Western medicine's attempt to become more scientific: Examples from the United States and Thailand [1]

Historically, scientism has been a prominent rationale both for the extensive Westernization of other indigenous medical systems, and for a vigorous pursuit of orthodoxy within Western medicine. But the 19th century colonial spread of Western medicine preceded the 20th century achievement of relative scientific orthodoxy within Western medicine, epitomized in the United States by the Flexner reforms in medical education. At the same time, increased technical standards in medical education led to unsolved problems of production and availability of physicians. Also the ideological success of science within academic Western medicine preceded the improvements in medical efficacy which resulted from the application of new science and technology to therapy. Considerations of medical efficacy include amelioration of suffering, as well as effects upon mortality (which are more conclusively demonstrable) and the curing of an individual's disease (which is a more popular expectation). In contemporary Western medicine there remain contradictions between therapeutics and the scientific study of disease. And in the West and elsewhere there remain a variety of medical sub-cultures. Continued or increased emphasis in medicine upon the pursuit of science may be neither universal nor eufunctional.