Medicine and culture
varieties of treatment [Lynn Payer]
This book was published first 1988, again 1995, and is still in print. This book compares and contrasts the attitude of physicians and patients in England, France, the USA and in Germany. This is not a book concerning different health systems, but rather a book concerning the fact how differently physicians and patients in these countries use diagnoses and therapies, and how, frequently unexpressed ideologies, thereby participates. Lynn Payer gets straight, that these assumptions drastically differentiate between countries, and that, what is by agreement recognized as diagnosis or therapy in one country, it is regarded in another country quite often as "malpractice".
Diseases & Doctors
"French doctors will diagnose vague symptoms as spasmophilia or something to do with the liver; German doctors will explain it as due to the heart, low blood pressure, or vasovegetative dystonia; the British will see it as a mood disorder such as depression; and Americans are likely to search for a viral or allergic cause."
"A belief in the terrain also undoubtedly plays a role in the fact that fewer invasive procedures are used in intensive care units in France than in the United States - with patients doing equally well in both countries."
"West Germans use about six times the amount of heart drugs, per capita, as do the French and English."
"'Herzinsuffizienz' really has no translation into English because it would not be considered a disease in England, France, or America. German doctors often translate it as 'cardiac insufficiency'."
"By far the strongest philosophical movement in Britain has been that of the empiricists. 'But because it ought to work doesn't mean it does ... The data are more important than the hypothesis' This respect for factual details explains why the British have been the chief proponents of the randomized, controlled trial in medical research."
"Not all French doctors are Cartesian, not all German doctors authoritarian romantics, not all English doctors kindly but paternalistic, not all American doctors aggressive. As with most caricatures, these pictures may be distorted, but they are based on truths found in the overall practices of each country."
Reintegration after organ transplantation
"Actually there are substantial cultural differences concerning the choice of pharmaceuticals or cures or the choice of certain operation methods, despite the international exchange of knowledge and experiences. One finds more to this topic in the book of Lynn Payer 'Medicine and Culture: Varieties of Treatment in the United States, England, West Germany, and France'" [ Volker Koellner, University Hospital Carl Gustav Carus, Dresden, 1999]