El orden judicial

In seeking to explore how consumers of CAM engage in co-creating value and what value they gain from consuming CAM, we must first attempt to understand who the CAM

consumer is and examine the nature of today’s consumer as the key protagonist. As

previously discussed it is thought the CAM consumer holds postmodern values particularly towards health and healing (Siahpush, 1998, 1999, 1999a). Does the CAM consumer

epitomise the postmodern consumer or what is often referred to as the ‘new’ consumer? There has been much discussion and debate about the ‘new consumer’ in consumer

literature: Who are they? Why are they important? How did they emerge? (Baker, 2003; Goldsmith, 2001; Lewis & Bridger, 2000; Prahalad & Ramaswamy, 2004a). Lewis and Bridger (2000) in their book, The Soul of the New Consumer, defines the ‘new consumer’ as individualistic, involved, independent and informed with an over-riding quest for authenticity. Old consumers, who still exist alongside new consumers, are relics from the

‘production orientated’ economy and described as conformist, uninvolved and uninformed.

Unlike the ‘new consumer’s’ drive for authenticity old consumers are motivated by a need

for convenience. Although the book is criticised for lacking in empirical research and adding little to consumer research (Goldsmith, 2001), it does provide an interesting account of, if not insight, into the changing profile of the consumer that contemporary marketing scholars are espousing (see Achrol & Kotler, 1999; Baker, 2003; Grönroos, 2008; Gummesson, 2002; Holbrook, 1994; Kotler et al., 2010; Prahalad & Ramaswamy, 2004, 2004a; Skousgaard, 2006; Stuart-Menteth, Wilson & Baker, 2006; Traulsen & Noerreslet, 2004; Vargo & Lusch, 2004; Woodruff, 1997). These consumers are described as more empowered (Kotler et al., 2010) and involved in the products and services they consumer. Kotler, et al. (2010, p. 4) believe “we are witnessing the rise of a values-driven

era”. They talk of consumers as “whole human beings with minds, hearts, and spirits”, who

not only want functional and emotional fulfilment but “human spirit fulfilment in the

products and services they choose”. Baker (2003) in her book New Consumer Marketing:

Managing a Living Demand System also talks about a new breed of consumer who is well-

informed and highly empowered. Baker’s (2003) approach is based on a ‘value-centric

orientation’ where value co-creation and value delivery are at the heart of all marketing activity.

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Prahalad and Ramaswamy (2004) concur with the changing role of the consumer from isolated to connected, from unaware to informed, from passive to active. The impact of this new consumer role has manifested because of technological advances enabling increased access to information globally, consumer networking and activism, plus providing opportunities for consumers to experiment with and develop products. Prahalad and Ramaswamy (2004) challenge the traditional notion of value and its creation, in that firms create and exchange value with consumers. These authors argue that the future of competition will require firms to co-create value with their consumers and thus will have to engage consumers in the co-creation of value. This engagement will involve personalised interactions that are meaningful and sensitive to an individual consumer. It is the co- creation experience, not the specific offering, which forms the basis of unique value. Prahalad and Ramaswamy (2004a) identified four consumer choice dimensions which they think condition the co-creation experience. First, consumers want freedom to interact with the firm via a variety of ways; second, consumers want to define choices that reflect their desires; third, consumers want to interact and transact quickly, easily, conveniently and safely; and fourth, consumers want their consumption experiences to be fairly priced (i.e. what they are willing to pay for).

The shift from a production-driven economy to a consumer-oriented society was highlighted by Baudrillard (1988). He argued that value is created during the consumption process and not at the point of value exchange as has been argued by economist for centuries. This is especially pertinent in health care where a new consumer is emerging, one that is “information strong, information seeking, non-authoritarian and increasingly

demanding” (Traulsen & Noerreslet, 2004, p. 203). Kelner and Wellman (1997b) in their study on health care and consumer choice concluded that many consumers feel free to choose from a range of health care options, from traditional medical care to alternative therapies in the search for better health and personal growth. Kelner and Wellman (1997b, p. 211) concur with the new consumer sentiment in health care.

We are seeing increasing numbers of “smart consumers”; people who are

well informed about health issues and up-to-date on the latest

“infomessage” from the media. These are consumers who prefer to use

their own judgement and the guidance of personal referrals to make health care decisions...Their decisions are individual ones, in which they act as concerned consumers rather than compliant patients

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Despite some obvious advantages for the empowered new consumer Rotfeld (2003, p. 7) warns “that in health care, the customer does not always know best”. The informed consumer is not necessarily a good thing. Rotfeld (2003) believes that not all health consumer needs should be satisfied because they are not the medical expert. Pandering to

consumers’ new found autonomy may not be in their best interest (Miskelly, 2006). In fact Miskelly (2006) in her study on ‘healing pluralism and responsibility’ found that patients of health care (orthodox, integrative and CAM) wanted to share the responsibility of their health with their health practitioner. Accordingly the orthodox model provides a more

secure ‘collectivist’ discourse than does the ‘neoliberal’ and ‘individualist’ ideology of

CAM, where taking responsibility for your own health is paramount. In her study, Miskelly (2006, p.249) notes that although “the fostering of individual responsibility for health and

wellbeing further enhanced patient perceptions of CAM”, the reality was patients did not necessarily want to take full responsibility for their own health. On the other hand, Long (2009) argues that CAM has the potential to contribute to the area of health promotion because it naturally supports individuals to take control of their own health and fosters behaviour change (Long, 2009).