Michigan Pediatrician Refuses to Treat Lesbian Couple's Baby

[seminoma]

See, my plan is to help fix the health disparies of marginalized groups that have been mistreated by those in the healthcare system. There is no evidence of white people or rich people being treated poorly in this context, so there is no problem, so there would be no reason to provide training. If historically white people were given fatal diseases then not treated for experimentation purposes without consent, their cells taken and sold without seeing a dime, if educated white women had significantly worse rates of infant mortality than black women with only high school educations, then yeah it probably would be a good idea - but that's not the case.

Addressing issues like these is way beyond the scope of a med school course or GME on empathy. Issues like infant mortality are huge issues that no doubt need to be fixed, but still they have nothing to do with physician empathy. A girl with only high school education and no access to healthcare is going to have a bad outcome regardless of her race. Yeah, the data shows that this outcomes are worse with black girls compared to white girls, but that's more about their access to care than their race. Take a black teen girl in an affluent neighborhood and a homeless white teen girl. The black girl is going to have a healthier baby. The issue here is a societal one, not one that the average physician is going to tackle from his/her office.

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[touchpause13]

Do you have any evidence at all that increased physician sensitivity training would actually help fix these problems, or are we just making recommendation based on what makes us feel good?

Do you have any better ideas?

I'm legitimately asking. I'm involved with the diversity coordinator at my school and this is what has been offered, but if there are better options out there I'd love to here them. I mean, it sucks that we don't have a lot of hard data, but at least getting people to know that these disparities exist is better than not.

 

[charmiedermie]

Do you have any evidence at all that increased physician sensitivity trainin would actually help fix these problems, or are we just making recommendations based on what makes us feel good?

Don't medical boards use it for physicians? Think of it as remediation in medical professionalism.

 

[charmiedermie]

Do you have any better ideas?

I'm legitimately asking. I'm involved with the diversity coordinator at my school and this is what has been offered, but if there are better options out there I'd love to here them. I mean, it sucks that we don't have a lot of hard data, but at least getting people to know that these disparities exist is better than not.

No, bc he's more than happy to criticize your ideas. It's irrelevant if a person actively decides not to change after gender sensitivity training. Doesn't mean that training is bad.

 

[VA Hopeful Dr]

Don't medical boards use it for physicians? Think of it as remediation in medical professionalism.

Only in so far as the boards expect residency to make sure you're not a terrible human being. They might also make you take a class if you get in trouble with the board.

Otherwise, not really an issue.

 

[seminoma]

Do you have any better ideas?

I'm legitimately asking. I'm involved with the diversity coordinator at my school and this is what has been offered, but if there are better options out there I'd love to here them. I mean, it sucks that we don't have a lot of hard data, but at least getting people to know that these disparities exist is better than not.

Yeah, go to the source and address the problem rather than critiquing failed solutions.

The problem being why people aren't going to college, why they are getting pregnant without a stable income, why they aren't pursuing prenatal care. Saying the rich white doctor needs to do more to save the poor uneducated pregnant girl isn't going to do anything.

 

[touchpause13]

Addressing issues like these is way beyond the scope of a med school course or GME on empathy. Issues like infant mortality are huge issues that no doubt need to be fixed, but still they have nothing to do with physician empathy. A girl with only high school education and no access to healthcare is going to have a bad outcome regardless of her race. Yeah, the data shows that this outcomes are worse with black girls compared to white girls, but that's more about their access to care than their race. Take a black teen girl in an affluent neighborhood and a homeless white teen girl. The black girl is going to have a healthier baby. The issue here is a societal one, not one that the average physician is going to tackle from his/her office.

No they don't

College educated black women have worse infant mortality rates than white women with just a high school education. Education and poverty make a big difference, but there is more there.
http://www.ishib.org/journal/20-1s2/ethn-20-01s2-s62.pdf

 

[charmiedermie]

Only in so far as the boards expect residency to make sure you're not a terrible human being. They might also make you take a class if you get in trouble with the board.

Otherwise, not really an issue.

Yes, but for certain medical board sanctioned issues, it is used as a tool to remediate.

 

[GUH]

Do you have any better ideas?

I'm legitimately asking. I'm involved with the diversity coordinator at my school and this is what has been offered, but if there are better options out there I'd love to here them. I mean, it sucks that we don't have a lot of hard data, but at least getting people to know that these disparities exist is better than not.

