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The purpose of this paper is to investigate the implicitly assumed universality of the best seller negotiation literature Getting to Yes by Roger Fisher and William Ury.

Existing cross-cultural negotiation literature was systematically searched for findings indicating either a higher or lower likelihood of successfully applying the authors’ advice in different cultural environments, as defined in the Hofstede framework or The Globe Study. The findings were aggregated, categorized into a matrix, synthesized and analyzed.

This paper finds that the assumed universality of the method of Getting to Yes and its single principles is not supported by research. Instead, a dichotomy of the four principles’ applicability along the Individuality dimension of Hofstede was found. Hence, the western orientation of Getting to Yes is reality, inhibiting its use in non-western cultures. However, in one principle – Invent options for mutual gain – the findings refute a successful application in western cultures. Additional findings and research gaps are presented.

Practitioners should apply Getting to Yes with caution, if at all, in a non-western environment. For the teaching of negotiations, alternative approaches for conducting negotiations in the non-western world are needed.

Although widely used in research, scholars only addressed sporadic comments concerning the limitations of Getting to Yes across cultures. Often the universality of Getting to Yes is either implicitly or explicitly assumed in research and practice. This paper approaches this topic systematically by providing evidence that Getting to Yes is not universal and conceptually sees negotiations through a western shaped perspective that provides considerable implications for research, practice and teaching.

We explored how clinicians assisting low-income US Latino patients with diabetes and limited English proficiency (LEP) made sense of language-discordant care in the context of the social determination of health.

We interviewed 14 physicians in an urban teaching hospital, recorded and transcribed the interviews, and read transcripts to identify themes and interpret meanings. We used a mixed qualitative approach and drew from the Marxian tradition that illuminates how the dynamic of the clinical encounter tends to reproduce the social order by excluding its critical appraisal.

Participants believed that language barriers undermine the quality of the clinical encounter and diabetes outcomes, were eager to serve disadvantaged patients, and were well schooled in the social determination of health and its role in diabetes inequalities. However, they appeared unable to conceptualize macro-level changes that may achieve greater health equity.

The structure of medical discourse appears to limit the ability of individual clinicians to conceptualize and engage in social change on behalf patients. Recent debates in primary care indicate that this limitation is currently being challenged. Health services for persons with diabetes and limited English proficiency in the United States and elsewhere require significant improvements in interpreter services. At a broader level, clinicians should consider stepping beyond the limited, traditional role of medical/behavioral advisor to engage in political action toward greater social equity, which would result in better health.

Research in the various dimensions of language discordance is largely quantitative thus the need for qualitative studies to inform practice and policy.