Abstract

Background
A critique of Complementary and Alternative Medicine is that its effectiveness is all placebo. In trying to deconstruct the placebo, scholars have looked at the context in the health encounter, identifying specific and non-specific effects in the doctor-patient relationship including communication; cognitive, psychological, and emotional element of the encounter; the meaning response during the encounter; the impact of the context on outcomes; and how the encounter is manipulated through such things as ritual.
Methods
This study used the chiropractic and osteopathic health encounter as a socially constructed space exemplars and used focus groups and a rapid ethnographic observation method in clinics to study the context of the encounter. The objective was to develop a systematic, valid, and rigorous methodology for collecting data about the contexts of health encounters.
Results
The study showed that the clinicians and clinical staff consciously construct social settings and the types of interactions that occur within them. This is done consciously and deliberatively.
Conclusion
The method we describe provided a rich data base on the context of the health encounter and it shows that these are not non-specific effects. The method could be applied to other health encounters in Complementary and Alternative Medicine and health care.

Key words: Complementary and Alternative Medicine; Health encounter; context; non-specific effects; placebo