Not my area of expertise. However, my school did have a mandatory panel discussion on LGBTQ health and healthcare issues led by a gay man, a lesbian woman, and a genderqueer "they". Living where we do, homosexuals are common and a lot of what the first two speakers said was already known to most of us. Less of us have had extensive exposure to transsexuals so that might have been educational but it ended up such that the "they" came across as high-strung, defensive, condescending, and hypersensitive - pretty much fulfilling some of the stereotypes about this population without giving us a whole lot of specific advice. Because of this, many of us didn't feel like we learned a lot from that session and I would prefer to see evidence that training improves outcomes before being dragged through more of it.

 

[touchpause13]

Yeah, go to the source and address the problem rather than critiquing failed solutions.

What's the source?

Do you me to wave a magic want and fix racism?

 

[seminoma]

No they don't

College educated black women have worse infant mortality rates than white women with just a high school education. Education and poverty make a big difference, but there is more there.
http://www.ishib.org/journal/20-1s2/ethn-20-01s2-s62.pdf

Wealthy black infants have worse outcomes than homeless white infants? Show me where that data is in that study, I don't want to read the whole thing.

 

[3rdan]

Don't medical boards use it for physicians? Think of it as remediation in medical professionalism.

Great idea. Let's put politically incorrect thought under the banner of "professionalism". Anyone remember Amir Al-Dabaugh?

 

[touchpause13]

Not my area of expertise. However, my school did have a panel discussion on LGBTQ health and healthcare issues led by a gay man, a lesbian woman, and a genderqueer "they". Living where we do, homosexuals are common and a lot of what they said was already known to most of us. Less of us have had extensive exposure to transsexuals so that might have been educational but it ended up such that the "they" came across as high-strung, defensive, condescending, and hypersensitive - pretty much fulfilling some of the stereotypes about this population without giving us a whole lot of specific advice. Because of this, many of us didn't really feel like we learned a lot from that session.

At least the training that we do is very - "where ever you come from is okay, and we aren't here to make anyone feel bad" So it's not combative in the least and is more, "it's okay to ask questions, it's okay to mess up, we don't expect you know have all the answers" I like that because I've never heard anyone say they felt guilty or shamed for their opinion (which tends to just piss people off and make them even more resistant to the idea as a whole). And we try and get facilitators of different groups to lead the small group discussions, but there isn't always someone who fits in that mold - like the elderly or people with disabilities one.

We did have a gay panel as well, that was lead by a church leader, and 2 people from the LGBTQ activist group in my city, as well as we've had a gay physician come in and talk about how to do a sexual history aimed at an LGBTQ population.

 

[touchpause13]

Wealthy black infants have worse outcomes than homeless white infants? Show me where that data is in that study, I don't want to read the whole thing.

No I'm sorry, I didn't mean that example specifically. I meant the example that I did give.

 

[seminoma]

What's the source?

Do you me to wave a magic want and fix racism?

You don't have to fix racism to fix healthcare disparities. I'm fairly confident a poor uninsured white guy will get the same level of treatment as a poor uninsured black guy. Likewise, LeBron is going to get the same level of treatment as Dirk. The fact that there are more poor uninsured black guys than poor uninsured white guys isn't because of racism. If you waved a magic wand and fixed racism, all those poor uninsured black guys wouldn't magically turn into middle-class black people.

 

[touchpause13]

Great idea. Let's put politically incorrect thought under the banner of "professionalism". Anyone remember Amir Al-Dabaugh?

They guy who sexually harassed his classmates, was kicked out of a patient's room for being disrespectful, and lied about getting a DWI? Great posterchild

 

[touchpause13]

You don't have to fix racism to fix healthcare disparities. I'm fairly confident a poor uninsured white guy will get the same level of treatment as a poor uninsured black guy. Likewise, LeBron is going to get the same level of treatment as Dirk.

So you think that all healthcare disparities are due to wealth inequity then?

 

[seminoma]

So you think that all healthcare disparities are due to wealth inequity then?

If your goal is to fix healthcare disparities then I believe given the choice of one magic wand to wave around, racism would be lower on the list than any of the following: income, access to care, health-insurance, education, genetic predispositions.

