How Ethnographies Will Propel Your Next Project

Interview with Arpita: Ethnographies

September 25, 2019

Arpita Chakrabarti is a Social Scientist and Senior Strategist at Insync, where she utilizes her ten years of experience moderating and conducting ethnographies to further the human-centric understanding of various therapeutic areas and conditions.

Today, she is sharing her experience with ethnographies, the value that they bring to understanding the patient and physician experience, and why a client should consider utilizing ethnographies in their next project.


 

Q: What is your role and what is your background in the social sciences?

Arpita: I hold a role that goes across two groups in the company: I’m part of the strategist team and I’m also part of the social science team. In terms of my background, I am trained as a cultural anthropologist. I have a Ph.D. in Cultural Anthropology from Rutgers University, New Jersey.

I have always been interested in the Social Sciences and Humanities, but I am really glad that I was drawn specifically to Anthropology. It is the discipline that I think of as most holistic because we really put the human being at the center, but we always look at the bigger context. You look at the micro, but you also learn to connect it with the macro.

A common method in Anthropology is doing life narratives and really getting the person to talk about their life events as a whole, and they tend to be loosely structured. Depending on your research topic you know what exactly you are going after but you let them direct the flow of the conversation to a great extent. What is fascinating is that when you take that person’s life narrative and you set it within the broader socio-economic, political, cultural context of that person’s life, you start to see all of these connections that are very, very interesting.

Bringing that into our work is useful, because we’re dealing with understanding people’s experiences. Whether it’s from the patient perspective of understanding their illness experience or from the HCP perspective of understanding what it’s like to do the work that they do and what motivates them, we’re placing their experiences within the larger socio-economic, cultural context in order to understand how that context shapes the way they see themselves, their illness experience etc.

 

Q: How many years have you been conducting ethnographies?

Arpita: At Insync, over four years. But overall, as an Anthropologist, for more than 10 years.

 

Q: Can you briefly describe what an ethnography is and what type of process you go through, specific to Insync?

Arpita: Ethnography is the most intensive, immersive method we have where you actually do get to immerse yourself in the context of the person you’re studying. In our [industry] context, it is typically either patients or HCPs.

With patients we typically conduct ethnographies in their home settings, but we have also done patient ethnographies in other kinds of settings. For example, we have conducted ethnographies in pharmacy settings in order to understand how patients navigate a pharmacy and interact with pharmacists.

We do a very compressed version of ethnography in the industry context. However, even if you spend four hours with a patient in their home, you see a very, very different side of them. They do get comfortable in a way that is simply not possible in a one-hour telephone interview. Besides, there is the benefit of direct observation from just being in their environment – for example, being able to see all the changes a person has made in their home environment in order to live with their condition, or being able to pay close attention to their body language when they speak about particularly significant moments during their illness journey.

With HCPs, I have done ethnographies in their offices. I have to say that I was skeptical about that when I first started because it seems like a pretty contained environment and you’re only seeing them for a few hours of a day, but it’s amazing how helpful it is. I would be shadowing them and immersing myself in their work world and, depending on what they are comfortable with, I get to see them interacting with their patients to some extent.

We talk a lot about HCPS and how time is such an issue. However, until I did in-office ethnographies with them, I didn’t realize how agile, tenacious and dexterous they have to be, both physically and mentally, because they’re constantly going from one patient to another. It’s only when you are shadowing them that you realize they are constantly switching gears in their minds because you are dealing with a different patient with a different set of problems and having to be on top of it.

I also never thought of how physically demanding it is, because they are constantly carrying their laptops and walking from one room to another. They are on their feet quite a bit through the whole day, barely taking any breaks. Once you see that you really start to appreciate what it means for this physician to have a pharmaceutical Rep come and meet them and have all of five minutes to give them the information that they need to communicate. You really start to think differently about how can we can help make those five minutes the most productive and useful for the physicians. Because he or she really is carving that time out, and taking time out of a very, very busy schedule.

 

Q: From project to project, how do you identify the main takeaway from an ethnography? In other words, how do you put together the pieces of the puzzle?

Arpita: The thing that is different about ethnography, compared to the other methods, is we don’t really follow a questionnaire, or even a strict discussion guide like we would for an interview. What we do have, based on the project objectives, is a list of themes that we want to make sure we cover in the time we are spending with the respondent. The wonderful thing about ethnography is that you really have the time and the right context in which to let the respondent lead the conversation in directions that it may not ever have gone in otherwise, because those directions are often triggered by being in that environment. Those are questions that we could never put into a discussion guide, because you just wouldn’t think to ask them.

The other thing that makes ethnography special is the ability to learn from direct observations made in the patients’ or physicians’ environment. For example, imagine you are in the home of a patient who has a rare heart condition. You are sitting there talking to her and she is telling you about all the lifestyle changes she has made. But you can smell the smoke in the fabric of the couch you’re sitting on and you know that either this person is really struggling with those lifestyle changes or there is somebody in the house who is still smoking, so she is a passive smoker. It really helps you understand that these changes are difficult for people. It’s not that they don’t understand, but people try really hard sometimes and they still find it really difficult.

Just being in that context you observe things which no one is ever going to articulate in words for you because it’s too commonplace for them. It’s so naturalized for them that they won’t think about telling you or articulating it in words.

 

Q: What is the value of ethnography for the client?  

Arpita: I think clients really value the experience of being able to see and listen to a patient within their own environment. It is incredibly impactful for them as it makes the patient experience of the illness so much more real. When you are sitting there and seeing this person and listening to the emotion in their voice as they talk about the long road to diagnosis, and you are seeing their six year old boy’s toys strewn around and hearing the fatigue and pain in her voice as she talks about how her condition makes it difficult for her to keep up with her boy – all of us, including our clients, walk away from it with something that they will always remember and that will inform any work they do subsequently.

We have also consistently demonstrated to our clients that the learnings you get from ethnography are deep and rich, different from what you would get through a more direct, structured set of questions. When you’re getting to insights that you know you would not have gleaned otherwise – i.e., without spending that time with them in their home, or in their kitchen, or in their office – it is important for us to point that out.

 

Q: Ultimately, why should a client choose us to conduct an ethnography?

Arpita: I think of Ethnography as a craft. Like other crafts, it requires learning the ‘how to’ but also needs practice. The more you practice the better you get at it. At insync, all ethnographies are conducted by social scientists who have not only been trained in the ‘how to’ but have been honing their craft for years.

In terms of the reasons for doing ethnographies at all, I can share a few. One, it’s the best way to get as up-close as you possibly can to the patient or HCP experience. Two, it’s the only method I know that takes our investigation to places we would never go to otherwise because its driven by the very contextual conversation that you’re having in the moment. Those directions are often triggered by things that are present within that specific environment and context. The third thing would be that it allows you an opportunity for immersive observation. There’s so much that you learn from observing in context that you would never learn through asking questions because people wouldn’t be able to articulate those things, or you wouldn’t be able to think about asking those questions. You have to be there to understand.

 


Arpita Chakrabarti, PhD, Social Scientist and Senior Strategist at Insync. 

Arpita Chakrabarti is a Social Scientist and Senior Strategist at Insync, where she utilizes her ten years of experience moderating and conducting ethnographies to further the human-centric understanding of various therapeutic areas and conditions.