Starting from Scratch

Some days it feels like we are starting from scratch when it comes to building anthropology’s presence in the public sector. When a department sets out to hire someone it is arguably with the intent to fill a gap. Of course FTE lines are hard to come by and maintain these days, so what is deemed a “need” may have to stretch in order to fit into an institutional design or accommodate a larger vision of future direction. Strategic navigation aside, anthropology departments frequently indicate characteristics sought in applicants such as a geographic area of study or a particular focus of scholarship.

When building a new “department” a case can be made for the goal of acquiring a critical mass. What can seem impossible for an individual gains strength and feasibility when there is more than one anthropologist in the room. This we are learning from experience. We are also finding that there are trade-offs, for example, once a case has been made for anthropology do you diversify a team at the expense of being able to speak as anthropologists? It does not take long to realize that even with an all-anthro team there is going to be variation in perspective and approach. Why this is surprising to non-anthropologists is still surprising to me. Perhaps because I have never assumed that all epidemiologists will agree with each other.

In the public sector, and conceivably in the non-academic private sector, it is interesting to note how often we are asked for our qualifications. Or, the shorter and more direct version: “Are you qualified to do [this]?”

Inquiries of this nature tend to leave one feeling a bit gobsmacked – in both the sense of being dumbfounded and also literally hit in the mouth – as you might imagine. For the three of us who write this column, we work primarily in a health care setting as medical anthropologists. This is an environment in which the other kind of doctors do not generally get asked questions of this nature. In the public sector, in particular in a health care setting, the distinction between a MD and a PhD is both subtle and in-your-face. For example, medical facilities in our area have begun adopting information systems in which staff wear, in addition to photo credentials, a tag that indicated role (e.g., NURSE, DOCTOR, JANITORIAL STAFF, etc.) As members of a health care system, it would make sense to be included in this uniform development – I have been told as much in the elevator by a variety of co-workers. However, there is yet to be a badge for ANTHROPOLOGIST, or even RESEARCH for that matter. While we anthropologists have joked about co-opting the DOCTOR badge, I have a couple of reservations. First, while I am all for being helpful and versed in basic first aid, I do not want to be called upon in an emergency when medical care is required. Now if someone wants to reflect on their medical experience or tell me their perspective on health care in America, then I am your girl. Second, in the public sector there are roles well suited to individuals with an MA or even a BA in anthropology. I would not want to elbow them out of the conversation by assuming that only a PhD can serve as qualification for ethnographically informed work.

So the question emerges, in a world where anthropology, let alone medical anthropology, is not necessarily part of the widely circulating discourse, how do we communicate and ensure in a clear, succinct, and professional manner that we are qualified? The question of training is a good place to start; Heather Reisinger gave a paper at SfAA last month that walked through an argument for training anthropology students with an eye towards marketability in the public sector. On the side of preparedness, this is critical and a conversation I imagine will present itself in this column in the future. However, right now I am on the other side, the hiring and envisioning a “department”-side of the equation. While doing one’s best to accumulate a critical mass of like-minded scholars and gain momentum for qualitative work is central to the task at hand, I am of the belief that it is equally as important to determine our role, function, and mission within the setting we seek to grow. Which brings us back to the question of how to convey one’s qualification as an anthropologist outside of the Academy. If having a PhD is not enough, or if there is a rationale for not limiting expertise to PhD training, then it seems the question stems from a misunderstanding of what anthropology can do. In the part of the public sector we are immersed in it’s not so much our theoretical orientation or geographic focus that comes into play, but our underlying analytic skills.

With that in mind and in an effort to be preemptive, the following was proposed by a colleague as a statement to precede all “what qualifies you” run-ins: I’m qualified because I’m an expert in understanding and analyzing the dynamics of cultural systems, and medicine is part and parcel of a cultural system, not alone and above culture. Not only does medical science operate with a shared set of cultural values and beliefs, but its individual practitioners (scientists, doctors, etc), operate with varying iterations of those beliefs and at differing levels of status and access to power. Understanding the relationships among those beliefs and that power is essential to improving health care.

Whether or not I find myself internalizing this view of qualification, I enjoy reading it and breathing in the position of strength and confidence that generated it. Two parting thoughts that embody the emotions this discussion fosters in me – cynicism and optimism. 1) With the recent death of Facts a whole conversation engaging the value of the work we do has sprung up. Again, I will not be surprised if this finds its way into a future column. 2) When questioning the work we do, I revisit that terrific slide show put together by students at the University of Southern Florida last fall in response to the Florida Governor’s short-sighted comments on the practice of anthropology and it makes me smile to be an anthropologist.

**The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government