 

[touchpause13]

@Mad Jack didn't you say that you had a really good LGBTQ training session at your school that was helpful? What was that like?

 

[touchpause13]

If your goal is to fix healthcare disparities then I believe given the choice of one magic wand to wave around, racism would be lower on the list than any of the following: income, access to care, health-insurance, education, genetic predispositions.

That's fair, I would agree

 

[touchpause13]

I'm just really surprised that my thought of, "instead of lawyering up or throwing this all over social media, but instead promoting cultural competency" is controversial.

 

[oldanddone]

edit:

Do you have any evidence at all that increased physician sensitivity trainin would actually help fix these problems, or are we just making recommendations based on what makes us feel good?

there is evidence. along the lines of sued less, and such. often because being sued comes from communication/empathy breakdown. now...to try and dig some of that up....

so to work on bridging differences and empathy/good communication in general doesn't have to silo all the various 'differences' into boxes. it creates a good 'core competency' for differences in general

 

[charmiedermie]

That doesn't mean it is an effective educational intervention, but rather an effective punitive/threatening intervention

There is nothing "punitive" or "threatening" about sensitivity training, even though the person may interpret it as being so. Taking their license away would be, but they're not doing that.

Great idea. Let's put politically incorrect thought under the banner of "professionalism". Anyone remember Amir Al-Dabaugh?

Not thoughts but actual actions. Thoughts are in your head. Medical professionalism falls under state medical boards and they work to remediate them.

 

[charmiedermie]

I'm just really surprised that my thought of, "instead of lawyering up or throwing this all over social media, but instead promoting cultural competency" is controversial.

Bc as you can see people here are averse to that training voluntarily bc they think it is a waste. So best way, pass a law and make public aware or medical board remediation.

 

[charmiedermie]

That's the obvious implication though

What's the implication? Yes, if you decide not to remediate, then you will likely face consequences. No different than defensive driving.

 

[oldanddone]

That's the obvious implication though[/QUOT

how sensitivity training gets wielded is often a product of a sick system that uses it as a hammer. agreed. and often not even for increasing sensitivity! for instance the 'disruptive' physician is often more disruptive to 'business as usual' - it's the disruption of business that brings in the hammer of sensitivity training. even if the physician is making good points about how sick the 'business' is. used as a tool to silence dissent.

the empathy/communication are often considered the 'soft skills' and nice, but better left out when time is the issue for the 'hard' curriculum of for instance nutrition. hah! nutrition! as if that is a central concern typically! unless a person wants to have an eating disorder, rigourous approach to nutrition is not usually a key focus. whereas communication/empathy actually are....not taught too effectively by the way in med ed with the checklist approaches either. and the checklist approaches rule supreme in typical senses of 'sensitivity training' as if one can learn 10 points about different silos, and that counts. except when you come up to a person and think you know their '10 points', but don't have the skills to make bridges and understand across difference, or recognize difference, there will be frustration that you know the 10 points, but that person still hates you/doesn't trust you/isn't understandable to you/resists 9 of the 10 points as blatant sterotyping! that just ends in frustration. that point has been mentioned already here, of the valuing of sterotyping/sensitivity competency checklist approaches at the expense of the individual - i would say the human being - in front of you/me.

 

[charmiedermie]

Because it doesn't demonstrate the effectiveness of the sensitivity training. It demonstrates the effectiveness of threatening to take someone's medical license away.

It's the punitive aspect that stimulates change (if change does even occur), not the training itself.

But the only way to know that is effective is whether another incident of the same nature happens again. Also you could say that for any type of remediation.

 

[oldanddone]

punitive reasons for stimulating change can be the least effective. so i'd bet the same incident happens again if the sensitivity training is part of something that is clearly punitive and not about a person excelling.
look at sports pscyhology with the ratio of 5 positives to 1 negative and compare that to the '**** sandwich' (excuse the language, just the terminology that gets used' which is considered progressive, to sandwich negative feedback between two positives. and then the folks who aren't progressive, edit: and are just outright malignant with no positives at all, creating an atmosphere to fail in.
to actually be interested in remediation is to look at sports pscyh and other thigns. and remediation doesn't happen in a vaccuum - there is often a hammer going on, and not even for what the person is in remediation for. it can get cloak-and-daggers and political.

