Dual perspectives: Navigating the roles of physician and ethnographer in sensitive spaces.

Background: Positionality is central to ethnographic research because knowledge is produced through situated and relational encounters. Clinician-ethnographers occupy complex insider-outsider positions, as their professional identity may shape access, behavior, disclosure, and interpretation within the field. In this article, I explore the multiple positionalities of the physician-ethnographer in acute hospital settings and argue that professional identity should not be perceived as bias to be neutralized, but as an interpretive resource. Methods: I draw on reflexive episodes from ethnographic fieldwork examining non-invasive advanced respiratory support. I consider moments of intervention and restraint, emotional steadiness, and shifting self-presentation to examine how professional identity and authority are experienced and negotiated in practice. Results: The withholding and expression of professional authority made visible how positionality reshaped interlocutor behavior, disclosure, and the stabilization of knowledge. When I was recognized as a physician, interactions were often organized around clinical credibility and technical knowledge. When positioned as a student or outsider, interlocutors more readily articulated uncertainty, emotional labor, and the relational dimensions of care. Professional authority persisted even when unexercised, and both intervention and restraint reorganized interactions within the field. Holding multiple positionalities revealed hierarchies and moral negotiations that structure acute care. Conclusion: The physician-ethnographer's multiple positionalities should not be understood as a methodological liability to be minimized. By reframing clinician positionality as analytically generative, I demonstrate how reflexive practice can reveal the relational and symbolic organization of clinical care. Professional identity is not external to ethnographic data, but forms part of the conditions through which knowledge is produced.