Social Justice in Medicine

[TwoHighways]

Here's what's going to happen. You're going to make your views known; some of your classmates will bi*** about you to the Dean of Inclusion, Openmindedness, and Intersectionality; you'll be asked to explain yourself; and you'll end up "moderating" your views in an acute panic to avoid further trouble. Assuming that your school doesn't cave to the screeching *****s who bi***ed about you in the first place and you continue essentially unscathed, you'll end up kicking yourself for having compromised.

Alternatively, you can keep your head down and avoid the drama. You're not in a position to fight the corporatized interests backing the SJW causes. Don't fight the clonglomerate of Doordash, Walmart, Amazon, Verizon, Uber, and 500 other giant companies. Jordan Peterson can afford to do so, because his career is political engagement. Yours is not. Stay quiet and stay safe from the mob.

I’ve already said a bunch of crap that has irked people, but again, I tend to choose my words carefully as to not be misconstrued or taken out of context. I’m not going to cower to anyone, and surely not an administrator in the department of SJW buzzwords that I likely have a deeper understanding of their own flawed belief system than they do. I’m old enough to simply not GAF the way a more traditional student still growing in their sense of identity, beliefs, and values would. So yeah, I’m done intentionally attempting to engage in a political debate with classmates and openly putting my views out there. I see the merit in keeping your head down and simply getting through the grind, but I won’t bite my tongue either when something egregiously false has been stated. We’ll see how it goes.

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[sloh]

Here's what's going to happen. You're going to make your views known; some of your classmates will bi*** about you to the Dean of Inclusion, Openmindedness, and Intersectionality; you'll be asked to explain yourself; and you'll end up "moderating" your views in an acute panic to avoid further trouble. Assuming that your school doesn't cave to the screeching *****s who bi***ed about you in the first place and you continue essentially unscathed, you'll end up kicking yourself for having compromised.

Alternatively, you can keep your head down and avoid the drama. You're not in a position to fight the corporatized interests backing the SJW causes. Don't fight the clonglomerate of Doordash, Walmart, Amazon, Verizon, Uber, and 500 other giant companies. Jordan Peterson can afford to do so, because his career is political engagement. Yours is not. Stay quiet and stay safe from the mob.

I’ve followed JP for a while. This question/dilemma was brought up to him before. He advised to keep your head down until the stakes are lower (wrt getting kicked out of medical school/residency). There are few, if any, professions that lean as hard to the left as medicine. Just look at how many physicians and residents were out protesting in crowds like packed sardines promoting BLM just days after castigating anyone for leaving their homes for anything but “essential” activities. Cognitive dissonance much?

 

[TwoHighways]

I’ve followed JP for a while. This question/dilemma was brought up to him before. He advised to keep your head down until the stakes are lower (wrt getting kicked out of medical school/residency). There are few, if any, professions that lean as hard to the left as medicine. Just look at how many physicians and residents were out protesting in crowds like packed sardines promoting BLM just days after castigating anyone for leaving their homes for anything but “essential” activities. Cognitive dissonance much?

Bruh, didn’t you know that racism is a greater public health crisis than the rona? You know what isn’t a public health crisis tho? Met syn. Move along folks, nothing to see here. Take your statin, metformin, and ace inhibitor and go about your day.

 

[ValeRx]

or feel morally superior to overcompensate for something.

That's called the Art of Virtue Signalling.

 

[Osminog]

I don't believe in the existence of systemic racism in the US, I don't support BLM's political agenda, I don't think people should tear down or vandalize public monuments they happen to not like, I don't think race is a social construct, I don't think there's a straightforward dichotomy between gender and sex, I don't support policies that try to achieve "equality" by favoring one group over another, and I don't want to defund the police.

Those are some of my political beliefs, and as unpopular as they may be in some circles, they reflect my best attempts at understanding society and human nature. These political beliefs, whether you agree with them or not, have nothing—literally nothing—to do with my ability to care for patients. Having certain out-of-fashion political beliefs doesn't necessarily make one heartless or unfeeling or hateful. If I had a patient who was a self-described communist "genderqueer" BLM advocate, I'd strive to offer him/her/them/xir the same high quality of care that I'd offer anybody else. After all, a physician's job is to heal people, not to judge them for their personal beliefs. And I would hope that the more left-leaning physicians and future physicians in this thread would offer me high-quality care if I were ever their patient, despite our political differences.

