Changing boundaries: Modes of coexistence of alternative and biomedicine

Judith T. Shuval*, Nissim Mizrachi

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

53 Scopus citations


In this article, the authors address the boundaries of institutional structures, the dynamics of their configuration, and the nature of their permeability. The authors explored these issues in Israel, where the changing relationship of bio- and alternative medicine elucidates recent processes of professional boundary redefinition. They used qualitative methods to analyze in-depth interviews in clinics and hospitals where alternative and biomedical practitioners work under the formal auspices of publicly sponsored biomedical organizations. The findings show an incursion by alternative practitioners into territories viewed until fairly recently as the exclusive domain of biomedicine. However, the "alternatives" are not defined as regular staff members, and their marginality is elucidated by a variety of visible structural, symbolic, and geographical cues. The authors used decoupling theory in interpreting the findings. Changed boundary contours signal underlying processes of social change that could have meaningful implications in defining membership criteria in the biomedical community.

Original languageEnglish
Pages (from-to)675-690
Number of pages16
JournalQualitative Health Research
Issue number5
StatePublished - 2004


  • Alternative
  • Biomedicine
  • Boundary
  • Complementary
  • Decoupling
  • Integrative medicine
  • Israel


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