Abstract

Differences in medical practice among countries are more significant than any similarities. Some examples: the prescribed doses of the same drug may vary among these four countries by as much as ten to twentyfold. The form of the drug varies; French patients have seven times the chance of getting a drug in suppository form as Americans. Surgeries per capita are performed twice as often in the United States as they are in England. Mastectomy rates are three times higher here than there. American surgeons perform coronary bypass surgery at six times the rate of their British colleagues. Blood pressure levels considered high enough to require treatment in the United States are considered normal in England. Blood pressure in the low-to-normal range is considered desirable in the United States; in West Germany, low blood pressure is considered cause for treatment. Antibiotics are used far more often here than in Europe. The list of such astonishing comparisons goes on and on.

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