Confronting Inner City Social Suffering in the County Hospital: Teaching Doctors to Heal Poverty

With the shrinking of the American welfare state, emergency departments in public hospitals have surfaced as sites where the homeless, the addicted, and the mentally ill come for care. Yet county hospitals are unprepared to deal with the swelling numbers of uninsured patients they see, and medical schools have largely failed to address the importance of class and culture in their clinical training programs.

With funding from the Foundation, Philippe Bourgois will examine the delivery of medical services to the poor by documenting the experience of doctors-in-training at the San Francisco General County Hospital. He will consider the socialization of doctors-in-training into medical culture, the breakdown of the public sector safety net for the poor, and the systematic difficulties medicine faces in addressing cultural differences among indigent patients. Bourgois will teach a group of medical students, interns, and residents at the hospital to take ethnographic field notes of their encounters with indigent patients. Bourgois will have the notes transcribed and will bring the doctors-in-training together to discuss their experience with poor patients. This will complement Bourgois' previous work assessing the experience of homeless patients.

Reports and Publications

• Bourgois, Philippe, Bridget Prince and Andrew Moss. 2004. "The Everyday Violence of Hepatitis C among Young Women Who Inject Drugs in San Francisco," Human Organization Vol. 63 (3), pp 253-264. (PDF)

• Rhodes, Tim, Merrill Singer, Philippe Bourgois, Samuel Friedman, Steffanie Strathdee. 2005. "The Social Structural Production of HIV Risk Among Injecting Drug Users," Social Science and Medicine Vol. 61, pp. 1026-1044