Patients from rural areas, like those who participated in our study, tend to choose healers based on their perception and experiences of health and illness. If they perceive illnesses as rok boaw boaw, which do not affect their work and lifestyle, they ask for help from traditional healers because this is effective, as well as cheaper and less time consuming than consulting mainstream health services. However, they will turn to modern doctors if they perceive their illness as serious or rok nuk nuk, major health problems that are life threatening. In effect, traditional healers serve as a primary health care resource for people in rural areas.
Lay people do not rely on one particular healing model. Switching strategies, including switching between healing models, is a normal way of seeking help. Thai people expect to exercise considerable agency in their health care choices; more agency than is normally provided by western health care services. They choose healers based on whether these practitioners can help them attain optimal health. If they have negative experiences of one healing form, they will consider other forms available to them. Thai rural patients use both traditional and modern medical systems for recovering from, or living with, their ailments.
It is clear from our study that the traditional healing system is an important primary care resource for citizens of rural southern Thailand. It is also clear that traditional medicine is valued precisely because it is available locally, in culturally appropriate ways, as an alternative or a complement to modern medical services that are available in regional centres. However, these modern medical services are often located at a significant distance from rural settlements. Any integrated model must ensure that the local character of traditional medical practice is retained, not regionalised as with modern health services. In a further publication, we intend to develop a proposal for integrating tradition healing into the Thai health system.