Patients treated by physicians and folk healers: a comparative outcome study in Taiwan.

Outcome of 118 patients treated by shamans in Taipei, Taiwan, is compared with that of 112 roughly matched patients treated by physicians. Impressive among the chief findings at time of follow-up evaluation, more than three-fourths of patients in both groups across five distinctive sickness types perceived their health problems as improved and were so evaluated by the research staff. Patient attributions of source of therapeutic efficacy were more complex and ambivalent. Counter to our hypothesis a higher proportion of patients were dissatisfied with shamanistic treatment than with biomedical care, and this held true even for somatization patients with psychiatric problems. The findings are interpreted with respect to serious limitations on research design and methods that pertain to this and, we believe, any other study of indigenous healing. These limitations call into question certain of the findings in particular, and illustrate why assessments of therapeutic outcome, besides reflecting biological constraints, should be recognized as differential cultural construals of socially constructed reality.