Does Biomedicine Control for Rhetoric? Configuring Practitioner-Patient Interaction
[First para.]: "The question of how to evaluate health interventions in which the clinial encounter may itself have therapeutic value has increasingly been foregrounded over the last two decades as health research agendas have adopted more encompassing views of health and illness. This movement toward a broader focus in health research stems in large part from rising incidence of chronic, functional conditions, such as pain, fatigue, impaired cognitive function, and intestinal discomfort--conditions for which conventional medicine has not been able to offer much solace. Patiences with these kinds of conditions seem to benefit, especially, from care that involves an interpersonal dimension (Barry, Stevenson, Britten, Barber, & Bradley, 2001; Wagner, Bennett, Austin, Greene, Shaefer, et al., 2005). However, investigating interventions that depend extensively on interaction among practicitioners and patients is difficulty to do through biomedicines gold-standard methodology, the randomized controlled trial (RCT). RCTs aim to isolate interventions from the context of their delivery through randomization, double-blinding, and placebo controls, but interventions are difficult to separate from their contexts in many aspects of clinical practice, nursing, hospital units (qua units), and alternative medicine. Such interventions are not easily randomized, blinded, or controlled because they comprise multiple, contingent, and interactive effects that cannot be isolated the way that a single drug's effects can be."