Closing the Deal: A Cross-Cultural Comparison of Treatment Resistance

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  • Clara Bergen
  • Tanya Stivers
  • Rebecca K. Barnes
  • John Heritage
  • Rose McCabe
  • Laura Thompson
  • Merran Toerien


Publication details

JournalHealth Communication
DateAccepted/In press - 5 Sep 2017
DateE-pub ahead of print - 5 Sep 2017
DatePublished (current) - 2 Nov 2018
Issue number11
Number of pages12
Pages (from-to)1377-1388
Early online date5/09/17
Original languageEnglish


This study investigates patient resistance to doctors’ treatment recommendations in a cross-national comparison of primary care. Through this lens, we explore English and American patients’ enacted priorities, expectations, and assumptions about treating routine illnesses with prescription versus over-the-counter medications. We perform a detailed analysis of 304 (American) and 393 (English) naturally occurring treatment discussions and conclude that American and English patients tend to use treatment resistance in different prescribing contexts to pursue different ends. While American patients are most likely to resist recommendations for non-prescription treatment and display an expectation for prescription treatment in these interactions, English patients show a high level of resistance to recommendations for all types of treatment and display an expectation of cautious prescribing. These behavioral trends reflect broader structural forces unique to each national context and ultimately maintain distinct cultural norms of good-practice prescribing.

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© 2017 Taylor & Francis Group, LLC. This is an author-produced version of the published paper. Uploaded in accordance with the publisher’s self-archiving policy. Further copying may not be permitted; contact the publisher for details

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