 

[touchpause13]

how sensitivity training gets wielded is often a product of a sick system that uses it as a hammer. agreed. and often not even for increasing sensitivity! for instance the 'disruptive' physician is often more disruptive to 'business as usual' - it's the disruption of business that brings in the hammer of sensitivity training. even if the physician is making good points about how sick the 'business' is. used as a tool to silence dissent.

the empathy/communication are often considered the 'soft skills' and nice, but better left out when time is the issue for the 'hard' curriculum of for instance nutrition. hah! nutrition! as if that is a central concern typically! unless a person wants to have an eating disorder, rigourous approach to nutrition is not usually a key focus. whereas communication/empathy actually are....not taught too effectively by the way in med ed with the checklist approaches either. and the checklist approaches rule supreme in typical senses of 'sensitivity training' as if one can learn 10 points about different silos, and that counts. except when you come up to a person and think you know their '10 points', but don't have the skills to make bridges and understand across difference, or recognize difference, there will be frustration that you know the 10 points, but that person still hates you/doesn't trust you/isn't understandable to you/resists 9 of the 10 points as blatant sterotyping! that just ends in frustration. that point has been mentioned already here, of the valuing of sterotyping/sensitivity competency checklist approaches at the expense of the individual - i would say the human being - in front of you/me.

I definitely see what you are saying.
Just sitting in a class and learning, say, "People in Asian cultures like to be called by Mr. or Mrs. whatever" isn't particularly helpful. The point of empathy training is to learn how to empathize with people of all different cultures in order to be able to learn how to find common ground, show respect, have effective communication with anyone that comes into your office. That's why I like the approach of having small group discussion in a non judgmental environment as well as actually interacting with people who come from a different culture than your own.
I still think it is important to have more in depth things about different cultures available - if you are working in an area with a very large gay population, there are things that it would be very helpful for you to know (don't assume lesbians don't get STIs, call transpeople by their preferred name, etc) but it's more important to learn how to respectfully talk to your patients and ask questions if you are unsure. Like with the trans example, they aren't going to bite your head off if you ask what their preferred name or pronoun is, but they will be less likely to trust you if you misgender them.

TL;DR - Learning how to communicate with people who have different backgrounds than yourself without being a dingus is important m'kay

 

[oldanddone]

I definitely see what you are saying.
Just sitting in a class and learning, say, "People in Asian cultures like to be called by Mr. or Mrs. whatever" isn't particularly helpful. The point of empathy training is to learn how to empathize with people of all different cultures in order to be able to learn how to find common ground, show respect, have effective communication with anyone that comes into your office. That's why I like the approach of having small group discussion in a non judgmental environment as well as actually interacting with people who come from a different culture than your own.
I still think it is important to have more in depth things about different cultures available - if you are working in an area with a very large gay population, there are things that it would be very helpful for you to know (don't assume lesbians don't get STIs, call transpeople by their preferred name, etc) but it's more important to learn how to respectfully talk to your patients and ask questions if you are unsure. Like with the trans example, they aren't going to bite your head off if you ask what their preferred name or pronoun is, but they will be less likely to trust you if you misgender them.

TL;DR - Learning how to communicate with people who have different backgrounds than yourself without being a dingus is important m'kay

yes i do agree with you. that at baseline techniques to promote how to relate across difference/recognize difference/empathy/communication that is not checklist based, and uses techniques like a facillitated small group (that i never found in med except for maybe the Ruth Remen Healer's Art kind of course and a few other sidelined moments, but not respected for the pedagogy that they are) etc. then, beyond that, is developing the curiosity about knowing more about different people and the cultures out there.

edit: i.e. not much like what the 'cultural competency' or 'sensitivity training' of today's med schools/corporate worlds espouse. but useful

 

[charmiedermie]

punitive reasons for stimulating change can be the least effective. so i'd bet the same incident happens again if the sensitivity training is part of something that is clearly punitive and not about a person excelling.
look at sports pscyhology with the ratio of 5 positives to 1 negative and compare that to the '**** sandwich' (excuse the language, just the terminology that gets used' which is considered progressive, to sandwich negative feedback between two positives. and then the folks who aren't progressive, edit: and are just outright malignant with no positives at all, creating an atmosphere to fail in.
to actually be interested in remediation is to look at sports pscyh and other thigns. and remediation doesn't happen in a vaccuum - there is often a hammer going on, and not even for what the person is in remediation for. it can get cloak-and-daggers and political.

