THE BLAME GAME: Constructions of Māori medical compliance

Mark W. This paper draws on a qualitative action research investigation of the treatment of Maori 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 Maori patients. We contrast these views with the experiences of Maori users of health care to highlight differences in the ways the two groups approach the issues. Clinicians widely described Maori patients as non-compliant in relation to their health. Explanations of non-compliance were diverse, ranging from Maori ignorance and poverty to attributions of wilfulness and self-destructiveness. The experiences of Maori 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 Maori, with implications for improved practice and better outcomes for Maori.