Learning About Healing In Family Medicine: Making Doctors In An American Medical Residency Program

摘要

This ethnographic study identified and described healing and the making of healers in the context of an American family medicine residency training program. The project goal was to describe the training of family medicine physicians through observation and interviews with resident and faculty physicians. The project investigated discourses and practices around healing. The aims of this study included: (1) to identify and describe the educational processes in a residency training program towards professional socialization of residents into family medicine. (2) To describe how the habitus of the residency informed the ways in which residents came to embody of the role of family medicine physicians. (3) To identify and describe definitions of and meaning-making around healing through discourses, practices, and engagement with family medicine’s values. Findings showed a range of healing definitions were mobilized in the setting, with attendant discourses and practices. Comparisons were made between the observed practices and expressed values, and those similar values and behaviors as described in family medicine literature, medical education literature, and the anthropology literature on healers and making healers cross-culturally. I conclude that while the physicians moved at times towards healing relationships with patients, they remained so bound by biomedical structures that they could not fully take-on family medicine’s object and achieve the making of healers. Dispositions that forwarded the physiciansu27 greater insights and authority regarding disease and disease treatment often overshadowed the espoused notions of understanding patientsu27 illnesses experiences or aiding patients in making sense of their health and sickness. This conclusion suggests more could be done to help those engaged with family medicine training to better conform to their own culturally-situated values. The result would be residents and future family medicine physicians who more fully embody the tenets of family medicine and the distinct object by which it defines itself.