Every remediation technique has a punishment behind it, if it is not done - every single one, and not just in medicine either. Remediation is effectively a second chance.

 

[Shikima]

What's the implication? Yes, if you decide not to remediate, then you will likely face consequences. No different than defensive driving.

You can't take away someone's license without having larger implications like having a counter-lawsuit for restricting trade and not allowing one to engage in their livelihood . You cannot force punitive counseling/classes because someone doesn't think the same way as you do much less even think about taking away someone's license.

Bottom line, we're all different and that includes having differing opinions. If you don't like it, then you are not following your own 'rules' for accepting *ALL* persons' experiences and how they identify themselves to the world. This is inherently contradictory and pretty much all credibility is lost for whatever social justice charge you're wanting enter into.

 

[oldanddone]

Every remediation technique has a punishment behind it, if it is not done - every single one, and not just in medicine either. Remediation is effectively a second chance.

ok i get your point that remediation inherently is a checkpoint, and not doing it means not advancing, and so is a punishment.
in the new curricula that will be 'competency based' (lots of pitfalls in that one...but the new rage in my jurisdiction) the idea will be that a person advances at their own pace, so possibly less 'remediations' because a person is able to learn at their own pace, less likely to fail, by not having achieved something by a certain time. less 'remediations' and more 'learning process'.

i know that remediation gets painted as a 'second chance' but that is a facile response without due diligence or effort. it sets up for failure, because by the time a person is remediating, if they had known how to change on their own, they would have.

there is more to remediation, from a thoughtful and effortful perspective. let me see if i can rustle up an article...brb..i know there is an opensource one on this... http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3641019/
there are others...there's a whole area of scholarship...which generally gets overlooked for the easy, superficial approach of 'second chance'.
even with the inherent punitive nature, there are ways that we make things more punitive - by mixing it in as a hammer to be used for other reasons, getting into blackballing rather than actually having a focus on improving, advancing 'office/hospital politics', etc.
i get that there is an inherent message of 'how you were doing things is not good'. and there are those who have the power to say that and stop advancement.
but there are ways that we really should look at and stop of making it more punitive and less helpful. more on the sports psychology end of the spectrum than the malignant environment. it would mean the powerful in this situation being willing to look at how they themselves are in need of remediation/overhaul of their approach. a little more relational.
once again, pie-in-the-sky stuff. but also related to the skills of relating across difference and being willing to change (both parties) in the process.
a bit pie-in-the-sky.
but great way to procrastinate on a saturday.
hmmm. possibly time to cut off and go do some Work.
just too interested in the discussions. so many great contributions. also a little more drilled-down and away from the original topic, starting to type with the whole 'professionalism'/CW thread in mind, more than this thread.
time to sit on the hands for a bit.

 

[charmiedermie]

You can't take away someone's license without having larger implications like having a counter-lawsuit for restricting trade and not allowing one to engage in their livelihood . You cannot force punitive counseling/classes because someone doesn't think the same way as you do much less even think about taking away someone's license.

Bottom line, we're all different and that includes having differing opinions. If you don't like it, then you are not following your own 'rules' for accepting *ALL* persons' experiences and how they identify themselves to the world. This is inherently contradictory and pretty much all credibility is lost for whatever social justice charge you're wanting enter into.

No one is punishing her for her "thoughts" or her "opinions". She acted on those thoughts/opinions and that is the issue. In general, state medical boards do sensitivity training as remediation for unprofessional behavior and it is done all the time.

 

[oldanddone]

i don't have love for seeing medical boards as above the need for looking at themselves for being discriminatory, erosive of what 'professionalism' means to the lowest common denominator, punitive, and judgemental. not a physician's friend, and certainly not a great set-up to be a physician's mentor.
i would place them and their interventions/remediations less along the sports psychology coaching and more towards the hammer. i would see them selecting techniques and approaches that prop up inherently sick systems. medical boards punish and judge and restrict doctors in ways that the public has come to think they are too loose, and physicians have come to feel discriminated against. they don't have either public or physician trust. failing on both ends. a rotten system that needs to look at itself. and probably won't. i'm not sure that sensitivity training as mandated by a medical board would have been the best way forward for any of the parties in this. restorative justice processes on the other hand, that's where i'd put my faith.

