Biomedical practices from a patient perspective. Experiences of Polish female migrants in Barcelona, Berlin and London

ABSTRACT

This paper focuses on the diversity in patients’ experience of bio-medicine and contrasts it with the normative view characteristic of health professionals. Ethnographic fieldwork among Polish migrant women in London, Barcelona and Berlin included interviews about their experiences with local healthcare and health professionals. Themes drawn from the narratives are differences between the cities in terms of communication between patients and health professionals, respect for patients’ choices and dignity, attitudes to pregnancy and birth (different levels of medicalization), and paediatric care. It is argued that patients continuously negotiate among their own views and expectations based on previous experiences and knowledge from personal communication; internet forums and publications; and the offer of medical services in the countries of their settlement. Patients experience pluralism of therapeutic traditions within and outside bio-medicine. In turn, representatives of bio-medicine are rarely aware of other medical practices and beliefs and this leads to various misunderstandings. By highlighting the pluralism of medical practices in European countries and the increasing mobility of patients, this case study has useful implications for medical anthropologists and health professionals in a broader Western context, such as raising sensitivity to different communication strategies and a diversity of curing traditions and expectations.

KEYWORDS:

• Ethnography
• biomedicine
• complementary medicine
• medical anthropology
• Polish migrants

Ethical approval

In Poland, there is no formalized ethical review process for disciplines such as anthropology within the universities (as e.g. comparable to the USA Institutional Review Boards). Under such circumstances it is the sole obligation of the researcher and author to follow the basic ethical principles: doing good, not doing harm and protecting the autonomy, wellbeing, safety and dignity of all research participants.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1. The term ‘medical landscapes’ is used to emphasize the impact of place on experience with medical practice, since medical systems refer to the provider's side while the author is interested in interactions within the patient–doctor-system. The term ‘therapeutic landscapes’ was used by Gesler (1992) who analysed how geographic formation is instilled with therapeutic forces.

2. The majority of the interviewed women were competent in the local languages; several women at the beginning of their stay would visit practices with family members to help them to communicate with medical personnel.

3. The names have been chosen randomly to protect the women's anonymity. All interviews were conducted in Polish, the quotations were translated by the author.

4. There are two parallel systems of healthcare in Poland: the national one based on taxes and a private one. Some employers co-fund admission to the private sector, yet the majority of the population has free access only to the national system. A patient may also choose to pay for a visit privately (usually to visit a specialist or consultant).

5. There are many advertisements on the web and in Polish newspapers and magazines published in the UK about Polish clinics and small practices in London, as well as discussions on internet forums about their quality.

6. Moxibustion is a traditional Chinese technique using burning herbs to stimulate acupressure points. To turn a breech baby, pressure is applied to a pressure point, located on the fifth toenail. It should increase the baby's activity level and encourage him to change to the vertex position.

Additional information

Funding

This work was supported by the Deutsch-Polnische Wissenschaftsstiftung [grant number 2011-23].