 

[dr_kateb]

That's called the Art of Virtue Signalling.

Could be, but I think that even the people that virtue signal are self-aware enough to realize they are being disingenuous, while many militant SJWs truly believe they are morally superior. Something that I've noticed in my life is that well-liked, talented, intelligent, good-looking people do not become SJWs. Your high school QB, soccer team captain, head cheerleader, etc are not the people that become SJWs as adults. It's the people who aren't liked, aren't attractive, the people that are the butt of everyone's jokes that have to show the world how righteous they are to make up for their lack of attention and/or validation.

And yes that's how I feel about these "medtwitter" troglodytes.

 

[deleted480308]

I'd argue that the way the Woke among us are hyperfocused on hammering demographics instead of shared humanity is counter-productive. Human beings are tribal by nature. By focusing incessantly, inappropriately, on the things that separate us, we only accentuate our tribal instincts. That's not a good thing.

I am not advocating for glossing over real differences in outcomes that can be mapped across demographic lines, but I am saying if you think "racism" is driving differences in healthcare at a societal level, you are tilting at windmills. You will accomplish nothing for no one.

I genuinely wish there was more productive work being done to advance real social justice, like a universal basic income, universal voter registration, universal day care etc etc. Instead we have the pathological self-promoters trying to convince others of their own self-righteousness in a vacuum. These people are part of the problem and are consuming oxygen better spent discussing meaningful and actionable solutions.

I'm afraid to say that if the centrifugal forces acting on us don't get checked, the genuinely disadvantaged among us will end off worse than where we started.

All of those universal policy ideas you mentioned are bad ideas. No one deserves to demand income just for existing, people should take care of their own children, and if you don’t have the drive to do the very minimal steps to register to vote your opinion should not be taken into account

 

[7331poas]

Nice false equivalence there.

Let's put it this way.

You learn about the effect of diet on metabolism and how it leads to disease.

You learn about how microbes cause disease.

You learn about how people's choices cause disease

You learn about how genes cause disease.

But societal causes of illness, which is a very real thing, is off the table????

No one is saying that you, as a doctor, need to be a social work, that's what social workers are for. But learning that racism actually makes people sick; that implicit biases are real and can affect medical decisions, are still a no-go?

Really?

The difference in all those examples is that learning the pathophysiology of disease directly affects my ability to provide care in the hospital. Learning about climate change does not. And yet every week at my school we have to sit through some social worker driven lecture on those topics.

 

[Matthew9Thirtyfive]

Your story makes less sense now? This guy apparently only got told to take 1 year off to "study racism" and then he can come back. The guy you know was straight up expelled for something less severe?

Yep. Again though, I am not privy to all the details. It is possible that there was more going on, but according to my friend, he didn't know of anything else. Perception is reality, unfortunately. When all of social media thinks your school is letting a vocal racist continue his education, you can either defend him or acquiesce. They chose the latter. I hope he sues.

 

[hamstergang]

While most posts aren't this blatant or ridiculous, many posts in threads like these strike me as having this tone:

Could be, but I think that even the people that virtue signal are self-aware enough to realize they are being disingenuous, while many militant SJWs truly believe they are morally superior. Something that I've noticed in my life is that well-liked, talented, intelligent, good-looking people do not become SJWs. Your high school QB, soccer team captain, head cheerleader, etc are not the people that become SJWs as adults. It's the people who aren't liked, aren't attractive, the people that are the butt of everyone's jokes that have to show the world how righteous they are to make up for their lack of attention and/or validation.

ie feeling superiors to those who care about social justice (where SJWs are obvious too dumb to really understand what they're arguing for).

I think that addressing these issues in med school makes sense not so much for their impact with individual patients, but because some issues are better solved via focus on population health. Med schools aren't trying to make future social workers, but it's not unreasonable for doctors to advocate for measures that will improve the health of their patient population.

