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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: 07 July 2022

Our Diabetes

Our Diabetes

Diabetes in the Japanese Exam Room

(p.92) Chapter Five Our Diabetes
Biomedicalization and the Practice of Culture

Mari Armstrong-Hough

University of North Carolina Press

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.

Keywords:   Patient-centered medicine, Paternalism, Clinician optimism, Strategies for clinical management, Provider responsibility

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