Studying health care institutions: Using paperwork as ethnographic research tools

Abstract

Checklists, memos, reports, and other standardized forms take up much space on ethnographers’ desks and pervade the lives of their research respondents. Despite the omnipresence and significance of paperwork, methodological descriptions of how to use forms as ethnographic research tools remain limited, however. Drawing upon ethnographic fieldwork conducted at a US transgender clinic, I describe three techniques with which ethnographers can study documents, namely by tracing paper forms’ origins, studying norms inscribed in them, and examining how people use forms. These three techniques help capture the powerful consequences of, and ethical dilemmas embedded in, health care institutions’ documentary practices, dynamics that may be impacted by shifts toward the digitalization of paperwork. I propose that ethnographers are to expand their ethnographic toolbox to include attention to documents as central features of social and institutional life that enable and problematize human action and individual decision-making.