argued that these strategies are contradictory: some involve allegiances, while others involve demarcation from biomedical science. A further outcome of these strategies is the promotion of complementary and alternative medicine treatments and solutions in everyday life. The success of these strategies therefore, although helping to reinforce the biomedical model, may simultaneously help complementary and alternative medicine to demarcate from it, posing thus challenges to mainstream healthcare.