Storylines of family medicine IX: people and places-diverse populations and locations of care.

Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine as interpreted by individual family physicians and medical educators in the USA and elsewhere around the world. In 'IX: people and places-diverse populations and locations of care', authors address the following themes: 'LGBTQIA+health in family medicine', 'A family medicine approach to substance use disorders', 'Shameless medicine for people experiencing homelessness', '''Difficult" encounters-finding the person behind the patient', 'Attending to patients with medically unexplained symptoms', 'Making house calls and home visits', 'Family physicians in the procedure room', 'Robust rural family medicine' and 'Full-spectrum family medicine'. May readers appreciate the breadth of family medicine in these essays.

Optimizing Community Bioethics Dialogues: Reflections on Enhancing Bi-directional Engagement on Health Care Concerns.

This article reviews our experience and observations from conducting six Community Bioethics Dialogues (CBD) with elderly residents in diverse communities in Galveston, Texas, from 2014 through 2016. CBD is a mixed method that combines focus groups, instruction, ethnography, and community-based research. CBD brings together select community members for 3 hours once a week for 6 weeks to identify values. We employed CBD to investigate how participants think about and react to issues surrounding Patient-Centered Outcomes Research (PCOR), Comparative Effectiveness Research (CER), and mental health. We offer a methodological approach for conducting and optimizing meaningful dialogues with community groups.

Visualizing Tensions in an Ethnographic Moment: Images and Intersubjectivity.

Images function as sources of data and influence our thinking about fieldwork, representation, and intersubjectivity. In this article, I show how both the ethnographic relationships and the working method of photography lead to a more nuanced understanding of a healing event. I systematically analyze 33 photographs made over a 15-minute period during the preparation and application of a poultice (topical cure) in a rural Andean home. The images chronicle the event, revealing my initial reaction and the decisions I made when tripping the shutter. By unpacking the relationship between ethnographer and subject, I reveal the constant negotiation of positions, assumptions, and expectations that make up intersubjectivity. For transparency, I provide thumbnails of all images, including metadata, so that readers may consider alternative interpretations of the images and event.

Ethical issues in patient-centered outcomes research and comparative effectiveness research: a pilot study of community dialogue.

Community bioethics dialogues were held on the topic of patient-centered outcomes research (PCOR) and comparative effectiveness research (CER). Participants were 65 and older and represented either a lower income, African American group (A) or a higher income White group (B). Participants were presented with a variety of background reading and study materials. Meetings were held 2 hr per week for 6 weeks. The groups showed both independence in judgment from the investigators and diversity of opinion between the two groups. Group B addressed more topics than Group A and in some instances explored additional policy nuances. Members of Group A appeared more cognizant of issues of social justice that affect vulnerable populations and appeared leery of approaches that suggested possible disrespect for their own personal experiences. Future plans call for both repeating the dialogue with additional, diverse community groups and repeating community bioethics dialogues on new topics with the same groups.