Why do people favour alternative medicine?
Abstract
Objectives: The primary aim of the study
was to investigate the determinants of
attitudes towards alternative medicine. The
study also examined the dimensionality of
dissatisfaction with conventional medicine.
Method: The data was based on a
telephone survey of a random sample of
787 Victorians. The survey was conducted
in 1997-8.
Results: Principle component analysis
showed that dissatisfaction with
conventional medicine has two distinct
dimensions, one relating to the medical
outcome and the other relating to the
medical encounter. Multiple regression
results showed that neither of these
dimensions explain people's attitudes
towards alternative medicine. Instead, a
substantial proportion of variance in this
variable was explained by a set of values
that include faith in natural remedies,
subscribing to a holistic view of health,
consumerism and believing in individual
responsibility.
Conclusion:The main reason people
favour alternative medicine is their health-
related values and beliefs.
Implications: Health policies of the future
should take into account values and
cultural change.
(Ausf N Z J Public Health 1999; 23: 266-71)
Submitted: February 1999
Revision requested: March 1999
Accepted: April 1999
266 AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH
Mohammad Siahpush
La Robe UniversitH Victoria
A lternative medicine refers to those
therapeutic systems that are not taught
widely in medical schools and are not gen-
view of health, reject authority, believe in in-
dividual responsibility for achieving good
health, and hold consumerist attitudes.
erally available inside hospita1s.l It includes An empirical assessment of the relative
such modalities as naturopathy, chiroprac- importance of the three major explanations
tic, homoeopathy and traditional Chinese requires multivariate analyses, which have
medicine. been rare in the published literature within
Alternative medicine has become popu- the field of alternative medicine. The few
lar in many Western countries in recent existing analyses overwhelmingly suggest
time^.^.^ Eisenberg; based on a sample of that values and beliefs play a large role in
1,539 adults in the United States, showed that shaping people's view and use of alternative
34% of respondents had used services of al- medicine. The evidence regarding dissatis-
ternative therapies at least once in the past faction with the medical outcome and the
, ~a survey of medical encounter is less clear. McGregor
year. Similarly, M a ~ L e n n o nin
3,004 Australians, found that 48.5% of and PeayI4 compared 85 respondents from
respondents had used at least one non- clients of an alternative health center (Touch
medically prescribed therapy in the past year. for Health) and 81 respondents from com-
As a consequence of this popularity, the ql..es- munity at large inAustralia.They found that,
tion of why people have turned to these thera- after controlling for occupation, unconven-
pies has received much attention in the social tionality (not being traditional, habitual or
science literature. conforming) and dissatisfaction with ortho-
Three major explanations have emerged.5 dox medicine proved to be significant pre-
The first suggests dissatisfaction with the dictors of alternative medicine use.
medical outcome - the inability of conven- Astin" used a random sample of 1,305
tional medicine to successfully treat many ill- Americans and, after adjusting for the effect
nesses.6.8The second suggests dissatisfaction of education and health status, revealed that
with the medical encounter - the doctor- dissatisfaction with orthodox medicine had
patient relationship within conventional medi- no impact on use of alternative medicine.
cine.'." The third suggests the emergence of Instead, such factors as subscribing to a
a set of values and beliefs, sometimes referred holistic philosophy of health and being at the
to as the postmoderm p h i l ~ s o p h y . ' ~ ~ ~ ~ ' ~ leading edge of cultural change predicted al-
An expanded discussion of these three hy- ternative medicine use.
potheses has been published e l s e ~ h e r e . ~ Finally, Yates et a1.,I6in their analysis of
Bakx argues that modernity, as embodied data from 152Australian patients with meta-
in science and biomedicine, is bankrupt and static cancer, controlled for social back-
that the recent popularity of the postmodern ground measures and showed that users of
philosophy is a reaction to the failures of the alternative medicine were significantly more
modernist project." Adherents of this new likely to value participation and personal
philosophy regard nature as benevolent, hold control in the process of treatment.
