{"title":"在以色列医院实践替代医学","authors":"J. Shuval","doi":"10.29011/2688-7460.100019","DOIUrl":null,"url":null,"abstract":"There is growing evidence that alternative health care practitioners and conventional physicians are working together in collaborative patterns. The paper examines these collaborative patterns in hospital settings in Israel. On the theoretical level the specific issues relate to theories concerning relationships between dominant institutional structures which enjoy the benefits of epistemological legitimacy as well as extensive, supportive social structures and groups of non-conformists who seek to attain many of the same goals by utilizing different methods based on other epistemologies. In the most general sense the issues involved concern processes of accommodation and social change. In an effort to examine the dynamics of the processes involved, data were collected twice: In 2000-2001, in an extensive research undertaking when CAM was beginning to show its presence in hospital settings and again in 2015 when a more modest second round of supplementary research was undertaken in an effort to observe changes over time. In 2000-2001 data were collected by means of semi-structured, qualitative interviews in four general hospitals in Jerusalem 19 persons were interviewed including 10 alternative practitioners working in a variety of fields and 9 conventional medical practitioners who worked with them (6 physicians and 3 nurses). Interviews focused on background and training, reasons for entry into the hospital, length of practice, status in the hospital system, mode of remuneration, content of work, modes of interaction with others in the hospital and problems encountered. In 2015-2010 in-depth interviews were carried out with CAM practitioners and policy makers in the Israel Ministry of Health and in a variety of health care institutions. These interviews focused on the role and functions of CAM in Israeli hospitals over the intervening period. Observations were carried out in selected hospital settings. An in-depth literature search regarding research and policy statements on the role of CAM in Israeli hospitals during the intervening period provided an overview of empirical changes. The paper discusses the early modes of entry into Israeli hospitals, the dilemmas faced and the mechanisms used to overcome barriers. The findings of the first wave of interviews suggest a dual process of simultaneous acceptance and marginalization of alternative practitioners. While small numbers of alternative practitioners were found to be practicing in a wide variety of hospital departments and in a broad spectrum of specialties, they were in no cases accepted as regular staff members and their marginality was made clear by a variety of visible structural, symbolic and geographical cues. Considerable increases in the number, activity and visible presence of alternative practitioners in the hospitals occurred by 2016. These are discussed along with the mechanisms utilized to expand their presence in Israeli hospitals. Citation: Shuval JT (2018) Practicing Alternative Medicine in Israeli Hospitals. J Family Med Prim Care Open Acc: JFOA-119. DOI: 10.29011/JFOA-119. 100019 2 Volume 2018; Issue 02","PeriodicalId":93553,"journal":{"name":"Family medicine and primary care -- open access","volume":" ","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2018-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"Practicing Alternative Medicine in Israeli Hospitals\",\"authors\":\"J. Shuval\",\"doi\":\"10.29011/2688-7460.100019\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"There is growing evidence that alternative health care practitioners and conventional physicians are working together in collaborative patterns. The paper examines these collaborative patterns in hospital settings in Israel. On the theoretical level the specific issues relate to theories concerning relationships between dominant institutional structures which enjoy the benefits of epistemological legitimacy as well as extensive, supportive social structures and groups of non-conformists who seek to attain many of the same goals by utilizing different methods based on other epistemologies. In the most general sense the issues involved concern processes of accommodation and social change. In an effort to examine the dynamics of the processes involved, data were collected twice: In 2000-2001, in an extensive research undertaking when CAM was beginning to show its presence in hospital settings and again in 2015 when a more modest second round of supplementary research was undertaken in an effort to observe changes over time. In 2000-2001 data were collected by means of semi-structured, qualitative interviews in four general hospitals in Jerusalem 19 persons were interviewed including 10 alternative practitioners working in a variety of fields and 9 conventional medical practitioners who worked with them (6 physicians and 3 nurses). Interviews focused on background and training, reasons for entry into the hospital, length of practice, status in the hospital system, mode of remuneration, content of work, modes of interaction with others in the hospital and problems encountered. In 2015-2010 in-depth interviews were carried out with CAM practitioners and policy makers in the Israel Ministry of Health and in a variety of health care institutions. These interviews focused on the role and functions of CAM in Israeli hospitals over the intervening period. Observations were carried out in selected hospital settings. An in-depth literature search regarding research and policy statements on the role of CAM in Israeli hospitals during the intervening period provided an overview of empirical changes. The paper discusses the early modes of entry into Israeli hospitals, the dilemmas faced and the mechanisms used to overcome barriers. The findings of the first wave of interviews suggest a dual process of simultaneous acceptance and marginalization of alternative practitioners. While small numbers of alternative practitioners were found to be practicing in a wide variety of hospital departments and in a broad spectrum of specialties, they were in no cases accepted as regular staff members and their marginality was made clear by a variety of visible structural, symbolic and geographical cues. Considerable increases in the number, activity and visible presence of alternative practitioners in the hospitals occurred by 2016. These are discussed along with the mechanisms utilized to expand their presence in Israeli hospitals. Citation: Shuval JT (2018) Practicing Alternative Medicine in Israeli Hospitals. J Family Med Prim Care Open Acc: JFOA-119. 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Practicing Alternative Medicine in Israeli Hospitals
There is growing evidence that alternative health care practitioners and conventional physicians are working together in collaborative patterns. The paper examines these collaborative patterns in hospital settings in Israel. On the theoretical level the specific issues relate to theories concerning relationships between dominant institutional structures which enjoy the benefits of epistemological legitimacy as well as extensive, supportive social structures and groups of non-conformists who seek to attain many of the same goals by utilizing different methods based on other epistemologies. In the most general sense the issues involved concern processes of accommodation and social change. In an effort to examine the dynamics of the processes involved, data were collected twice: In 2000-2001, in an extensive research undertaking when CAM was beginning to show its presence in hospital settings and again in 2015 when a more modest second round of supplementary research was undertaken in an effort to observe changes over time. In 2000-2001 data were collected by means of semi-structured, qualitative interviews in four general hospitals in Jerusalem 19 persons were interviewed including 10 alternative practitioners working in a variety of fields and 9 conventional medical practitioners who worked with them (6 physicians and 3 nurses). Interviews focused on background and training, reasons for entry into the hospital, length of practice, status in the hospital system, mode of remuneration, content of work, modes of interaction with others in the hospital and problems encountered. In 2015-2010 in-depth interviews were carried out with CAM practitioners and policy makers in the Israel Ministry of Health and in a variety of health care institutions. These interviews focused on the role and functions of CAM in Israeli hospitals over the intervening period. Observations were carried out in selected hospital settings. An in-depth literature search regarding research and policy statements on the role of CAM in Israeli hospitals during the intervening period provided an overview of empirical changes. The paper discusses the early modes of entry into Israeli hospitals, the dilemmas faced and the mechanisms used to overcome barriers. The findings of the first wave of interviews suggest a dual process of simultaneous acceptance and marginalization of alternative practitioners. While small numbers of alternative practitioners were found to be practicing in a wide variety of hospital departments and in a broad spectrum of specialties, they were in no cases accepted as regular staff members and their marginality was made clear by a variety of visible structural, symbolic and geographical cues. Considerable increases in the number, activity and visible presence of alternative practitioners in the hospitals occurred by 2016. These are discussed along with the mechanisms utilized to expand their presence in Israeli hospitals. Citation: Shuval JT (2018) Practicing Alternative Medicine in Israeli Hospitals. J Family Med Prim Care Open Acc: JFOA-119. DOI: 10.29011/JFOA-119. 100019 2 Volume 2018; Issue 02