Culture and clinical care. Folk illness beliefs and behaviors and their implications for health care delivery

TLDR

Physicians and patients often hold discrepant models of health and illness, and when patients believe they have illnesses outside the biomedical paradigm—commonly called folk illnesses—communication during clinical visits can be impaired. The article proposes an approach to evaluate patient-held beliefs and behaviors that diverge from biomedicine, illustrated by a case of folk illness to examine its impact on perceptions, treatment‑seeking, clinical care, and physician–patient communication. The authors discuss guidelines for addressing folk beliefs and behaviors in a culturally sensitive manner. Published in JAMA 1994;271:690‑694.

Abstract

This article presents an approach to the evaluation of patient-held beliefs and behaviors that may not be concordant with those of biomedicine. Physicians and patients often hold discrepant models of health and illness that may affect the effectiveness of communication during the clinical visit. An extreme example of such a discrepancy exists when the patient feels that he or she has an illness that is not defined within the biomedical paradigm. These are commonly referred to as folk illnesses. An example of such an illness is provided in order to discuss the effects of folk beliefs on patient-held perceptions of health and sickness, treatment-seeking behavior, clinical care, and physician-patient communication. Guidelines for addressing clinical issues surrounding folk beliefs and behaviors in a culturally sensitive way are discussed. (<i>JAMA</i>. 1994;271:690-694)