The Blame Game

Abstract

This paper draws on a qualitative action research investigation of the treatment of Māori with ischaemic heart disease, in the course of which interview data were gathered from individual patients and health care providers. Thematic analysis is used to describe clinicians’ discourses around uptake of medical advice by Māori patients. We contrast these views with the experiences of Māori users of health care to highlight differences in the ways the two groups approach the issues. Clinicians widely described Māori patients as non-compliant in relation to their health. Explanations of non-compliance were diverse, ranging from Māori ignorance and poverty to attributions of wilfulness and self-destructive-ness. The experiences of Māori patients suggest engaged, proactive and mindful health-seeking—at odds with the predominant clinician discourses. The findings are discussed as a factor in the cultural competence of clinicians to work successfully with Māori, with implications for improved practice and better outcomes for Māori.