Self-treatment and its discussion in medical consultations: how is medical pluralism managed in practice?
Abstract
Recent policy changes in the UK such as deregulation of prescribed medicines and the introduction of telephone helpline services are intended to promote self-treatment. Drawing on interviews with, and consultations between, 35 patients and 20 general practitioners, we use Kleinman's (Patients and Healers in the context of culture: an exploration of the Borderland between Anthropology, Medicine and Psychiatry, University of California Press Ltd., London) model of the three sectors of health care in order to examine the range of self-treatments people use and the discussion of these treatments in medical consultations. We argue that despite the availability of a range of treatment options and policy changes advocating greater use of self-treatment, patients are inhibited from disclosing prior self-treatment, and disclosure is affected by patients' perceptions of the legitimacy of self-treatment. The findings are in keeping with Cant and Sharma's (A New Medical Pluralism, Alternative Medicines, Doctors, Patients and the State, UCL Press, London) contention that although there has been a pluralisation of "legitimate" providers of health care and a restructuring of expertise, biomedicine itself remains dominant.
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Self-help was considered a separate category due to problematic formal/informal categorisation in relation to bereavement support.
“Self-help was considered a separate category due to problematic formal/informal categorisation in relation to bereavement support.30”
From Support received after bereavement by suicide and other sudden deaths: A cross-sectional UK study of 3432 young bereaved adults (2017) · cites this paper as [30]
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“It has been established that this development has changed the way healthcare is organized in many Western countries, putting a larger responsibility on the patients to participate in the process of caring (Stevenson et al. 2003; Hansson 2006; Lewis 2006).”
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“For example, self-management has been viewed as purposive action which stops at the outset of the consultation in which 'proper' medicine takes over [16] or something which is marginalized in the consultation in favor of medical instruction[ 17 ].”
Complementary and Alternative Medicine
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“In previous studies it was also found that self-treatment was common when the severity of the illness was perceived to be low [18-20].”
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“In other studies patients have reported being reluctant to discuss their perspective of management strategies because they believe that some doctors are not receptive to the patient’s view (Schulman-Green et al., 2006; Stevenson et al., 2003).”
Descriptions of self-treatment for the middle-aged and elderly in Shanxi, China
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“The focus on biomedical theory, evidence, and safety highlights the need for evidence on TCA efficacy, mechanisms and safety and improved access to information.(12,15,17) The unique relationship between families and HVs could facilitate the ‘harmonious marriage’ of TCA and conventional medicine.”
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“…the parallel existence of a biomedical health care system and other forms of natural and scientific health care (postmodern scientific health care) such as chiropractic, naturopathy, homoeopathy, and aromatherapy (Raffaetà, 2013; Stevenson, Britten, Barry, Bradley, & Barber, 2003; Unschuld, 1980).”
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“as supplementary to the professional care systems (Stevenson et al. 2003), I have demonstrated that, for most interviewees, it was the first avenue of care before”
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Self-Monitoring for Health: Questions for an Emerging FieldPreprint
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Brave new world for interventional bronchoscopy
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“…shows, patients are well aware of the tensions associated with participation; they may be reluctant to discuss their own self-care practices (Stevenson et al., 2003) and tread carefully when trying to insert their own ideas or concerns into medical consultations to avoid usurping the…”
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Self-care for health in rural Bangladesh
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- Authors
- Stevenson, F. A., Britten, N., Barry, C. A., Bradley, C. P., & Barber, N.
- Affiliations
- King's College London (GB)
- Brunel University of London (GB)
- University College Cork (IE)
- University of London (GB)
- Corresponding author
- Stevenson, Fiona A.
- Venue
- Social Science & Medicine
- Publisher
- Elsevier BV
- Published
- 2003-08
- Volume
- 57
- Issue
- 3
- Pages
- 513-527
- ISSN
- 0277-9536 (ISSN-L)
- OpenAlex
- W1980004891
- Cited by
- 134
- References
- 65
- Citations by year
- 2026: 4 · 2024: 5 · 2023: 2 · 2022: 2 · 2021: 5 · 2020: 3 · 2019: 6 · 2018: 4 · 2017: 10 · 2016: 3 · 2015: 2 · 2014: 5 · 2013: 5 · 2012: 12
- FWCI
- 27.10
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Social Science & Medicine (publishedVersion)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Topics
- Health Sciences › Medicine › Complementary and alternative medicine › Complementary and Alternative Medicine Studies
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Social Sciences › Sociology and Political Science › Migration, Identity, and Health
- Keywords
- self-medication, medical pluralism, medical consultation, general practitioners, complementary and alternative medicine, patient-physician communication
- MeSH terms
- Complementary Therapies, Attitude of Health Personnel, Culture, Nonprescription Drugs, England, Family Practice, Humans, Patient Acceptance of Health Care, Physician-Patient Relations, Referral and Consultation, Self Care, Self Disclosure, Self Medication, Sociology, Medical, State Medicine, Health Care Sector
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