The Weakness of Contemporary Cultural Medicine
The term Cultural Medicine is used to refer to changes to a medical system provided specifically to reach out to and serve a diverse culture. The title is applied differently than Integrative Medicine. Integrative Medicine acknowledges that there are different preventive and reactive ways to address issues of preventive health, health maintenance, disease, injury and medical care (IntgMed), many of them cross-cultural. Cultural Medicine is applied to all that is not specifically IntgMed. Rather, it is that which supports underlying layers of infrastructure required to deliver ever-expanding, culture-specific positions, products and services, rather than focused, inclusive services.
An example of inclusive delivery is recognition that the national language is English. A focused, nationally oriented, fully integrative system of medicine would acknowledge the beneficial elements of all IntgMed, but it would be delivered in English (except non-translatable elements). This approach encourages all citizens to learn and excel in English and markedly limits the cost of IntgMed products/services components delivery. If for example, government-paid and/or delivered services focus on delivering a more culture-neutral, English-based IntgMed service only, costs would be markedly reduced and all citizen-consumers would be encouraged to become more English-language proficient. As an aside, pharmaceutical products, medical technologies, acupuncture needles, physical therapeutic manipulations and exercises, and other key elements of IntgMed do not recognize the human body as gender, ethnicity or culture-specific – they simply perform functions. Such subdivisions are behaviors of service providers.
One of the primary sets of questions ignored by state and U.S. governmental agencies is:
1. Who is most qualified to determine if a proposal or intervention should be that in which we should invest given all other needs, ideas, and proposals?
2. Who should be responsible for payment for this proposal/intervention if we proceed with it?
3. Define success. What does it look like?
4. When (initial and follow-up) and how shall we measure the effectiveness of the subsequent program, service, or intervention?
5. Is it not appropriate for payers (e.g., public taxpayers) to receive easily accessible, unbiased reporting of interim services delivery progress and performance measurements?”, and
6. What will we do if measured results are not as expected and desired (e.g., inadequate Return on Investment)?
If you took your car in for service, paid for the services, and only fifty percent of the claimed fixes were effective, would you be satisfied? No, you would not be satisfied. If the same automotive repair company employed you, yet still provided you and your peers with the above-described poor service, would you then be satisfied and recommend to your friends that they should be satisfied in similar circumstances? You should respond, “No.” You should not be favorably biased toward the repair company simply because it employs you. However, government initiatives usually provide many millions, if not billions of dollars to the recipients of their investments, including the creation of well-paying jobs. And, unlike as would be the case in private industry, recipients of these public windfall monies and opportunities are loath to give up your tax money, and are often willing to publicly denigrate you for demanding that they be held accountable (e.g., fix the entire car as promised versus aren’t you satisfied with partial function?)