TY - JOUR

T1 - ‘Fantastic hands' - But no evidence

T2 - The construction of expertise by users of CAM

AU - Pedersen, Inge Kryger

AU - Baarts, Charlotte

PY - 2010

Y1 - 2010

N2 - Both in the Scandinavian welfare states and elsewhere the private CAM market acts as a health provideralongside the state. There is very limited established scientific evidence for the effects of treatments andoften they are non-authorised. How, then, do users construct and attribute expertise to CAM practitioners?Drawing on 90 in-depth interviews with 30 Danish CAM users of reflexology or acupuncture,three aspects of expertise emerged from the empirical analysis of how the CAM users ascribe legitimacyto the therapies involved. Thus, expertise is: (i) embodied and produced by means other than those usedin evidence-based knowledge or abstract expert systems; (ii) constructed by making a clear-cut divisionbetween the roles and responsibilities of the practitioner and the user; and (iii) constructed on the basisof specific training or education that practitioners have achieved. The expertise that the users seek andconstruct is not necessarily available, and users therefore consult many different kinds of experts. Indoing so, they may themselves become the ‘experts’ in heterogeneous, context-specific dimensions ofknowledge. In conclusion we propose further studies of what lay people can offer to a democratised andcustomer-sensitive system of health care as an area of inquiry that holds promise for providinga sociological approach to the domain of expertise.

AB - Both in the Scandinavian welfare states and elsewhere the private CAM market acts as a health provideralongside the state. There is very limited established scientific evidence for the effects of treatments andoften they are non-authorised. How, then, do users construct and attribute expertise to CAM practitioners?Drawing on 90 in-depth interviews with 30 Danish CAM users of reflexology or acupuncture,three aspects of expertise emerged from the empirical analysis of how the CAM users ascribe legitimacyto the therapies involved. Thus, expertise is: (i) embodied and produced by means other than those usedin evidence-based knowledge or abstract expert systems; (ii) constructed by making a clear-cut divisionbetween the roles and responsibilities of the practitioner and the user; and (iii) constructed on the basisof specific training or education that practitioners have achieved. The expertise that the users seek andconstruct is not necessarily available, and users therefore consult many different kinds of experts. Indoing so, they may themselves become the ‘experts’ in heterogeneous, context-specific dimensions ofknowledge. In conclusion we propose further studies of what lay people can offer to a democratised andcustomer-sensitive system of health care as an area of inquiry that holds promise for providinga sociological approach to the domain of expertise.

U2 - 10.1016/j.socscimed.2010.06.007

DO - 10.1016/j.socscimed.2010.06.007

M3 - Journal article

VL - 71

SP - 1068

EP - 1075

JO - Social Science & Medicine

JF - Social Science & Medicine

SN - 0277-9536

IS - 6

ER -