anti-science sentiments, believe in a holistic In these works no clear distinction was
Correspondence to:
Dr Mohammad Siahpush, Humanities and Social Sciences: La Trobe University, PO Box 821,
Parkers Road, Wodonga 3689. Fax: (02) 6058 381 1; e-mail: M.Siahpush@aw.latrobe.edu.au
1999 VOL. 23 NO. 3

made between dissatisfaction with the medical encounter and
medical outcome. Probably, the only empirical study that has
clearly made this distinction was the author’s own work.s In a
review of literature on the explanations for the popularity of alter-
native medicine, the author found that some works point to the
inability of conventional medicine to cure degenerative and chronic
diseascs and its failure to offer relief from pain associated with
many c~nditions.~,’The author also found that others point to the
interaction patterns that transpire during consultation^.^-" It is
argued that doctors tend to be authoritative, spend too little time
with patients and explain very little of the nature of illness, diag-
nosis and prognosis. In a previous research, the author used a ran-
dom sample of 209 Australians and, after controlling for socio-
demographic variables, found that dissatisfaction with the medi-
cal outcome had no effect on attitudes towards alternative medi-
cine. Instead, dissatisfaction with the medical encounter and
postmodern values and beliefs (belief in natural remedies, anti-
technology sentiment, and consumerism) were significant predic-
tors of people’s attitudes.
The present research expands the author’s earlier work by em-
ploying a much larger random sample of Australians. The analy-
sis attempts to assess the relative importance of the three explana-
tions for people’s attitudes towards alternative medicine: the medi-
cal outcome, the medical encounter, and the postmodern values/
beliefs exp1anation.A secondary aim ofthis research is to empiri-
cally verify that dissatisfaction with conventional medicine has
two dimensions, one relating to the medical outcome and the other
to the medical encounter.
Methods
Sampling
Ethics clearance for this research was obtained from the Hu-
man Ethics Committee of La Trobe University (Project no. 961
37). The sampling universe was all non-institutionalised adults in
the state of Victoria in Australia. Telephone interviews of 787
respondents were completed. The proportion of females in the
sample was 64%.The respondents were on the average 40.1 years
old and had completed 13 years of education.These statistics were
similar to what the author had found in an earlier study of a region
in Victoria.s The sample was selected based on a two-stage dis-
proportionate probability sampling technique. The first stage con-
sisted of selecting a systematic sample of telephone numbers from
the White Pages for non-metropolitan regions ofvictoria. Use of
directories is justified in regions in which the proportion of un-
published telephone numbers is low. Telstra authorities assured
that in all regions of Victoria except Melbourne, the percentage
of unlisted numbers is less than 10. The author was only able to
obtain an exact figure for the Albury-Wodonga region ( 6.7%).
For the metropolitan region of Melbourne, random digit dialling
was employed so that the sample would include the large propor-
tion of unlisted telephone numbers.
The second stage of sampling involved random selection of
individuals using the ‘last-birthday’ method."^^^ In comparison to
other methods such as the Kish method of random selection.” the
1999 VOL. 23 NO. 3 AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH
Why do people favour alternative medicine?
last-birthday method yields higher response rates?Osince it is short,
direct and non-invasive. The refusal rate of the present survey
was 2 1.3%.The interviews were structured and consisted of a set
of Likert type attitudinal and belief items as well as demographic
variables.
Because of the varying population sizes of different regions in
Victoria, and in order to sample a reasonable number of respond-
ents from regions with a low population density, disproportionate
sampling was employed. In the statistical analysis of data, cases
were weighted to compensate for this disproportionate sampling.
A second weighting scheme was used in order to compensate for
varying household sizes. When households have different sizes,
individuals in larger households have a smaller probability of se-
lection. Thus, for each case a weight proportional to the size of
the household was used.The overall weight assigned to each case
was the product of the two weights mentioned above. This overall
weight was also divided by its mean so that the final weighting
variable would have a mean of unity and that tests of significance
would not be invalidated due to an artificially large sample size.?’
Measurement
The questionnaire consisted of 59 questions and on the aver-
age each interview was approximately 12 minutes. Most were
conducted in the mornings and afternoons. Many call backs were
also made in the evenings to reach respondents who were unavail-
able during the day. The questionnaire included a large battery of
four-point Likert type statements with response categories rang-
ing from ‘strongly agree’ to ‘strongly disagree’.These items were
the basis of the scales developed for the dependent and the inde-
pendent variables. Principle component analysis was used to con-
firm the scalability of each scale. The score of each scale is the
average of the z-scores of the items composing the scale.