 

[Leahjoos]

I don't believe in the existence of systemic racism in the US, I don't support BLM's political agenda, I don't think people should tear down or vandalize public monuments they happen to not like, I don't think race is a social construct, I don't think there's a straightforward dichotomy between gender and sex, I don't support policies that try to achieve "equality" by favoring one group over another, and I don't want to defund the police.

Those are some of my political beliefs, and as unpopular as they may be in some circles, they reflect my best attempts at understanding society and human nature. These political beliefs, whether you agree with them or not, have nothing—literally nothing—to do with my ability to care for patients. Having certain out-of-fashion political beliefs doesn't necessarily make one heartless or unfeeling or hateful. If I had a patient who was a self-described communist "genderqueer" BLM advocate, I'd strive to offer him/her/them/xir the same high quality of care that I'd offer anybody else. After all, a physician's job is to heal people, not to judge them for their personal beliefs. And I would hope that the more left-leaning physicians and future physicians in this thread would offer me high-quality care if I were ever their patient, despite our political differences.

You don’t believe in system that is responsible for murdering black people and treating them unjustly compared to the majority... It requires a level of sympathy & compassion to understand, its basic human rights and any opinion against systematic racism just shows the lack of understanding and privilege. As much as you think opinions don’t play into health care it does.

Your views are everything in this world especially those political ones. If you don’t care about the countless deaths and murder of black people, how are you qualified to passionately save a black life if you don’t care about black lives? It doesn’t make you hateful for having a difference of opinion but it does indirectly make you biased and affects the quality of care... I wouldn’t want to be treated by someone that didn’t understand the issues plaguing me and my community.

 

[TwoHighways]

You don’t believe in system that is responsible for murdering black people and treating them unjustly compared to the majority... It requires a level of sympathy & compassion to understand, its basic human rights and any opinion against systematic racism just shows the lack of understanding and privilege. As much as you think opinions don’t play into health care it does.

Your views are everything in this world especially those political ones. If you don’t care about the countless deaths and murder of black people, how are you qualified to passionately save a black life if you don’t care about black lives? It doesn’t make you hateful for having a difference of opinion but it does indirectly make you biased and affects the quality of care... I wouldn’t want to be treated by someone that didn’t understand the issues plaguing me and my community.

Please tell me about white privilege and what makes America such a horrible, racist society that is murderous exclusively to black people. Please go into detail about how not supporting BLM as a political organization makes me any less capable of providing quality medical care for black patients.

Seriously, I would literally flee the country if I felt this way, and I’m not saying that people have a different point of view than my own should “leave”, but your rhetoric is a bit much, no? What are your solutions to what you perceive to be injustices? More “awareness”? For white people to pay for the sins of the past? To punish the “privileged”? Where do you draw the line of who is and isn’t privileged? One could make the argument that an American living at the poverty level today is better off than the vast majority of the world’s population and enjoys a far better standard of living than the richest person in the world did at the turn of the century.

If you want to have a nuanced discussion about criminal justice reform, let’s have that discussion as adults and stop with the implication that if people don’t buy into the SJW rhetoric hook, line, and sinker, they are incapable of being good physicians or even worse, are closeted racists. We’d likely find some common ground.

For all the talk about inclusion and diversity, it sure doesn’t seem to be extended to the marketplace of ideas and beliefs that run counter to SJW ideology.

 

[Cornfed101]

If he called Trump the devil’s anus and burned an effigy in his front yard, he would probably be called a hero.

I think this happens pretty regularly

 

[VA Hopeful Dr]

C'mon VA, make it challenging for me! These took about four mins to find, for starters. I'd dig up more but the daughter wants a ride to Starbucks.

