The Changing Culture in Modern Medicine: A Psychiatrist's Perspective

Cultural competence advances global healthcare by promoting greater understanding of individual patients, combined interventions, and maximum adherence. However, the healthcare professional’s culture and the culture of medicine itself must also be considered. In westernized medicine, especially America, improved technology and therapeutics profoundly impact medical culture; but medical economics is as significant. Managed care and Medicare Diagnosis-Related Groups (DRGs) strongly affect American medical economics with resultant decreased physicians’ incomes, increased patient volumes, decreased time spent with each patient, and decreased subjective/objective quality of care. Physicians’ roles blur with duties delegated to lesser qualified healthcare professionals to maximize patients seen and generated incomes. In psychiatry, performing multiple psychopharmacology visits hourly is economically more productive than an hour therapy session. Doctors need to understand that in entering medicine they enter a life’s career of nobility in which they serve others, do not expect to become wealthy, but at life’s end are able to state “a job well done with caring for all.” Perhaps then, less harm will be done to patients in doctors’ haste to earn more money by seeing too many patients too briefly.