Dependent variable: The dependent variable is attitudes to-
wards alternative medicine. This concept refers to attitudes to-
wards both alternative therapies and therapists. In the beginning
of each interview, respondents were told that in the research alter-
native medicine predominantly refers to naturopathy, acupunc-
ture, herbal medicine and chiropractic. The following six items
were included in the scale of attitudes towards alternative medi-
cine (a=0.82):
Overall, I prefer alternative medicine to conventional medicine
I would recommend alternative medicine to anyone of my friends
who might get ill.
I think most alternative therapies do not work.
I would never use the services of alternative therapists.
I trust most alternative therapists.
I think most alternative therapists are quacks.
Higher scores on this scale represent a more favourable atti-
tudes towards alternative medicine.
Dissatisfaction with the medical outcome and the medical
encounter: Twelve items represented the concept of dissatisfac-
tion with conventional medicine. Principle component analysis
with Varimax rotation was used to verify that this concept had
two distinct dimensions, one concerning the clinical efficacy
267
Siahpush

Table 1. Factor loadings based on a principle component analysis of items related to dissatisfaction with conventional
medicine.
Items Factor 1 Factor 2
I think conventional medicine is unable to treat a lot of illnesses. -0.00 0.74
I have very little confidence in the ability of most GPs to give correct diagnosis. 0.41 0.59
Doctors can rarely do much for sick people. -0.09 0.70
Many doctors don't help their patients get well. 0.30 0.80
I feel confident that doctors are able to cure most illnesses. -0.30 -0.69
Most doctors are too authoritative in their relationship with their patients. 0.71 0.14
Doctors have too much Dower over their Datients. 0.70 -0.07
Most doctors soend too little time with their Datients. 0.80 -0.05
Most doctors do not give enouah exDlanations to their Datients. 0.72 0.24
Most
-. .
doctors
--
listen carefully to their patients during consultations. -0.73 -0.08
-
Most doctors have a lot of respect for their patients.
..-.. - - .
-0.67 -0.35
Most doctors
~~~~ _...
pay a lot of attention to the individual needs of their patients.
~
-0.82 -0.19
__

(medical outcome) of and the other concerning interaction pat-
terns (medical encounter) involved in conventional medicine.The
analysis, summarised in Table 1, resulted in two factors (compo-
nents) with eigenvalues greater than one (4.93 and 1.92). These
factors together accounted for 57.11% of the total variance in the
variables. All the variables with high loadings (0.5 and above) on
the first factor clearly represent dissatisfaction with the medical
encounter. All the variables with high loadings on the second fac-
tor clearly represent dissatisfaction with the medical outcome. Sub-
scquently, two scales were created for each of these dimensions
( a=0.86 anda=0.75, respectively). Higher scores on these scales
represent higher levels of dissatisfaction with conventional medi-
cine.
Natural remedies: This concept refers to a belief that natural
remedies are safer and more effective than chemical drugs pre-
scribed by doctors. The following six items were included in the
scale of natural remedies (a=0.60):
I prefer natural remedies to chemical drugs.
Most prescription drugs have negative side effects.
Additives such as preservatives and artificial colouring are harmful
to health.
Most prescription drugs obtained from pharmacies are effective.
I think it is necessaryfor people who are ill to take medications that
doctors prescribe.
Without medications that doctors prescribe, illnesses can never he
cured.
Higher scores on this scale represent a higher level of confi-
dence in natural remedies and more misgivings about chemical
and prescription drugs.
Anti-science sentiment: Two items were used to create the
scale of anti-science sentiment ( ~ 0 . 2 9p<O.OOO
; I):
Science is able to provide us with a better world.
Technological progress creates an environment harmful to people.
Higher scores on this scale represent a stronger anti-science
sentiment.
Holism: This concept refers to the belief that health is multi-
faceted involving an integration of mind, body and ~ p i r i t . The~~~'~
belief in the natural ability of the body to heal itself is also a char-
acteristic of holism.24Five items were used to create the scale of
holism (a=0.61):
Health is more than just keeping your body fit.
Health is about harmonising your body, mind and spirir.
Imbalances in a person's life are the major causes of illnesses.