STRUCTURAL RACISM AND HEALTH INEQUITIES: Old Issues, New Directions1

Racial minorities bear a disproportionate burden of morbidity and mortality. These inequities might be explained by racism, given the fact that racism has restricted the lives of racial minorities and immigrants throughout history. Recent studies have ...

www.ncbi.nlm.nih.gov

Experienced discrimination and racial differences in leukocyte gene expression

Racial disparities in health outcomes between African Americans and European Americans have been well-documented, but not fully understood. Chronic in…

www.sciencedirect.com

Differential Effects of Personal-Level vs Group-Level Racial Discrimination on Health among Black Americans - PubMed

Perceived group-level racial discrimination may serve as one of several health protective factors even when individuals perceive personal-level racial discrimination. The present findings demonstrate the importance of examining both personal- and group-level experiences of racial discrimination...

pubmed.ncbi.nlm.nih.gov

Race, socioeconomic status, and health. The added effects of racism and discrimination - PubMed

Higher disease rates for blacks (or African Americans) compared to whites are pervasive and persistent over time, with the racial gap in mortality widening in recent years for multiple causes of death. Other racial/ethnic minority populations also have elevated disease risk for some health...

pubmed.ncbi.nlm.nih.gov

Biopsychosocial correlates of discrimination in daily life: A review - PubMed

The bulk of the literature on the relationship of discrimination to health has relied on retrospective reports of perceived exposure to discrimination. Much less is known known about the real-time within-person association between discrimination and biopsychosocial processes. Intensive...

pubmed.ncbi.nlm.nih.gov

In order:

1. Social science that shows that social segregation still exists but doesn't address health in any way (also not a medicine journal).

2. Let's let the last sentence of the abstract speak for itself (emphasis is mine): "In sum, differential exposure to racial discrimination may contribute to racial disparities in health outcomes in part by activating threat-related molecular programs that stimulate inflammation and contribute to increased risk of chronic illnesses." Even the authors admit this isn't actually shown to be true just that it COULD be true.

3. Again, let's let the article speak for itself (emphasis again mine): "Results: Perceived personal-level racial discrimination was associated with worse mental health. In contrast, perceived group-level racial discrimination was associated with better mental as well as physical health." So if you THINK someone is being racist against you then you have worse mental health. It doesn't actually have to be racism its only if you think it is. No thanks.

4. This is at least tries. Even when controlling for SES, minorities have worse health outcomes. But here's where it gets tricky. The article seems to indicate that most of the health disparities are due to things like food deserts, lack of access to care, stuff like that. Now racism is often the cause of that, but its those problems that are the cause of health disparities. Its like how Vitamin C deficiency is the cause of scurvy. Being a British sailor in the 1600s lead to vitamin C deficiency which lead to scurvy. So is being a sailor a cause of scurvy? Of course not.

5. This one just shows that discrimination happens and that is leads to poor mental health, but its the same for all types of discrimination. Its not racism specifically that causes the problem, its people being jerks for whatever reason.

 

[deleted480308]

You don’t believe in system that is responsible for murdering black people and treating them unjustly compared to the majority... It requires a level of sympathy & compassion to understand, its basic human rights and any opinion against systematic racism just shows the lack of understanding and privilege. As much as you think opinions don’t play into health care it does.

Your views are everything in this world especially those political ones. If you don’t care about the countless deaths and murder of black people, how are you qualified to passionately save a black life if you don’t care about black lives? It doesn’t make you hateful for having a difference of opinion but it does indirectly make you biased and affects the quality of care... I wouldn’t want to be treated by someone that didn’t understand the issues plaguing me and my community.

I think there is a large difference between being able identify instances of racism and deciding the whole system is racist. And that comes before the discussion of how to address it.

it’s possible a more nuanced approach might get you more of the results you want

 

[Matthew9Thirtyfive]

You don’t believe in system that is responsible for murdering black people and treating them unjustly compared to the majority... It requires a level of sympathy & compassion to understand, its basic human rights and any opinion against systematic racism just shows the lack of understanding and privilege. As much as you think opinions don’t play into health care it does.

Your views are everything in this world especially those political ones. If you don’t care about the countless deaths and murder of black people, how are you qualified to passionately save a black life if you don’t care about black lives? It doesn’t make you hateful for having a difference of opinion but it does indirectly make you biased and affects the quality of care... I wouldn’t want to be treated by someone that didn’t understand the issues plaguing me and my community.

Let’s try to avoid labeling—either through implication or overtly—anyone who disagrees with you as racist and maybe tone down the hyperbole that any one race is being indiscriminately murdered left and right by doctors/cops/lawyers/fry cooks and that anyone who doesn’t agree with that is a racist or part of the problem. You might get a better response, because I think most people believe racism is bad and is present in some form in this country still. We can talk about racism in certain institutions and the reasons it’s still here, what to do about it, etc. But blasting anyone who doesn’t subscribe to your exact beliefs or who doesn’t support your favorite political group will get you nowhere.

