Cultural competence is often defined as the understanding and integration of patients' cultural themes including culturally-based syndromes, diagnostic process, and treatment. Cultural competence is essential to the advancement of global healthcare for it allows greater understanding of individual patients, focuses on combined interventions, and maximizes adherence. However, healthcare professional's culture and culture of medicine itself must also be considered. In westernized medicine, especially America, advances in technology and therapeutics play a large role in changing medical culture; but medical economics is as significant for one now witnesses a once noble profession changing into a “business.”

Commentary on clinical medicine practices and changes in medical culture.

Managed care and Medicare DRGs strongly affect American medical economics with resultant: decrease in physicians' incomes, increased number of patients seen daily, decreased time spent with each patient, and decreased subjective/objective quality of care. Physicians' roles have blurred with duties delegated to lesser qualified healthcare professionals in order to maximize patients seen and income generated by physicians. In psychiatry, performing multiple psychopharmacology visits hourly is economically more productive than an hour therapy session.

Doctors need to understand that in entering medicine they enter a life's career of nobility in which they serve others and do not expect to become wealthy, but at life's end are able to state “a job well done with caring for all.” Perhaps then less harm will be done to patients in the doctors' haste to earn more money by seeing too many patients too briefly.