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Biomedicalization and the Practice of CultureGlobalization and Type 2 Diabetes in the United States and Japan$
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Mari Armstrong-Hough

Print publication date: 2018

Print ISBN-13: 9781469646688

Published to North Carolina Scholarship Online: September 2019

DOI: 10.5149/northcarolina/9781469646688.001.0001

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PRINTED FROM UNIVERSITY OF NORTH CAROLINA PRESS SCHOLARSHIP ONLINE (www.northcarolina.universitypressscholarship.com). (c) Copyright University of North Carolina Press, 2022. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in NCSO for personal use.date: 05 July 2022

Your Diabetes

Your Diabetes

U. S. Health Care Providers’ Orientations toward Patients

(p.75) Chapter Four Your Diabetes
Biomedicalization and the Practice of Culture

Mari Armstrong-Hough

University of North Carolina Press

This chapter uses interview data with American health care providers to examine clinicians’ strategies for negotiating with patients to elicit cooperation and participation in their own self-management. It argues that physicians in both countries switch between different models of the provider-patient relationship as they see fit to the situation. The American providers stressed that, ultimately, responsibility for managing the disease rested with the patient. However, they were markedly pessimistic about their patients’ capacity for change and likely course of disease progression. Providers’ low expectations and pessimism contributed to a preference for small, simple lifestyle changes in combination with medication rather than bold lifestyle change.

Keywords:   Patient-centered medicine, Paternalism, Clinician pessimism, Strategies for clinical management, Individual responsibility

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