Medical anthropology and the family physician

As family physicians increasingly begin to practice in a variety of settings both in the U.S. and abroad, they are faced with the challenge of caring for patients from different ethnic and socioeconomic backgrounds. In particular it has been suggested that delivering effective and acceptable community oriented primary care requires a deeper understanding of the cultural background of patients, their families, and the social contexts in which they live. In this paper, the authors provide an introduction to the field of medical anthropology--the discipline which studies the cultural dimensions of health, illness, and the medical care system. The "anthropology of family medicine" (the theoretical focus) is distinguished from the "anthropology of family practice" (the applied focus), and contributions from medical anthropological research at the micro (practitioner-patient relationship), intermediate (family), and macro (community) levels of analysis are examined. In particular, three clinical case vignettes are presented which illustrate the ways in which cultural issues can become critical in the care of patients and their families. Finally, the activities of the STFM Task Force on Skills and Curriculum Development in Cross-Cultural Experiences are described, and future directions for research and teaching efforts are proposed.