Treatments should concentrate only on symptoms rather than the
whole person.
I think my body has a natural ability to heal itsel$
Higher scores on this scale represent a stronger belief in
holism.
Rejection of Authority: Five items were used to create the
scale of rejection of authority (a=0.69):
Health practitioners should treat their patients as equals.
Patients should be able to have input in what remedies health practi-
tioners prescribe.
Health practitioners should ask f o r patient k participation in theproc-
ess of healing.
Patients should have some say over what goes on during consulta-
tions.
Health pmctirioners should act as authority figures in their relation-
ship with patients.
Higher scores on this scale represent a stronger rejection of
authority exercised by health practitioners and a stronger belief in
patient participation.
Individual Responsibility: Four items were used to create the
scale of individual responsibility (a=0.56):
It is ultimately the individual who is responsible for hisiher health.
Achieving good health requires a change of lifestyle.
Achieving good health requires hard work and commitment.
We are what we are because of the choices we make.
Higher scores on this scale represent a stronger belief in indi-
vidual responsibility in maintaining health.

268 AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH 1999 VOL. 23 NO. 3
 Why do people favour alternative medicine?

Consumerism: Consumerism refers to the tendency to value Results

the existence of a large number of therapeutic options from which
to c h o o ~ e . ~ , ’ ? . * ~ , ’ ~ T
is honly
e r e one item in the dataset that repre-
sents this concept:
It S , p o d that nowaday we have so many dlperent types of therapies
t(i choosr,from.
This one variable is clearly a valid indicator of consumerism
and is a strong predictor of attitudes towards alternative medi-
cine, as shown in the analysis below. Higher scores on this item
represent a stronger belief in consumerism.
As this study is the first to examine postmodern values towards
health, all of the relevant attitudinal items in the questionnaire
had to be created for the purpose of this research. Yet there are
some similarities between them and items used in other research.
For example, some of the items used as indicators of the belief in
‘natural remedies’ are similar to the questions that appeared under
‘health consciousness’ in Furnham and Forey ’s “Do you
think that prescription drugs are always suitable?” and “Do you
prefer to avoid taking prescription drugs?”Also, some of the items
used as indicators of belief in ‘holism’ and ‘individual responsi-
bility’ are similar to questions used in the scales of ‘health locus
of control’ discussed by Furnham and ForeyZ7and Furnham and
Smith:?*“Treatment should concentrate on ‘symptoms’rather than
on the ‘whole’ person”, “I think my body can help heal itself”,
and “There is little one can do to prevent illness”.
Gender (O=male, I = female), age and years of education were
used as control variables. The statistical analysis of data, which
involved principle component analyses and Ordinary Least Squares
(OLS) regressions, was performed using SPSS for Windows
(Version 8).
Bivariate results: All significant bivariate correlations were
in the expected direction (Table 2). Dissatisfaction with both the
medical outcome and medical encounter were associated with fa-
vourable attitudes towards alternative medicine. Faith in natural
remedies, holding anti-science sentiments, subscribing to a holis-
tic view of health, rejecting authority, consumerism and believing
in individual responsibility were all associated with a positive
attitudes towards alternative medicine. It is also worth noting that
all of the correlations (except the correlation between anti-
science sentiment and rejection of authority) between values were
positive, a finding that adds to the validity of the indicators used
in this research to represent the postmodern philosophy.
OLS regression results: Preliminary analyses showed that the
regression error terms were not heteroscedastic and multi-
collinearity did not create a problem in estimation. Thus OLS
regression was used. Table 3 presents the results of three sequen-
tial models. Model 1 included control variables and the scale of
dissatisfaction with the medical outcome. Model 2 added the scale
of dissatisfaction with the medical encounter to model 1. Model 3
included all the independent variables. This model was used to
answer the research question: what is the relative importance of
the medical outcome, the medical encounter and the postmodern
explanations of people’s attitudes towards alternative medicine.
Model 1 explained only 2.3% of the variation in the dependent
variable, In this model dissatisfaction with the medical outcome
had a significant impact on the dependent variable in the expected
direction. This model also showed that men, more educated and
older individuals tended to have more favourable attitudes towards
alternative medicine.

