Physician Anthropologists

2019 ◽  
Vol 48 (1) ◽  
pp. 187-205 ◽  
Author(s):  
Claire L. Wendland

Physician anthropologists have contributed extensively to the anthropology of biomedicine, as well as to other aspects of medical anthropology. Their use of detailed clinical case narratives allows elucidation of what is at stake for individuals and communities in the course of any given illness. Biomedically informed observations of bodies illustrate the connections between microscopic harm and macrosocial arrangements, while observations of clinical spaces and medical knowledge production contribute to current debates over evidence, metrics, migration, and humanitarianism. In moving away from culturalist explanations for illness, physician anthropologists have drawn attention to the manifold workings of structural violence—and have often sacrificed the possibility of deep epistemological challenges to biomedicine. While raising a note of caution about the moral authority of physician anthropologists, I recognize that much of this scholarship has laid the intellectual groundwork for a movement toward equity that refuses to justify poor-quality health care for poor people.

Author(s):  
Joia S. Mukherjee

This chapter explores the seminal topic of Universal Health Coverage (UHC), an objective within the Sustainable Development goals. It reviews the theory and definitions that shape the current conversation on UHC. The movement from selective primary health care to UHC demonstrates a global commitment to the progressive realization of the right to health. However, access to UHC is limited by barriers to care, inadequate provision of care, and poor-quality services. To deliver UHC, it is critical to align inputs in the health system with the burden of disease. Quality of care must also be improved. Steady, sufficient financing is needed to achieve the laudable goal of UHC.This chapter highlights some important steps taken by countries to expand access to quality health care. Finally, the chapter investigates the theory and practice behind a morbidity-based approach to strengthening health systems and achieving UHC.


2014 ◽  
Vol 58 (3) ◽  
pp. 245-251 ◽  
Author(s):  
Gary M. Franklin ◽  
Thomas M. Wickizer ◽  
Norma B. Coe ◽  
Deborah Fulton-Kehoe

Author(s):  
Sheila Leatherman ◽  
Linda Tawfik ◽  
Dilshad Jaff ◽  
Grace Jaworski ◽  
Matthew Neilson ◽  
...  

Abstract Quality problem or issue There are record-setting numbers of people living in settings of extreme adversity and they continue to increase each year. Initial assessment There is a paucity of validated data on quality and safety across settings of extreme adversity. Choice of solution This paper argues for an action framework to address the unique challenges of providing quality in extreme adversity. Implementation We describe a preliminary Quality in Extreme Adversity framework which has been informed by—and will continue to be validated through—literature, data collection, WHO expert consultations and through working in settings of extreme adversity with national authorities and NGOs. Lessons learned Poor quality care costs lives, livelihoods and trust in health services. The recommended framework, based on evidence and experiential lessons, intends to address the WHO goal for 2019–2023 of ‘one billion people better protected from health emergencies’ (9).


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Manon Haemmerli ◽  
Timothy Powell-Jackson ◽  
Catherine Goodman ◽  
Hasbullah Thabrany ◽  
Virginia Wiseman

Abstract Background For many low and middle-income countries poor quality health care is now responsible for a greater number of deaths than insufficient access to care. This has in turn raised concerns around the distribution of quality of care in LMICs: do the poor have access to lower quality health care compared to the rich? The aim of this study is to investigate the extent of inequalities in the availability of quality health services across the Indonesian health system with a particular focus on differences between care delivered in the public and private sectors. Methods Using the Indonesian Family Life Survey (wave 5, 2015), 15,877 households in 312 communities were linked with a representative sample of both public and private health facilities available in the same communities. Quality of health facilities was assessed using both a facility service readiness score and a knowledge score constructed using clinical vignettes. Ordinary least squares regression models were used to investigate the determinants of quality in public and private health facilities. Results In both sectors, inequalities in both quality scores existed between major islands. In public facilities, inequalities in readiness scores persisted between rural and urban areas, and to a lesser extent between rich and poor communities. Conclusion In order to reach the ambitious stated goal of reaching Universal Health Coverage in Indonesia, priority should be given to redressing current inequalities in the quality of care.


Author(s):  
Stephen J. Swensen ◽  
Tait D. Shanafelt

The current health care delivery system is perfectly designed to create high rates of professional burnout in physicians, nurses, advanced practice providers, and other health care professionals. In most organizations, a gap exists between the quality of care professionals aspire to deliver and the quality of care actually delivered, which creates burnout. Poor quality health care is fundamentally about waste, and leaders in the health care industry have primary accountability and responsibility for system waste. The following are five categories of waste in health care: Failures of care delivery and care coordination, overtreatment, administrative complexity, pricing failures, and fraud and abuse.


2000 ◽  
Vol 23 (3) ◽  
pp. 132 ◽  
Author(s):  
Patrick Bolton ◽  
Michael Mira ◽  
Arn Sprogis

Effective and integrated primary health care services are seen world wide as the lynch pin of an equitable,efficient and high quality health care. Health services dominated by specialist care suffer either fromuncontainable costs (USA with 14% of GDP) or poor quality care (Russia and other former members of theSoviet bloc). Ierachi et al. (2000) argue that Australia should take the retrograde step of endorsing a servicewhich aims to "provide rapid, high quality and continuously accessible unscheduled care, for conditions coveringthe full spectrum of acute illness and injury" (emphasis added). They aim to provide care "for conditions", notfor people. General practice provides care for people, not just diseases or injuries.


2020 ◽  
Author(s):  
Carey Candrian ◽  
Kristin G Cloyes

Abstract Lesbian, gay, bisexual, and transgender (LGBT) older adults are at particular risk for receiving inequitable end-of-life care. Their health care wishes may be ignored or disregarded, their families of choice are less likely to be included in their decision making, and they may experience increased isolation, bullying, mistreatment, or abuse, which ultimately contribute to receipt of poor-quality health care. This is particularly important during sensitive transitions along the care continuum to end-of-life settings; 43% of respondents of a 2018 survey of 865 hospice professionals reported having directly observed discriminatory behavior toward LGBT patients. Lack of visibility and accountability perpetuates vulnerabilities and the potential for discriminatory treatment. Unfortunately, while other areas of health care have prioritized and normalized collecting sexual orientation and gender identity (SOGI) data, hospices do not routinely assess patients’ SOGI in the context of end-of-life wishes and decisions. Drawing insight from a sample of 31 in-depth interviews with older LGBT adults, this paper focuses on one participant’s story—Esther’s. We chose her story to illustrate how care can be compromised at the end of life if an open discussion with patients about what and who matters most to them at the end of life, is avoided.


2006 ◽  
Vol 354 (11) ◽  
pp. 1147-1156 ◽  
Author(s):  
Steven M. Asch ◽  
Eve A. Kerr ◽  
Joan Keesey ◽  
John L. Adams ◽  
Claude M. Setodji ◽  
...  

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