Ethnography in Health Services Research: Oscillation Between Theory and Practice

The well-known divergence between what policy and protocol look like on paper, and what happens in the actual practice of daily life remains a central challenge in health services provision and research. This disparity is usually referred to as the theory-practice gap and contributes to concerns that scientific evidence fails to make substantial impacts on the processes of service delivery. In this article, we present an argument for the inclusion of ethnographic methods in health services research and show that this approach enables researchers to address this divergence by working within it. We trace how ethnography, through generative processes of oscillation, can take us beyond lamenting the gap and capture the relational dynamics of people working together in complex systemic arrangements. By moving from example to methodological reflection, to principle of research, we demonstrate how the oscillation of ethnographic research between theory and practice can productively contribute to the field of health service research.