In many countries traditional systems operate alongside hospitals rather than being displaced by them. The persistence is explained by access, continuity and the kind of account each system offers.
Proximity is the first factor
Traditional practitioners are distributed where people live, including areas where clinical facilities are distant or thinly staffed.
A practitioner reachable on foot within a village is used before a hospital reachable only by a day's travel, regardless of what either offers.
Where clinical provision has expanded, use of traditional practitioners has usually shifted rather than stopped, moving toward complaints that clinical services handle less readily. Long-running conditions, digestive complaints and joint pain are the categories that most often stay with the traditional practitioner.
They supply an explanation as well as a treatment
Traditional systems answer why a person became unwell, connecting the episode to diet, season, conduct or circumstance.
Clinical consultations are often too brief to construct that account, and a mechanism explained in physiological terms may not address the question being asked.
People frequently use both, taking clinical treatment for the condition and a traditional account for the sense of it.
The relationship is continuous rather than episodic
A traditional practitioner is usually known to a family across years and generations, and consultations occur without a formal referral.
That continuity means context does not have to be re-established each time, which is precisely what fragmented clinical care struggles to provide.
The relationship also extends beyond illness into ordinary questions about food, routine and life events. A practitioner consulted about a wedding date or a child's diet occupies a role no appointment system is structured to fill.
Regulation formalised these systems rather than removing them
Several countries created registration schemes, training standards and licensing bodies for traditional practitioners during the twentieth century.
Formalisation gave these systems institutional standing: colleges, qualifications, professional bodies and in some cases public funding.
That entrenched them further, because a registered profession with a training pipeline is far more durable than an informal practice.
Where the systems actually meet
Integration in practice is usually pragmatic rather than theoretical, with clinicians and traditional practitioners working in parallel and patients moving between them.
The recurring practical concern is interaction between herbal preparations and prescribed drugs, which requires each side to know what the other has given.
Disclosure is the weak point, since patients often do not mention traditional preparations to a clinician who they expect to disapprove. Clinicians who ask directly and without comment get substantially better information than those who wait to be told.