Diagnosis as a social process: benefits of classic ethnographic practices and some practical considerations

Reducing diagnostic error and understanding how to prevent it remain critical goals of medical research. While diagnostic error has been studied through a variety of approaches, recent scholarship has increasingly highlighted the value of social science perspectives, particularly ethnographic methods. Chopra (2020) introduced "focused ethnography" as a valuable and efficient method for studying diagnostic errors in healthcare settings. We extend this conversation by arguing that more traditional ethnographic practices - especially open-ended and iterative research design, extended fieldwork, and researcher immersion in clinical communities - remain essential for examining the complexity of medical diagnosis. Diagnosis is now widely understood as a team-based process involving physicians, nurses, patients and families, and other healthcare professionals who exchange information and distribute tasks to reach a diagnosis (Graber 2017). We argue that only deep immersion in this fundamentally social process allows researchers to identify the subtle barriers and facilitators shaping diagnostic work and assess how diagnosis unfolds in practice as teamwork. In this article, we illustrate how classic ethnographic practices can be implemented to gain a deeper understanding of diagnostic processes and highlight some key methodological considerations when planning an ethnography in a healthcare setting.