title: Global Health Care-seeking Discourses Facing Local Clinical Realities: Exploring the Case of Cancer.
abstract: Using cancer as an example and drawing on Pierre Bourdieu's concepts of field and on prolonged fieldwork in Danish general medical practice settings, we examine how discourses about what counts as legitimate help-seeking practices are negotiated in local clinical encounters. Overall, we identify competition between two discourses on help-seeking practices. This competition is present most when people seek help with unspecific, vague, or diffuse illness complaints, voicing uncertainty as to what counts as signs of illness, characteristic of proactive discourses emanating from global, scientific biomedicine. Such indistinct help-seeking conflicts with the dominant discourse in the local clinical setting and is characterized by an overt focus on identification of the chief complaint. The analysis illustrates how competing discourses may result in conflicting expectations to the clinical encounter and prove counterproductive to ensuring early diagnosis of cancer.
authors.affiliation: Research Unit for General Practice, Research Centre for Cancer Diagnosis in Primary Care (CaP), Faculty of Health and Department of Culture and Society Aarhus University. rsa@feap.dk.
authors.forename: Rikke Sand
authors.initials: RS
authors.lastname: Andersen
authors.affiliation: Research Unit for General Practice, Research Centre for Cancer Diagnosis in Primary Care (CaP), Faculty of Health and Department of Culture and Society Aarhus University.
authors.forename: Marie Louise
authors.initials: ML
authors.lastname: Tørring
authors.affiliation: Research Unit for General Practice Research Centre for Cancer Diagnosis in Primary Care (CaP) Faculty of Health Aarhus University.
authors.forename: Peter
authors.initials: P
authors.lastname: Vedsted
mesh_terms: D060432:Anthropology, Medical; D003718:Denmark / Q000453:epidemiology; D005260:Female; D058006:General Practice; D014943:Global Health; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D012878:Skin Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality*
keywords: health care system; health care-seeking; patient delay