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非凡医学:走向初级保健的人类学

Extra/ordinary medicine: Toward an anthropology of primary care.

机构信息

Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, USA; Global Brain Health Institute, Department of Neurology, University of California, San Francisco, USA; Department of Humanities & Social Sciences, University of California, San Francisco, USA.

Department of Family and Community Medicine, University of California, Davis, USA.

出版信息

Soc Sci Med. 2024 Apr;346:116707. doi: 10.1016/j.socscimed.2024.116707. Epub 2024 Feb 20.

Abstract

Primary care is at the forefront of healthcare delivery. It is the site of disease prevention and health management and serves as the bridge between communities and the health care system As ethnographers of primary care, in this article we discuss what is gained by situating anthropological inquiry within primary care. We articulate how anthropologists can contribute to a better understanding of the issues that emerge in primary care. We provide a review of anthropological work in primary care and offer empirical data from two ethnographic case studies based in the United States, one focused on social risk screening in primary care and the other examining the diagnosis and care of people with dementia in primary care. Through these cases, we demonstrate how research of and within primary care can open important avenues for the study of the multidimensionality of primary care. This multidimensionality is apparent in the ways the medical field addresses the social and structural experiences of patients, scope of practice and disciplinary boundaries, and the intersection of ordinary and extraordinary medicine that emerge in the care of patients in primary care.

摘要

初级保健处于医疗保健服务的最前沿。它是疾病预防和健康管理的场所,也是社区和医疗保健系统之间的桥梁。作为初级保健的民族志学者,在本文中,我们讨论了将人类学调查置于初级保健中的意义。我们阐明了人类学家如何为更好地理解初级保健中出现的问题做出贡献。我们回顾了初级保健中的人类学工作,并提供了两个基于美国的民族志案例研究的经验数据,一个专注于初级保健中的社会风险筛查,另一个研究了初级保健中痴呆症患者的诊断和护理。通过这些案例,我们展示了初级保健中的研究如何为研究初级保健的多维性开辟重要途径。这种多维性在医学领域解决患者的社会和结构性体验、实践范围和学科界限以及普通医学和非凡医学在初级保健中对患者护理的交叉等方面都很明显。

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