Introduction

The integration of complementary and alternative medicine (CAM) into orthodox healthcare systems and the professionalisation of these services are global phenomena. These developments place new challenges on both the governance of healthcare and the dominance of orthodox medicine (Saks, 2006). However, national governments and professional bodies respond in different ways to these new demands. Integration and professionalisation are driven by various forces and the success of new professional projects is uneven. This chapter explores the processes of integration of CAM into the official healthcare system in Russia. It places the demand for, and supply of, ‘folk medicine’ in the context of fundamental political and cultural changes in Russian society; this includes tensions and contradictions in the discourse of ‘folk medicine’ and the professionalisation of alternative medical practitioners.

We introduce an anthropological approach to the study of professions that highlights the significance of culture and context. We explore the dynamics here to answer three main questions:

• • What is the global context for the integration of professional cultures in healthcare?

• • What are the main cultural, economical and political conditions that shape the dynamics of relations between CAM and orthodox medicine in Russia?

• • What is the nature of contemporary collaboration between CAM practitioners and orthodox doctors?

We draw on material from the research project on ‘The dynamics of social and professional status of traditional medicine specialists in Russia’, which builds on a larger project funded by INTAS, the European Union Fund for Eastern European research (for details, see Yurchenko and Saks, 2006). The research is based on a content analysis of popular medical periodicals over the last 15 years and qualitative interviews with CAM providers who practise different forms of ‘ethno-treatment’ (traditional forms of healing of specific ethnic origin). Here we focus on in-depth interviews with medically qualified (14) and lay practitioners (7) of CAM in the provincial city of Saratov in 2005 and 2006.

The chapter starts by discussing the global dimensions of the integration of CAM with orthodox healthcare, arguing for cross-cultural sensitivity. This is followed by an analysis of the integration of CAM services in the context of the changing Russian society and healthcare system. The findings from our interviews highlight the flexibility of boundaries between doctors and healers and the diverse strategies of professionalisation in the context of Russian culture and market-driven transformations. Finally, some conclusions are drawn on culture as a resource for professionalisation.