Medicine and Culture

Medicine & Culture Payer, Lynn. Medicine & Culture: Varieties of Treatment in the United States, England, West Germany, and France. New York: Henry Holt, 1988. 204 pp. Many people who travel in the course of their job, or those who go abroad on holiday, are often surprised to discover that medicine and healthcare can vary enormously from that which they are used to at home. In her book Medicine & Culture, Lynn Payer compares and contrasts the practice of medicine in four major western countries: U.S.A., Britain, Germany and France.

Payer does not deal with the countries' health care systems, but focusses her analysis upon the different approaches taken to medical diagnosis and treatment within each country, and how these vary from one to the other. The basis of these variances, and the cause of the obvious differences, is, according to the author, linked to culture.

The structure of the book takes the form of a study into the standard medical practices and "acceptable" treatments within each culture, and an examination of how doctors in the four countries diagnose and treat disease. Payer, through the use of interviews and statistical evidence, shows that medicine and medical diagnosis are not as scientific and objective as most people assume.

By using examples to illustrate her points, the author claims that the clinical foundations of medicine, and the general assumption about diagnosis and treatment vary dramatically from country to country and, that what is 'acceptable' medicine in one country could be considered as malpractice in another. The central focus, and major argument, of Medicine & Culture is that the medical professionals, within the four countries under study, understand and practice medicine in radically differently ways as a result of their particular national history and culture.

This observation is extended by Payer to include medical training and the general population within each country. Therefore the book emphasizes the differences, not only between the medical staff, but also between the patients of each country. Medicine & Culture's primary argument is directed at American doctors and patients, and their general tendency to regard their country's medicine as the most scientifically correct manner in which to diagnose and treat disease.

Payer suggests that the American medical profession, and the public, should adopt a wider perspective and consider the way in which their country's medical practices are established and influenced by historical traditions and cultural biases. By devoting a seperate chapter to each of the four central countries, Payer's expands upon her theories and ideas, and examnines specific medical conditions and the manner in which the doctors of each country approach the areas of diagnosis and treatment. Considering.