Within System Distinctions

One common typology describing complex medical systems is the tripartite scheme of popular, folk, and professional medicine (Kleinman, 1978). The key variables are: who provides care and in what context. In the "popular" sector, non-specialists, such as one's self, mother, friends, or other kin and relations, provide treatment. Treatment is based on shared cultural understandings, and generally occurs in a family or household context. Folk sector healers are specialists; their practice is based on cultural traditions and philosophies. Legally sanctioned official systems make up the "professional" sector.

This three-part scheme is an advance on simple public-private dichotomizing, in which private or household care is separated from care provided within the formal health care system, and discounted. But the typology does have an unanticipated shortcoming in relation to its potential for cross-cultural application: although it specifically allows that some non-biomedical practices, such as Ayurvedic or traditional Chinese medicine, should be classed as professional medicine due to their routinized, formalized, professionalized nature, this is easily forgotten by those who would view those therapeutic modalities as so-called folk practices.

Bonnie O'Connor's model (1995) has only two parts: conventional medicine, and vernacular medicine. "Vernacular" medicine subsumes Kleinman's (1978) folk and popular sectors; "conventional" medicine consists only of the official, authorized, authoritative, dominative health care industry or system—whatever that may be in a given cultural context. The contrast is simple but important, because it explicitly highlights the dominative position held by conventional medicine. Anthropologists can apply this lesson cross-culturally because the power dynamics and medical status hierarchy that O'Connor's model reflects are, to at least some extent, universal (all systems have conventional medicine of some kind).

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