 

[Shikima]

No one is punishing her for her "thoughts" or her "opinions". She acted on those thoughts/opinions and that is the issue. In general, state medical boards do sensitivity training as remediation for unprofessional behavior and it is done all the time.

We're not talking about the physician directly. This turned into a larger discussion about 'thoughts' and the subsequent control of said 'thoughts'. You aren't allowed to legislate thinking or apply any kind of punitive measure associated with non-compliance or to the aire of loosely defined 'unprofessionalism'.

Discussion of unprofessionalism leads to a different, slippery slope discussion and I don't want to detract from this discussion.

Again, the cornerstone of what has been proposed was making continued licensure based on the completion of mandatory and what would be considered punitive education. This is not allowable by any means.

 

[oldanddone]

Again, the cornerstone of what has been proposed was making continued licensure based on the completion of mandatory and what would be considered punitive education. This is not allowable by any means.

i thought this does often happen, as mentioned above. a complaint might be made, a physician brought into a hearing, and outcomes enforced for continued licensing, such as sensitivity training. i thought not only is it allowable (according to the boards) but also done

edit: in the hearing would be debated what the actions were, what basis the physician has for what they did, etc, if they contravened any laws...i.e. the points made in this thread around right of conscience and the relevant non-disciminatory laws and when they kick in...it would all get discussed, and then the outcome would be developed...no?

 

[Shikima]

i thought this does often happen, as mentioned above. a complaint might be made, a physician brought into a hearing, and outcomes enforced for continued licensing, such as sensitivity training. i thought not only is it allowable (according to the boards) but also done

edit: in the hearing would be debated what the actions were, what basis the physician has for what they did, etc, if they contravened any laws...i.e. the points made in this thread around right of conscience and the relevant non-disciminatory laws and when they kick in...it would all get discussed, and then the outcome would be developed...no?

So, without having the whole story, members of this forum have announced themselves as prosecutor, judge and jury while handing down sentences of admonishment based on social guilt which are leading towards censure on her license or potentially something worse. A mark which will follow her.....

Something that we need to be very careful of setting precedence upon.

 

[charmiedermie]

We're not talking about the physician directly. This turned into a larger discussion about 'thoughts' and the subsequent control of said 'thoughts'. You aren't allowed to legislate thinking or apply any kind of punitive measure associated with non-compliance or to the aire of loosely defined 'unprofessionalism'.

Discussion of unprofessionalism leads to a different, slippery slope discussion and I don't want to detract from this discussion.

Again, the cornerstone of what has been proposed was making continued licensure based on the completion of mandatory and what would be considered punitive education. This is not allowable by any means.

Only if you have a lapse in professionalism, can the medical board mandate that you complete certain types of remediatory activities.

 

[Shikima]

Only if you have a lapse in professionalism, can the medical board mandate that you complete certain types of remediatory activities.

Again, a different discussion..... and you were supporting the idea for someone to go before the board if they weren't demonstrating (sic) 'appropriate social awareness'.

Bad idea. Slippery slope.

And again I challenge you to check yourself on what inclusion really means. Hint: It doesn't mean special interest groups.

 

[charmiedermie]

Again, a different discussion..... and you were supporting the idea for someone to go before the board if they weren't demonstrating (sic) 'appropriate social awareness'.

Bad idea. Slippery slope.

And again I challenge you to check yourself on what inclusion really means. Hint: It doesn't mean special interest groups.

Nope. I was addressing it with respect to what she did, her action, as being unprofessional (my opinion). I would have said the same if she was an atheist doctor against Christian parents.

 

[oldanddone]

Only if you have a lapse in professionalism, can the medical board mandate that you complete certain types of remediatory activities.

