The Blackwell Companion to Medical Sociology

434 Deborah Lupton
One study of Sydney patients, conducted by myself and colleagues, found that
although they had chosen their general practitioner in a casual manner, only a
small minority of the respondents reported ever changing to another GP or even
consideringsuch a move. While they may have occasionally sought help from
other doctors or alternative practitioners, the majority of respondents adhered to
a satellite rather than a pluralist model of health care, preferringto return to
their regular GP for care whenever possible (Lupton et al. 1991). In another,
more recent study, again of patients living in Sydney, I found that the participants
expressed their belief in the power of biomedicine to cure illnesses and save
lives, and were particularly impressed by the advances made in high-technology
surgical procedures and drug therapies. The authority and expertise that attend
biomedicine and those who are medically trained still carried much weight
amongthese patients (Lupton 1996, 1997).
These findings would suggest that the Australian medical profession retains a
significant degree of social and cultural status. While Medicare does incorporate
some degree of structural control over doctors' professional activities, as most
general practitioners and specialists are not salaried workers in public hospitals
but rather are self-employed, they are under far less government control than are
practitioners in such fully public systems as the British National Health Service.
Further, medical practitioners in Australia, particularly AMA officials, still have
a high profile in terms of acting as influential spokespeople on medical matters in
the public domain. They are frequently reported as authoritative experts in the
news media in reports on medical and health issues compared with other health
care providers or consumer bodies (Lupton 1995b; Lupton and McLean 1998)
and hold important roles in decision-makingbodies in hospitals and government
agencies (Willis 1993). Although news stories in the Australian press report
cases of medical negligence or misconduct, they also frequently represent
doctors as skilled, heroic, and fighting to maintain high standards of patient
care in the face of fundingpressures for health care delivery (Lupton and
McLean 1998).
In recent years, challenges to the dominance of orthodox practitioners in
Australia have come from practitioners of alternative therapies, who have
sought to have their therapies legitimized. Universities now offer courses in
such therapies as chiropractic, homoeopathy, and acupuncture, and chiropractors
and osteopaths have achieved statutory registration as legitimate health
care providers in Australia. Only acupuncture is officially recognized through
attractinga Medicare rebate, however, and this is only the case if it is performed
by a medical practitioner. The AMA has also played an important role in
opposingthe entry of alternative practitioners into orthodox health care system,
arguing that alternative therapies are ``unscientific'' (Easthope 1993). The medical
profession thus far has successfully prevented alternative therapists from
practisingin hospitals.
One study conducted in the state of South Australia in 1993 found that one in
five of the respondents had ever sought treatment from alternative practitioners
(MacLennan et al. 1996). But while alternative therapies continue to gain popularity
amongAustralians, orthodox medicine remains far and away the first
source of health care. Although more Australians are seeking care from alternat-