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Free download from www.hsrcpress.ac.zawith concrete features of and procedures at the setting.The outpatient centre where the study was located is attached to a generalhospital. It is a relatively specialised setting, serving a large, metropolitanWhite population of, for the main part, fairly indigent persons. About fourfifthsof the patients who attend the day clinic at the centre are 65 years andolder. 15 At the time of the investigation 17 the centre provided health care to anestimated 14 000 ambulant patients per month, or 700 patients on eachweekday. The day clinic operates from 07h00 until 16h00. Morning sessionsare mostly taken up with patients’ visits for regular consultations with doctorsand certain specialists. Afternoon sessions are directed at specialist clinicconsultations. The study was confined to the family medicine clinic, which isthe normal “general practice” service, where the majority of chronic diseasesare primarily treated.Approaching informants and subsequent interaction took place over severalmonths. Permission for access to undertake the investigation was first securedfrom the Director of Hospital Services. The researcher was then referred to theSuperintendent of the hospital who on granting his approval referred her to theDeputy Superintendent and the First Matron of the Outpatient Department andthe Head of the Social Work Department of the hospital. It was explained toofficials that the aim of the research was primarily to study an instance ofclient-agency interface in a medical setting, and that the focus would be on theelderly persons’ perceptions of medical encounters at the centre.Interviews were also conducted with the Chief Administrative Officer and hispersonnel on difficulties and problems connected with the administration andprovision of the service to aged persons. Officials were able to provide insideperspectives of events and problems that the researcher was not yet familiarwith. These interviews served as a sounding-board for developing insights,propositions and hypotheses, and more broadly gaining entry to situations andpersons.Access to the organisational setting and most of its subsettings was readilyachieved. The researcher then interviewed clerks, cashiers, nursing-sisters,trainee nurses, orderlies, porters and voluntary workers. Records were kept ofall conversations with informants, by jotting down notes during interviews andwriting these up more comprehensively immediately afterwards. Whereverpossible and where these were available, statistics were scrutinised and copiesof documents and statistical records were secured.Denzin (1978: 97) states that in naturalistic observation it is necessary to payattention to the spatial, temporal, ritualistic and interactional features of asocial organisation. If an investigator has successfully entered the subjects’world, it is possible to know where the critical observational and sampling210