This article first describes the unique place of emergency medicine (EM) within the American healthcare system. Second, it examines the uncertainty that underlies the practice of emergency medicine. It then describes how risk is perceived, negotiated and minimised by emergency physicians in their day-to-day practice. Finally, it explores how the management of medical risk is related to the establishment of trust within the physician–patient interaction and to the construction of the 'competent physician'. In caring for patients, the emergency physician must minimise risk and instil trust within a pressured, time-sensitive environment. Consequently, the management of risk and display of competence to patients are simultaneously accomplished by symbolic representations, the use of medical diagnostic tools in decision-making, and narrative construction within the clinical interaction.
The Case of Emergency Medicine
Volunteering and Civil Society in Czech Health Care
This article examines how boundaries of the state are negotiated and projected in Czech health care volunteering. Hospital regimes and the professional care provided by doctors and nurses are widely imagined as a domain of intensified state authority, a legacy of state socialism. I explore attempts by NGO actors, hospitals, and local government officials involved in three Czech volunteer programs to create alternative, non-medicalized forms of patient care as civil society, thereby reproducing the boundary between state and non-state that characterized civil society discourses of the 1990s in the region. Yet unlike those discourses and the anthropological analyses they have informed, this process of boundary making does not constitute the state and civil society as inevitably antagonistic or competitive entities.