Table 2.Zero-order correlations and descriptive statistics for all variables

Attitudes Age Education Gender Dissatis. Dissatis. Anti- Natural Holism Rejection Individ.
towards medical medical science remedies of Respon
alt. med. outcome encounter sentiment authority siblity

Education 0.05 -0.26’

Gender -O.Ogb 0.18‘ -0.00
-~
Dissatis. O.Ogb -0.16‘ -0.06 0.03
Medical
Outcome
Dissatis.
medical
encounter 0.15‘ -0.02 -0.27‘ -0.07a 0.40’
Anti-science
sentiment 0.11‘ -0.15‘ 0.25’ -O.Ogb 0.15’ 0.21‘
___ -
Natural
remedies 0.27’ -0.12’ -0.01 -O.lOb 0.34’ 0.39‘ 0.40’
Holism 0.31‘ -0.01 -0.02 -O.lOb -0.01 0.23‘ 0.12’ 0.29‘
Rejection of
authority 0.22‘ O.Ogb -O.llb -O.lOb 0.14‘ 0.27’ -O.OBa 0.13’ 0.30‘
.
lndivid
Responsiblitv 0.27‘ 0.1 lb 0.22c 0.01 0.01 0.02 0.22‘ 0.15’ 0.45’ 0.21‘
Consumerism 0.41‘ 0.03 -O.Ogb -0.15’ 0.07a 0.29‘ 0.04 0.17‘ 0.38‘ 0.46’ 0.31’
Notes:
(a) pc0 05 one-tailedt-test.
(b) p 0 . 0 1 one-failed 1-test.
(c) p<O 001, one-tailedf-test.

1999 VOL. 23 NO. 3 AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH 269
Siahpush

Model 2, in which the scale of dissatisfaction with the medical
encounter was entered into the equation, explained only 3.6% of
the variations in the dependent variable. Dissatisfaction with the
mcdical encounter had a significant effect on attitudes towards
alternative medicine, but the effect of dissatisfaction with the
medical outcome disappeared in this model.
Finally, Model 3, in which postmodern values were entered
into the equation, explained 23% of the variation in attitudes to-
wards alternative medicine. The inclusion of postmodern values
accounted for an increase of about 540% in the proportion of vari-
ance cxplained. In this full model the effects of neither dimen-
sions of dissatisfaction with conventional medicine were signifi-
cant. All of the postmodern values except anti-science sentiment
and rejection of authority had significant effects on the dependent
variable in the expected direction. The only significant demo-
graphic variable was education.
Discussion and conclusion
This article made a conceptual and empirical distinction be-
tween two dimensions of dissatisfaction with conventional medi-
cine: dissatisfaction with the medical outcome and with the medi-
cal encounter. Multivariate analyses showed that, after control-
ling for postmodern values and beliefs, neither of these dimen-
sions were significant predictors of attitudes towards alternative
medicine. This finding is congruent with Astin's work, which
found no significant effect of dissatisfaction with conventional
medicine on the use o f alternatives. This finding is also mostly
congruent with the author's previous research5 where it was found
that dissatisfaction with medical outcome had no impact on atti-
tudes towards alternatives. In that research, it was also found
that the effect o f dissatisfaction with the medical encounter re-
mained significant after controlling for postmodern values. HOW-
ever, it was shown that the unique contribution of the set of
postmodern values in explaining attitudes towards alternative
medicine was about twenty times as large as the unique contri-
bution of dissatisfaction with the medical encounter.
The main contribution of this work is the finding that subscrib-
ing to the postmodern philosophy is associated with a positive
perception of alternatives. It was shown that faith in natural rem-
edies, subscribing to a holistic view of health, consumerism and
believing in individual responsibility were significant predictors
of attitudes towards alternative medicine. It is the congruence of
the postmodern philosophy with the practices and beliefs of many
alternative therapies that attracts people.13 Complementary prac-
titioners commonly use natural and non-invasive treatments, es-
pouse a holistic view of health, allow patient participation in the
process of healing,29 and stress that it is the responsibility of the
individual to achieve a desired state of health.13 The biomedical
establishment should perhaps be comforted by the findings of this
research as they suggest that medical practices (or malpractice)
play a small part in the growth of alternative systems. A main
concern for biomedicine should be the fact that it is probably per-
ceived not to be holistic, not to use natural remedies or allow pa-
tient participation. In general, health policies of the future should
be sensitive to cultural currents. Obviously, providing health care
is much more than solely addressing the physical basis of a condi-
tion. In order for health policies to make effective use of resources
and available therapeutic systems, they should take into account
values and cultural change.
