The cultural meanings and social uses of illness. A role for medical anthropology and clinically oriented social science in the development of primary care theory and research.

Basic research that is conceptually and methodologically innovative and that fosters long-term research programs should play a role in the academic development of primary care, alongside more practical applied studies of specific clinical problems. A creative tension between the two has been a distinctive attribute of academic medicine and should be fostered in family medicine and other primary care disciplines. The biopsychosocial model offers a paradigm for the incorporation of clinically oriented social science research as one basic science approach in which primary care researchers can receive advanced training and pursue an academic career. The author briefly illustrates such a career with reference to studies (his own included) on the social uses and psychocultural meanings of illness. Somatization, a major problem in primary care, is illuminated by such a clinically applied social science research framework. Developing the scientific basis of an academic discipline involves intellectual education in systematic scholarship to create and critique concepts as much as it requires training in the application of rigorous research design and powerful statistical techniques.