 

[deleted859689]

SPF here we come!

 

[TwoHighways]

Where all important discussions worth having are sent to die.

 

[Goro]

SPF here we come!

Even after three pages, the discipline being displayed here is amazing! I'm proud of all of you for not letting this thread become a dumpster fire.

 

[blockrudder1]

Without analogy, this thread has lost direction

 

[Neopolymath]

Changes in medical school curriculum that are not related to actual medicine are mostly done as a bandaid for an imperfect and perhaps impossible to improve admissions process. Some goals of admission are unattainable by Woke standards and thus the normal, professional, functioning members of the student body will always be exposed to this nonsense. The curriculum is always playing catch up to impossible goals.

I'm not going to be baited into talking about race on here (and not being allowed to defend my point by the new interpretation of the TOS) by some screeching, frenzied posters so I'll mention a very similar example of why I think the above.

Take all these doctor-bashing interprofessional sessions everyone has to sit through. The people who know how to work correctly in teams are tortured by this junk and the people who actually need it aren't paying attention at all. Making this stuff mandatory solely punishes the good people. Do we need these sessions if admissions specifically selects and seeks out people who clearly show competency in this area before school? The answer is no. So perhaps admissions should actively recruit people that display these characteristics of it's supposedly so important. I proved my competency and then I was punished (thank you covid for cancelling these things.)

Here's where we bring it back to Woke topics. Admissions committees either know it's BS marketing propaganda to quiet down the loud outlier students and therefore realize the competency is just "be a good, normal, not racist person as evidenced by not doing bad things" or they really think everyone should sit through these workshops because we are all terrible people.

Ok, here's the end game issue at play: even if admissions somehow only admitted people with applications illustrating the person went out of their way to do Woke-approved things before med school, thus showing competency, everyone would still be subject to a 2 hour meeting each week about this stuff. Why would there need to be a constant time sink about something that everyone is competent in? Not everyone who believes in these topics wants to discuss them ad nauseum because they could do something with that time like see family, workout or study. It's because most people miss the entire point of these SJW tirades/ mandatory sessions. They are mostly about hearing themselves talk about something they are passionate about and that positive feedback dopamine reward from being in an echo chamber. A captive audience, even of people who agree with you in my made up certified woke class, provides a chance for people to rally around each other and get pumped up.

We need to stop adding qualifying statements to "be a good person" in medical school. We definitely need to stop taking students' time away from their families to talk about things that many of them agree with already. And if it's so important, admin needs to put their money where their mouth is and do a better job admitting people in the first place so we don't waste time during the year dealing with this BS over and over.

 

[Matthew9Thirtyfive]

SPF here we come!

Nah, it’s going well so far.

I’m watching it, but if it really starts to go insane and I just happen to be busy, someone tag me so I can address it.

 

[dr_kateb]

While most posts aren't this blatant or ridiculous, many posts in threads like these strike me as having this tone:


ie feeling superiors to those who care about social justice (where SJWs are obvious too dumb to really understand what they're arguing for).

I think that addressing these issues in med school makes sense not so much for their impact with individual patients, but because some issues are better solved via focus on population health. Med schools aren't trying to make future social workers, but it's not unreasonable for doctors to advocate for measures that will improve the health of their patient population.

I’ve never seen a group of people so desperate to be commended for doing their jobs and need to show that they are better than other doctors who supposedly don’t treat the patient holistically. Just because they are active on social media doesn’t really mean anything. I recently read an article on Eugene Hu? Gu? Where apparently he’s awkward and creepy in real life, and just spends his day trying to think of viral Tweets.

edit: speak of the devil.... this was tweeted an hour ago lol and also somewhat proving my point of medtwitter’s aura of moral superiority

 

[Weirdy]

Ask about the man's situation. Understand that he lives in his car and tell him that it will likely get worse unless he can find somewhere to stay until it gets better. Think of a creative way to help keep it elevated, warm, and dry in his car if possible.

xx yo male patient with Hx significant for uncontrolled DMII presents to ED with b/l wounds on distal hallux. States has been there for 6 weeks until he experienced fevers, chills, nausea and went to ED. Has no pain in the toes but notices drainage. Leaves it exposed. "Friend" gave him some abx of which he does not know the name and does not recall how much he took. Has not seen his PCP in years. Does not check his blood glucose, does not recall last A1c.