Finally, methodological weaknesses of this research should b e
noted.

Table 3. Regression of attitudes towards alternative medicine on independent variables

IndependentVariables Model 1 Model 2 Model 3

B (SE b) B (SE b) B (SE b)
Gender
. ~~ ___ -0.138' (.042) -0.11Eb (0.042) -0.036 (0.039) __
Age
~~ ..._I______ _ _ _ _ _ _ _ _ _ _ 0.002a
_ _ _ _(.001)
__~-~ 0.002a (0,001) 0.002 (0,001)
Education O.OIOa (.005) 0.016b (0.006) O.OIOa (0.005)
Dissatisfaction with medical outcome 0.1 13' (.033) 0.048 (0.038) 0.002 (0.036)
Dissatisfaction with medical encounter 0.122' (0.035) -0.023 (0.034)
Natural remedies 0.236' (0.046)
Anti-science sentiments -0.018 (0.029)
Holism 0.094b (0.038)
Rejection of authority 0.007 10.032) ~

Individual responsibility 0 073a (0.034)

Consumerism 0 42EC(0.051)
Intercept -0 303 -0.381 -1.113
- __-_ -
Degrees of freedom 781 780 774
-
R'
~ -
0 028 0.043 0.240
Adjusted R2 0.023 0 036 0.230 -
SEE
- __ 0.554 0 550 0.492
Nores
(a) p c 0 05 one-railed 1-resr
(b) p<O 0 1 one-tafled r-rest
(c) pc0 001, one-tafled1-resr

270 AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH 1999 VOL. 23 NO. 3
___._
First, the research focused on attitudes towards alternative
medicine, not its actual use by patients. Although attitudes are
expcctcd to correlate closely with actual behaviour, examining
behaviour proper would provide a better understanding of the
growth of alternative medicine. However, the fact that the results
of this research parallel those o f Astin’s,15 where useinonuse o f
alternatives was the dependent variable, suggests that attitudes
and actual behaviour are closely linked in this case.
Second, the reliability coefficients of some of the scales were
not high. Future research should experiment with a larger number
of ikins and attempt to develop more reliable measures of some
of the dimensions of the postmodern philosophy.
Third the technique of data collection employed in this re-
search, i.e. telephone surveys, can be criticised. A major draw-
back o f telephone surveys is their noncoverage of households
withoul a telephone line. Though no accurate statistics are avail-
able, i t is safe to assume that in most industrial societies, includ-
i n g h s t r a l i a , telephone services are readily available to most social
strata. It is at the very bottom o f t h e social hierarchy that the avail-
ability of telephone services is questionable. Thus, the results of
this study can not be generalised to the highly disadvantaged seg-
ments of the population. Another methodological weakness was
that whereas random digit diailing was used to produce phone
numbers in Melbourne, White Pages were used for other regions
in Victoria. This means that the population of the study included
all of those with a telephone line in Melbourne and all of those
with a listed telephone number in other areas of Victoria. It
should be noted that the decision to limit random digit dialling to
Melbourne was solely a practical one as the personnel cost of this
technique is three to four times greater than that ofusing theWhite
pages to generate phone numbers.
In conclusion, the findings of this study suggest that the main
reason people favour alternative medicine is their health-related
values and beliefs. Dissatisfaction with biomedicine does not ap-
pear to play an important part in shaping people’s attitudes to-
wards alternatives. This was only a preliminary study in delineat-
ing the postmodern philosophy and examining its impact on the
popularity of alternative medicine. It is hoped that future research
will make further advancements in the measurement of this cul-
tural trend and assess its effect on actual use of or the intention to
use alternative medicine.
Acknowledgments
The author wishes to thank Karen Linton and Peter Deane for
conscientious data collection and management,
1999 VOL. 23 NO. 3 AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH
Why do people favour alternative medicine?
