Diabetes in the Japanese Exam Room
This chapter examines Japanese providers’ strategies for managing patients with diabetes using interview data and participant observation from full-time clinical shadowing of outpatient and inpatient exams at three major health centers, diabetes education classes, medical staff meetings, all-hospital assemblies, and dialysis center activities. While American health care providers spoke privately about diabetes and patients with diabetes in pessimistic terms, Japanese providers maintained high expectations and hopes for type 2 diabetes outcomes, even in private when they were not cheerleading patients. Providers in Japan imagined the origins and inevitable progression of diabetes differently from their peers in the United States, rendering them more optimistic about patients’ futures and more likely to favor lifestyle change.
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