Medicine and Culture: Varieties of Treatment in the United States, England, West Germany, and France - Hardcover

When an internist I was seeing for the first time finally diagnosed as a mitral valve prolapse that heart murmur other internists had been hearing for years, he told me I should take antibiotics whenever I had any dental procedure whatsoever, including having my teeth cleaned....To make certain I was really dealing with American culture bias, I later passed this incident by a French professor of medicine to see what the practice in France would be. He explained that for the third and most severe grade of mitral valve prolapse a French doctor might prescribe antibiotics for a patient having a tooth pulled.

In a highly illuminating comparative study of medicine in the U.S., England, West Germany and France, medical journalist Payer (How to Avoid a Hysterectomy) speculates that to a large extent medical care is determined by value judgments rooted in national character and priorities rather than on scientific criteria. The four countries have equivalent life expectancies, she notes, despite widely differing approaches to medical treatment. She charges that American physicians favor technology and aggressive intervention over reflection, and she links German concern for the heart to a lingering romanticism. Despite the economy-conscious English system, extensive geriatric programs cater to the revered aged, while, she claims, French medicine, especially psychiatry, reflects the country's Cartesian habit of thought as opposed to empiricism. Types and rates of gynecological and cosmetic surgery, radiology and anesthesiology vary greatly among the countries, as do their use of contraceptives and drugsespecially antibioticsand alternate or holistic medicine. The author therefore urges patients to consider medical biases and range of treatment options.
Copyright 1988 Reed Business Information, Inc.