References
1. Jonas WB. Alternative medicine. J Furn frurt 1997; 45:3 4-7.
2. Paramore LC. Use of alternative therapies: estimates from the 1994 Robert
Wood Johnson Foundation national access to care survey. J Pain Syrnptonr
Manage 1997; 13: 83-9.
3. MacLennan AH, Wilson DH, Taylor AW. Prevalence and cost of alternative
medicine in Australia. Lancet 1996; 347: 569-73.
4. Eisenberg DM, Kessler RC, Foster C. et al. Unconventional medicine in the
United States: prevalence, costs, and patterns of use. N Engl J Med 1993;
328: 246-352.
5. Siahpush M. Postmodern values, dissatisfaction with conventional medicine
and popularity of alternative therapies. J Sociol 1998: 34: 58-70.
6. Anyinam C. Alternative medicine in western industrialised countries: and
agenda for medical geography. Can Geographer 1990; 34: 69-76.
7. lngliss B, West R. The alternative health guide. London: Michael Joseph,
1983.
8. Holden C. Holistic health concepts gaining momentum. Srienre 1978; 200:
1029.
9. Easthope G. The Response of orthodox medicine to the challenge of alterna-
tive medicine in Australia. Aust N Z J Sociol 1993; 29: 289-301.
10. Sharma UM. Using alternative therapies: marginal medicine and central con-
cerns. In: Abbot P, Payne G, editors. New Directions in the sociology ofhealth.
London: The Falmer Press, 1990.
1. Taylor RCR. Alternative medicine and the medical encounter in Britain and
the United States. In: Salmon JW, editor. Alfernative medicines: popular and
policy perspectives. New York: Tavistock, 1984: 191-228.
2. Bakx K. The ‘eclipse’ of folk medicine in western society. Sociol Neulth
Illness 1991; 13: 20-38.
3. Coward R. The wjhole truth: the rnyfh ofalternofive medicine. London: Fdber
and Faber, 1989.
4. McGregor KJ, Peay ER. The choice of alternative therapy for health care:
testing some propositions. Soc Sci Med 1996; 43: 1317-27.
15. Astin JA. Why patients use alternative medicine? J A m MedAssoc 1998; 279:
1548-53.
16. Yates PM, Beadle G, Clavarino A, et al. Patients with terminal cancer who
use alternative therapies: their beliefs and practices. Soriol Health /l/ness
1993; 15: 199-216.
17. O’Rourke D, Blair J. Improving random respondent selection in telephone
surveys. J Murk Res 1983; 20: 428-32.
18. Salmon C, Nichols J. The next-birthday method for respondent selection.
Public Q 1983; 47: 270-6.
19. Kish L. Survey sampling. New York: Wiley, 1995.
20. Lavarkas P. Telephone survey methods: sampling, selection and supervision.
Newbury Park: Sage, 1993.
2 I . Czaja R, Blair J. Designing surveys: a guide to decisions and procedures.
Newbury Park: Sage, 1996.
22. Goldstein MS, Sutherland C, Jaffe DT, Wilson J. Holistic physicians and
family practitioners: similarities, differences and implications for health policy.
Soc Sci Med 1988; 26: 853-61.
23. Gordon JS. Holistic medicine: toward a new medical model. J Clin Psychia-
f r y 1981; 42: 114-9.
24. Otto HA, Knight JW. Wholistic healing: basic principles and concepts. In:
Otto HA, Knight JW, editors. Dimensions in wbolisfic healing. new frontiers
in the treatment of the whole person. Chicago: Nelson-Hall, 1979.
25. Riessman F. Alternative health movements. Soc Policy 1994; 24: 53-7.
26. Cassileth BR. The social implications of questionable cancer therapies. Cun-
cer 1989; 63: 1247-50.
27. Furnham A, Forey I. The attitudes, behaviours, and beliefs of patients of
traditional vs complementary (alternative) medicine. J Clin Psycbol 1994;
50: 458-69.
28. Furnham A, Smith C. Choosing alternative medicine: a comparison of the
beliefs of patients visiting a general practitioner and a homoeopath. Soc Sci
Med 1988; 26: 685-9.
29. Aakster CW. Assumptions governing approaches to diagnosis and treatment.
Sac Sci Med 1989; 29: 293-300.
271