Pertinent physical shows streaking erythema, probe to bone. Xrays show osteolytic changes consistent with osteomyelitis, elevated WBC etc.

Patient lives at home with his wife. After questions thoroughly explained and treatment options discussed including IV abx managed/consulted by ID and partial/total toe amputation- he wants a 2nd opinion.

Rounded on him again, patient firmly opts for Abx and is aware of possible amputation, adamant against it.

Pathology like the above ends up in amputation, even after we try conservative treatment, advise them to regularly check up with their PCP, advise them to do visual foot checks due to loss of protective sensation, advise them to keep their blood glucose under control with their PCP and adhere to their meds, advise them to wear diabetic socks and check for weeping or blood, advise them to wear supportive shoes and not walk barefoot.

But it just ends up in amputation and that's all our fault right? We didn't do enough right?

Do you understand why your comment might come off as a bit abrasive?

 

[Steve_Zissou]

I don't believe in the existence of systemic racism in the US, I don't support BLM's political agenda, I don't think people should tear down or vandalize public monuments they happen to not like, I don't think race is a social construct, I don't think there's a straightforward dichotomy between gender and sex, I don't support policies that try to achieve "equality" by favoring one group over another, and I don't want to defund the police.

Those are some of my political beliefs, and as unpopular as they may be in some circles, they reflect my best attempts at understanding society and human nature. These political beliefs, whether you agree with them or not, have nothing—literally nothing—to do with my ability to care for patients. Having certain out-of-fashion political beliefs doesn't necessarily make one heartless or unfeeling or hateful. If I had a patient who was a self-described communist "genderqueer" BLM advocate, I'd strive to offer him/her/them/xir the same high quality of care that I'd offer anybody else. After all, a physician's job is to heal people, not to judge them for their personal beliefs. And I would hope that the more left-leaning physicians and future physicians in this thread would offer me high-quality care if I were ever their patient, despite our political differences.

If you don’t think race is a social construct, do you believe it to be a biological one?

 

[radsisrad]

I’ve never seen a group of people so desperate to be commended for doing their jobs and need to show that they are better than other doctors who supposedly don’t treat the patient holistically. Just because they are active on social media doesn’t really mean anything. I recently read an article on Eugene Hu? Gu? Where apparently he’s awkward and creepy in real life, and just spends his day trying to think of viral Tweets.

edit: speak of the devil.... this was tweeted an hour ago lol and also somewhat proving my point of medtwitter’s aura of moral superiority

He's a liar. Different groups have different propensities toward things like HTN, HLD, DM, etc. His following consists almost entirely of people who "f***ing love science" but don't actually know any.

 

[Osminog]

You don’t believe in system that is responsible for murdering black people and treating them unjustly compared to the majority... It requires a level of sympathy & compassion to understand, its basic human rights and any opinion against systematic racism just shows the lack of understanding and privilege. As much as you think opinions don’t play into health care it does.

Your views are everything in this world especially those political ones. If you don’t care about the countless deaths and murder of black people, how are you qualified to passionately save a black life if you don’t care about black lives? It doesn’t make you hateful for having a difference of opinion but it does indirectly make you biased and affects the quality of care... I wouldn’t want to be treated by someone that didn’t understand the issues plaguing me and my community.

It’s not that I “don’t care.” If I thought that there actually were countless hatred-inspired murders of black people by white people, I would be extremely concerned about it. But based on my best efforts to sift through the objective evidence (e.g., federal crime data) and figure out the truth, I’ve come to the conclusion that that’s not what’s going on. I am concerned about the factors that I believe really do disproportionately affect black lives, such as obesity, heart disease, diabetes, certain types of cancer, and gang violence.

My understanding of our country’s social issues is different from yours, but that doesn’t mean that I harbor a bias against or disdain for black patients, or that I would care less about their satisfaction and outcomes.

