For Here or To Go?

I was watching a rerun of Gordon Ramsay's Kitchen Nightmares, in which Chef Ramsay attempted to aid a failing French restaurateur who believed that his business suffered because American diners didn't "appreciate the quality of life" as they do in France, and didn't want to enjoy rich foods over a 3 hour service. Throughout the program, Ramsay convinced the chef to begin cooking simpler dishes that were more attractive to American clientele, which would allow for shorter service time and higher turnover of tables, and thus, more profit. In order to achieve success, the French chef had to adapt.

Is this the case for all service in American culture? Although it is known that slower meal consumption aids digestion and prevents overeating, Americans typically eat quickly and move on with their day's responsibilities. The most successful businesses in America offer fast services (fast food restaurants, one-stop shopping, online ordering, quick lube stations), multi-tasking (smartphones, multi-function gaming consoles) and low prices. Medically, the "minute clinics" flourish -- a mechanism to see a health professional to manage minor problems, complete physicals, and get out quickly. American society revolves around convenience, impulse, and speed. A doctor's office appointment is often too long to accommodate. In this society, who has the time to wait? Once seen, patients expect a pill or a shot for immediate relief. The culture no longer allows for extended respite, or long recoveries in countryside sanitariums.

In the clinics and wards, this is referred to as "Fast Food Medicine" or "Drive-Thru Healthcare". Patients demand the organized service of a Subway, with the speed of the fastest sandwich artist, and the efficiency of McDonalds, with relief as immediate as heartburn after downing a QPC or a 10 pc nugget meal.

In my health promotion undergraduate education, we discussed the principles of cultural acceptance and tailoring health treatments to fit the cultural norms. If American culture is that of speed and pressure, is it reasonable to expect American patients to adapt to long-term lifestyle changes? Are we, as health professionals, akin to the arrogant French chef, insisting that our way is superior, and the customers are the ones with the problems? Do we need a different approach to address chronic health problems in Americans?

Perhaps the following would enhance care of Americans:

• focusing on short term goals (i.e. losing 2 lbs this week)
• accentuating immediate relief  (i.e. feeling stronger the night after working out)
• less wait time in the office (allowing kiosk check-in, not over- or double-booking appointments)
• more availability (more offices in strip malls,close to schools and centers of commerce)
• price lists, depending on patient payment plans

We tailor treatment to patients of different cultures on a daily basis. Let's not forget our own.