Integrating CAM and biomedicine in primary care settings: Physicians' perspectives on boundaries and boundary work

Judith T. Shuval, Revital Gross, Yael Ashkenazi, Leora Schachter

Research output: Contribution to journalArticlepeer-review

23 Scopus citations


In this article, we present the results of a study that was conducted among 15 family physicians who had incorporated complementary and alternative medicine (CAM) into their clinical work in Israel. We aimed to explore the types of boundaries those physicians encountered, how these boundaries were contoured, and under what circumstances they were crossed. We conducted in-depth interviews with the physicians in 2008, and found that epistemological and cognitive boundaries did not pose a problem for them. However, with regard to the organizational boundary, the participants indicated that it was necessary to use a variety of strategies before they could utilize their CAM skills. Many of the participants indicated that the epistemological differences between the biomedical and CAM paradigms, such as the absence of evidence-based medicine in CAM practices, are not important. The ease with which boundaries were crossed in the complex social context described here is characteristic of postmodern societies. On the whole, the integrative physicians interviewed can be viewed as "postmodern" professionals who reject the impermeability of many long-established boundaries and hierarchies.

Original languageEnglish
Pages (from-to)1317-1329
Number of pages13
JournalQualitative Health Research
Issue number10
StatePublished - Oct 2012

Bibliographical note

Funding Information:
We thank the National Institute for Health Policy and Health Services Research in Israel for funding the study.


  • alternative and complementary medicine
  • boundaries
  • health care, primary
  • relationships, patient-provider
  • sociology


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