"What happens on the van, stays on the van": the (re)structuring of privacy and disclosure scripts on an Appalachian mobile health clinic

Abstract

Over the past two decades, mobile health clinics have emerged to address the health needs of underserved populations. Mobile clinics offer curbside care in the primary settings of people's lives: churches, parking lots, grocery stores, and community centers. Drawing on 18 months of ethnographic fieldwork, I explore how physical and symbolic space helps shape the (re)writing of traditional health care scripts of provider-patient confidentiality and medical disclosure in a mobile clinic serving residents of 21 counties in southeastern Ohio. This analysis centered on how clinic staff members blurred the symbolic and physical space of privacy, merged personal and professional discourses, and triaged multiple patient disclosures in the face of social and spatial constraints.