Ah I see. In other words, because so far no-one in the discussion would know the relevant anti-discrimination laws/guidelines, and how that balances with right to reject and when based on conscience, there would be no sense of whether there was a lapse. if a complaint were made, it would be the work of that committee to determine. in the meantime, lots of discussion about the various things that would be part of that kind of discourse - conscience, thought/action, what constitutes a first appointment for an unborn/not yet person, whether first appointments initiate relationship, whether ending relationship constitutes abandonment, anti-discrimination laws in particular states and what they include and whether they apply, and then beyond what would be able to prevail on enforcing sensitivity training/sanction of license. whether there would be fair or healthy process in those kinds of assessments made by gatekeepers whether courts or boards.

in the thread, also discussed is the broader context of other sanctions such as in another thread discussion about blue cross insurance rules on what they decide is acceptable/unacceptable reasons to turn down a potential patient with blue cross insurance, whether that would create sanctions re: continuing to be a provider in such insurance, whether that respects physician's right of conscience and balances, what slants media stories will use, and whether that is useful or not for bringing about local/broader change, use of consumer dollar sanctions in the form of ratings, what broader implications that has.

I see your point that there may not even be a judgement to make on whether sanctions/remediation/trainings are required. that case would likely be argued in front of a board or a court depending on whether a complaint or suit were developed.

 

[rajhanda]

There should be a political commissar in every medical society and regulatory agency to prevent unacceptable deviations from diversity.

There are streets in Syria where merchants protect their business by displaying an ISIS flag, because word is if you don't, well, that's disrespect, and off you go into a cage... Fast forward to a future in America and the rainbow flag... There must be diversity until there shalt be no diversity.

 

[Shikima]

Nope. I was addressing it with respect to what she did, her action, as being unprofessional (my opinion). I would have said the same if she was an atheist doctor against Christian parents.

What if I said your opinion is wrong?

 

[jdh71]

How many people know exactly what patient population they are going to be working with in medical school? I don't really see how it's a waste of time. For us it was a total of 6 hours over the course of 2 months. 1 hour per group - watch a movie, then small group discussion.

And no it's not mandatory - but a lot of people do it, the spots tend to fill up within an hour

I just don't need a class to know how to be a good doctor.

It's kind of sad that this even has to occur.

 

[touchpause13]

I just don't need a class to know how to be a good doctor.

It's kind of sad that this even has to occur.

Everyone says that.

(For real I don't think you personally need a class to learn how be a respectful human being, but there certainly people who do)

Plus it doesn't hurt any by going to it, maybe you learn some things, maybe you don't.

 

[charmiedermie]

What if I said your opinion is wrong?

That's fine if you think it's wrong. What's your point?

 

[Shikima]

That's fine if you think it's wrong. What's your point?

It's ok to enforce your opinion on others, but as soon as someone else does you're on the charge of the moral light brigade.
Time for you practice that tolerance you want others to submit to.

 

[jdh71]

Everyone says that.

(For real I don't think you personally need a class to learn how be a respectful human being, but there certainly people who do)

Plus it doesn't hurt any by going to it, maybe you learn some things, maybe you don't.

And if you don't, you waste your time. It's like the lamest lottery in the world.

Hey. I'm cool with your voluntary sensitivity classes or whatever. The bottom line is I didn't know how to deal with Karin refugees until I had term as patients. Same with Samali's and the Sudanese. Same with two different tribes of native Americans. And Bosnians. To name a few off the top of my head. Everything is still nuanced - even if you are told in a class that such and such a group does this. If patient is second generation they may be more "American" than anything and think you are a weirdo if you treat them like grandma.

This isn't the kind of stuff you pick up in a class a few hours watching a video and talking in a group about it.

Of course many of you will think of full of crap until such a time as you go through this yourself and have to grudgingly admit your uncle jdh was right.

 

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And if you don't, you waste your time. It's like the lamest lottery in the world.

Hey. I'm cool with your voluntary sensitivity classes or whatever. The bottom line is I didn't know how to deal with Karin refugees until I had term as patients. Same with Samali's and the Sudanese. Same with two different tribes of native Americans. And Bosnians. To name a few off the top of my head. Everything is still nuanced - even if you are told in a class that such and such a group does this. If patient is second generation they may be more "American" than anything and think you are a weirdo if you treat them like grandma.

This isn't the kind of stuff you pick up in a class a few hours watching a video and talking in a group about it.

Of course many of you will think of full of crap until such a time as you go through this yourself and have to grudgingly admit your uncle jdh was right.

Listen I went to it and I got something out of it, that's the reason I'm recommending it. Take it as you will