The paediatric clinic as negotiated social space

Contemporary urban diversity combined with increasing specialisation in tertiary care, technological innovations, and complexity of pathologies, render patient-physician relations challenging for both patients and practitioners. Based on ongoing research in a university paediatric hospital in Montreal, this paper examines how patient-physician relations are played out in the space of the clinic in which a set of social, cultural, structural and asymmetrical relations intertwine. Through an ethnographic approach, which includes the observation of multi-disciplinary clinical settings as well as interviews with clinicians and families (migrants and non-migrants), the paper examines how the 'images' of both the patient (his family) and the physician play an active role in the clinical encounter. Interpretations of parental attitudes by practitioners are linked to their perceived background within the local and institutional configuration of norms and values, including the notion of a 'good parent'. This research problematises the concept of culture as it is engaged by clinicians (by excluding their own) and promotes reflection on an anthropologically informed clinical practice.