CommunicationMedicine 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".
"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]
Selling Sickness. How Drug Companies Are Turning Us All into Patients (Allen & Unwin, 2005)
Over three decades ago the maverick thinker Ivan Illich warned that an expanding medical establishment was medicalising life itself, undermining the human capacity to cope with the reality of suffering and death, and making too many well people into patients. He criticised a medical system “that claims authority over people who are not yet ill, people who cannot reasonably expect to get well, and those for whom doctors have no more effective treatment than that which could be offered by their uncles or aunts” (2).
A decade ago medical writer Lynn Payer described the process she called disease-mongering, in which doctors and drug companies unnecessarily widened the boundaries of illness to recruit more patients and sell more drugs (3). Her writings have become ever more relevant as the industry’s marketing roar becomes louder and its grip on the healthcare system much stronger. [Source » US: selling to the worried well … Ray Moynihan / Alan Cassels ]
Disease-Mongers: How Doctors, Drug Companies, and Insurers are Making You Feel Sick (Lynn Payer & 1992)
Lynn Payer, formerly chief medical correspondent for the International Herald Tribune and health editor for the New York Times, is arguing in this book that far too many doctors, as well as drug companies and insurers, are bilking the public, frightening people with ineffective tests, and concentrating too much on benign conditions.
The book's thesis is compelling: doctors, drug companies, and device manufacturers are engaged in "broadening the definitions of diseases" in order to increase demand for their products and services. Since the book was first published in 1992, the evidence has mounted that Payer's view of the medical establishment is all too accurate.
The epidemiological data (or lack of data), is reviewed in order to find a basis for some common health recommendations, practices and beliefs. The breast cancer screening advice for women under age 50 is to receive a physical examination and a mammogram every 2 years. However, research studies show that women who underwent regular screenings did not fare much better against breast cancer than those who were not screened. Nonetheless, physicians support the recommendation and manufacturers promote their mammogram machines as profit-making ventures. Even worse for the individual, mammograms detect noncancerous abnormalities that must be checked out, they cause anguish and unnecessary surgical expenses – and thus mammograms provide a source of income one way or the other.
» The pharmaceutical industry has a dream: at least one disease (and more than one prescription drug) for every American - Stan Cox
We cannot live by scepticism alone (Harry Collins; Essay; 2009)
The term 'science studies' was invented in the 1970s by 'outsiders', such as those from the social sciences and humanities, to describe what they had to say about science. Science studies have been through what my colleagues and I at the Cardiff School of Social Sciences, UK, see as two waves. In wave one, social scientists took science to be the ultimate form of knowledge and tried to work out what kind of society nurtures it best. Wave two was characterized by scepticism about science.
[…]
This third wave will be resisted. Post-modernists have become comfortable in their cocoon of cynicism. And some natural scientists have become too fond of describing their work as godlike. Others are ready to offer simple-minded criticisms of deeply held beliefs. But the third wave is needed to put science back in its proper place.
[…]
Here is the link to the full article Scientists have been too dogmatic about scientific truth and sociologists have fostered too much scepticism ... at Nature.com