...audiences. addition, medical education campaigns driven increasingly from global headquarters, reflecting the international nature publication planning, symposia production and key opinion leader development.

However, global medical education campaigns still need to be implemented locally. They still need to alter the behaviour of physicians and patients within cultures that can vary widely, even within the same country. Those programmes and campaigns that do not work with the local cultural grain risk not attaining their full potential.

Culture clashes

Despite the rise of global brands in pharmaceuticals and fast-moving consumer goods, the pervasive influence of multinational media companies, increasing European integration, Stockholm and Siena, Madrid and Manchester, Bradford and Barcelona remain very different cities. Attitudes to health and medicine across Europe reflect this diversity.

French doctors, for example, traditionally managed diseases such as spasmophile, colibaccilose and crise de foie that--notes anthropologist Daniel Moerman in Meaning, Medicine and the 'Placebo Effect' (1)--"simply don't exist elsewhere in the world." Similarly, in Germany, the rate of coronary heart disease that is broadly similar to the rest of the major markets. (1)

However, Lynn Payer in Medicine and Culture points out that the Germans traditionally use six times more cardiovascular medicines than the French or British. Furthermore, based on the conventional criteria for assessing electrocardiagrams (ECGs), German physicians decide that some 40% of patients need heart medicine. When doctors in the USA examine the same ECGs, they decide that just 5% require treatment. (2)

The reason for this discrepancy lies in...

NOTE: All illustrations and photos have been removed from this article.



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