So far, demedicalization has been described in terms of shifting responsibility and decision making from medical practitioners to customers, using some of the same information, the same tests, diagnostic techniques, and medication monopolized by physicians. There is another meaning to demedicalization: recourse to alternative practitioners and alternative therapies. An Office of Alternative Medicine was established in 1991 within NIH and apparently is still experiencing birth pangs. 6
As mentioned in Chapter 7, various ethnic groups have a tradition of folk medicine that is still alive in this country. And there are therapies for specific conditions, some of which are being incorporated into standard medical practice, such as massage for physical rehabilitation, acupuncture for riskless anesthesia. Other practices are more comprehensive, such as homeopathy, which is quite common in Europe. This topic lies beyond our scope. But there is no indication that demedicalization in this country is likely to proceed via adoption of alternative therapies or greater resort to nonmedical practitioners (psychological problems aside).
Demedicalization of health care is the result of a growing belief in lifestyle as a determinant of health; a desire to keep one's health under one's own control; better information as a basis for choice and action; fear of treatment, surgery especially; some loss of faith in the medical industry; and a growing repertoire of test kits, diagnostic instruments, and over-the- counter drugs.