An approach to community assessment in medical practice.

An ethnographic model for community based medical practice is proposed. Its goal is to anticipate areas of value and expectation conflict between the physician and his or her practice community setting. Three types of ethnographic information gathering are outlined: (1) desk assessment, based on the ethnographic use of newspapers, maps, census records, (2) informant methods, and (3) participant observation. It is argued that these lead to an understanding of the community's health-related beliefs and practices and to the ability to deliver community oriented health care. Examples of this ethnographic approach are given from the authors' experiences. A method to represent graphically the process of community analysis is provided.