| In recent years, scholars and providers in the health professions have been engaged in a dialogue on 'diversity.' Driven by multiple forces---the increasing integration of the social and behavioral sciences, as well as the humanities, into medical education; the growing field of medical ethics; patients' rights movements; and the pressures of an increasingly market-driven healthcare system---healthcare providers have begun to recognize and address the need to provide appropriate care to patients coming from a variety of different backgrounds and experiences. The greater part of this discourse is focused on cultural and ethnic diversity, as evidenced in the proliferation of literature on 'cross-cultural medicine,' 'cultural awareness,' and 'cultural competency' in medicine. Other parameters of diversity are being taken into account as well, particularly in the areas of gender, age, and use of alternative and complementary medicines. The movement toward taking difference into account in clinical medicine and research is important and necessary; however, it is often limited by problematic and oversimplified notions of diversity. Scholars working in the area of medical folklife have a great deal to offer to the discourse on diversity in medicine.;This dissertation examines the ways in which the concept of 'diversity' is employed in medicine through a discourse analysis of the literature and ethnographic observation of examples of current clinical practice. The dissertation explores three central ways in which diversity is being defined and theorized in medicine---by ethnicity and culture, age, and gender---and problematizes conceptions of diversity used in the medical literature and clinical practice. It concludes with a review of practical approaches for health professionals to employ in the clinical setting that will lead to care which is responsive to patient differences. |
