Working at the National Institutes of Health: Developing a New Set of Cross-Over Skills as an Applied Medical Anthropologist

This article reviews a portion of my professional career in academia and outside of academia for the purpose of highlighting the cross-over professional development skills that I learned to use in different fields of expertise. Although I had received my academic doctoral training at an applied medical anthropology program (Wayne State University, Detroit, MI) in the 1980s and a few years later completed a postdoctoral fellowship program which earned me a Masters of Public Health degree (MPH) from Emory University (Atlanta, GA), I really did not know what it was truly like to be a public health professional until I was hired, trained, and worked for the National Institutes of Health. Cross-over skills are skills that allow a professional to transfer to another high-skilled professional job successfully. It is not until I immersed myself in a completely different work setting when I discovered that these cross-over professional development skills were advantageous to my professional career.

Examining Medical Anthropological Theory as a catalyst for the failure of Clinically Applied Medical Anthropology

Medical anthropological theory may be understood in two ways: first as a set of anthropological concepts and second as the application of these concepts. The theoretical concepts themselves are rarely challenged because they have been fairly well developed. However, the approach to theory and its application has traditionally been underdeveloped and thus requires more thought and practice among anthropologists. This paper asserts that a particularly clear example of the problem with the approach to and application of medical anthropological theory can be viewed in the context of clinically applied medical anthropology (CAMA). I examine two medical anthropological concepts that applied medical anthropologists use in their dealings with clinicians – critical medical anthropology and the culture concept. In doing this, I demonstrate that although these concepts are useful and clinicians need to employ them, there are a number of problems with the theoretical approach. I argue that these problems limit the application of these concepts to CAMA and offer preliminary suggestions to resolve them. In particular, clinically applied anthropologists employing critical theory should work to present a more balanced view of the clinic and physician. In addition, anthropologists working in the clinical setting must update the CAMA literature to ensure a thorough assessment of the current use of anthropological knowledge and concepts – such as culture – in medical schools and clinics.

The Parallel Lives of Biocultural Synthesis and Clinically Applied Medical Anthropology

In this paper, I give a brief history of the development of the school of critical medical anthropology (CMA) and trace its influences on both biocultural synthesis and clinically applied medical anthropology. I show how CMA has had a profound influence on biological and medical anthropology and how it has shaped our understandings of the relationships between biology and economics. I argue that although a critical perspective of health and well-being has been an important and necessary addition to both biological anthropology and clinically applied medical anthropology. we ought to be careful to trace how rather than simply assert that economics influence biology and health. I also argue that CMA's political economic perspective utilizes a narrow understanding of culture, and that biocultural synthesis could do well to look beyond a materialist view of culture and engage other theoretical schools in cultural anthropology. Finally. I show one such potential line of engagement between the disciplines by paralleling the concept of adaptation in biological anthropology to the concept of complicity in medical anthropology.

Health Interventions: A Focus for Applied Medical Anthropology Theory

Health promotion and intervention programs are biological, cultural, social and political undertakings. Frequently, they are based on epidemiological research, and do not work because they rely solely on quantitative measurements of risk. While this approach can demonstrate cause and effect between risk factors and disease, it lacks the understanding of lay rationality, and the social, political, and economic influences which make individuals vulnerable to disease - a vital component to the development of successful interventions. It is in this area that medical anthropology can make a critical difference to health intervention planning, with its qualitative methodology and theoretical perspectives. This paper reviews the theoretical debate currently taking place within the discipline, and proposes an applied critical medical anthropology approach which engages, rather than challenges the system, and responds to the needs of intervention issues. By collaborating with colleagues in other areas of health, and forming closer alliances, medical anthropology can target a challenging, exciting and critical focus for praxis, and make important contributions to health intervention planning.