Doctor of Philosophy, Case Western Reserve University, 2021, Anthropology
The processes of globalization — characterized by global flows of people, technologies, capital, images, and information that shape people's imagined worlds — continue to spur the growth of megacities and the concomitant health dilemmas therein. As globalization shapes both the practice and the idea of medicine and healthscapes, this transformation is translated into shifting desires, expectations, and identities for both physicians and patients in the clinical encounter — the focal points of this study. This dissertation project utilizes an ethnographic design (semi-structured interviews, participant observations, and archival research) over a 19-month period in Mumbai, India to examine the following question: How does the clinical encounter unfold in relation to the doctor-patient interaction to construct expectations? This study takes the following two premises: 1) A thick ethnographic description of the clinical encounter is fundamentally linked to the bi-directional shaping of local, global and micro, macro ideologies. 2) Biomedicine (its practitioners, its seekers, its associated clinical encounters, and its institutions) is a prominent focal point on which the concepts of identity and globalization pivot in Indian society. Therefore, this study of the doctor-patient interaction is framed to serve as a microscopic observation of macroscopic globalization forces. I interviewed physicians and patients and observed their clinical interactions at 3 Obstetrics/Gynecology clinical sites in Mumbai: a private clinic, a semi-private hospital, and a municipal hospital. Based on data collected from 603 participants, the most pertinent aspects of identity in the micro-level clinical encounter in Mumbai involve the following: age, gender, sex, social status, educational level, language, profession, ethnicity, and lifeworlds. Additionally, I provide data on how the emerging themes of physician synergy, ritual, medical record, and traditional remedies illustrate salient aspe (open full item for complete abstract)
Committee: Atwood Gaines MA, PhD, MPH (Committee Chair); Jim Shaffer MA, PhD (Committee Member); Janet McGrath MA, PhD (Committee Member); Eileen Anderson-Fye EdMA, EdD (Committee Member)
Subjects: Asian Studies; Behavioral Sciences; Communication; Cultural Anthropology; Ecology; Ethics; Ethnic Studies; Families and Family Life; Foreign Language; Gender; Gender Studies; Gynecology; Health; Health Care; Health Care Management; Health Sciences; Mass Communications; Mass Media; Medical Ethics; Medicine; Minority and Ethnic Groups; Obstetrics; Personal Relationships; Personality; Regional Studies; Social Research; Social Structure; Sociolinguistics; South Asian Studies; Technology; Womens Studies