 

[Osminog]

If you don’t think race is a social construct, do you believe it to be a biological one?

I think that race is a set of morphological traits relating to human ancestry, and that there are genetic influences that partly account for differences in various predispositions and outcomes among racial groups.

This discussion is beyond the scope of the thread, though. My point is that the above opinion, which seems to be becoming more and more unpopular in contemporary America, has no bearing on my ability to effectively and compassionately care for individual patients of all backgrounds.

 

[NicMouse64]

The problem isn't that we are learning SES or socioeconomic determinants of health in our classes. It's just how it is delivered. Basically, here's the problem, everyone observes the problem, talks about it, etc. The problem I have is, what is our role as physicians? Not what is our role as "providers" or NP/PA/social worker/etc. What specifically within our education and role makes us think that we are in a special role to help solve the problem? In my opinion, there is nothing special about our education, barring the perceived prestige and social standing that being a doctor provides towards solving the problems of socioeconomic determinants of health (although that is eroding more and more as time goes on). Maybe all the things that you see on a daily basis with sick people, but much of that is barred from communication with the public by HIPAA. Certainly, there are things we can do to improve in our roles: look out for your own biases, consider pricing of drugs, consider cost of procedures, consider environmental factors.

Solving housing inequities, police violence, schooling inequities, college admissions biases, etc.? Out of the scope of our profession. And that's where it all gets so twisted with the "woke" crowd. There's a way of delivering a useful clinical curriculum that focuses on our role in the issues. The problem is it's become more of a political class where it's basically engrained in you that these things happen and you have a role. But fails to discuss the next step (what is the role). That's where the curriculum needs some big overhaul. Discussion of actual roles and less nonsense about "being a good citizen" or "calling out the biases of yourself and others" or "treating the patient holistically (puke)".

 

[Steve_Zissou]

I think that race is a set of morphological traits relating to human ancestry, and that there are genetic influences that partly account for differences in various predispositions and outcomes among racial groups.

This discussion is beyond the scope of the thread, though. My point is that the above opinion, which seems to be becoming more and more unpopular in contemporary America, has no bearing on my ability to effectively and compassionately care for individual patients of all backgrounds.

I think it’s well within this scope. Viewing different “races” as biologically separate categories rather than a tool used for categorizing based on, usually, a single trait (skin color) can lead to severely biased treatment of others. I remember a conversation we had a while back in the SPF about a couple of black young men who were hanging out at a starbucks and were kicked out for “looking suspicious” where you and I were on opposite side. Practically the whole argument was hinged on how they looked physically, which I still maintain was normal style.

I say this to point out that I, who believes race to be a social construct, will get grouped in with people like Osminog, who believe it to be a biological one, simply because we’re both against SJW stuff in school. If I point out that I disagree with the SJW stuff in public, I get grouped in with guys who believe different races have different levels of intelligence, hard work capability, etc. I am not that.

If I were to follow up to my question regarding it being a biological construct, then I have to ask, what are the races you believe to exist and what ties them together?

 

[readmypostsMD]

If you don’t think race is a social construct, do you believe it to be a biological one?

Of course it’s biological. If it weren’t biological, why would the groups be different colors? Because people systemically painted each other different colors? DNA man... it’s a thing

 

[readmypostsMD]

I’ve never seen a group of people so desperate to be commended for doing their jobs and need to show that they are better than other doctors who supposedly don’t treat the patient holistically. Just because they are active on social media doesn’t really mean anything. I recently read an article on Eugene Hu? Gu? Where apparently he’s awkward and creepy in real life, and just spends his day trying to think of viral Tweets.

edit: speak of the devil.... this was tweeted an hour ago lol and also somewhat proving my point of medtwitter’s aura of moral superiority

bruh Eugene Gu is ****ed. He got dismissed from his residency program and now spends all his time on Twitter, it’s actually pretty sad, he’s probably got a boat load of accumulating debt

 

[Steve_Zissou]

Of course it’s biological. If it weren’t biological, why would the groups be different colors? Because people systemically painted each other different colors? DNA man... it’s a thing

Sure enough, melanin content is determined by your genetics. Which was part my point that it really only works well for identifying one trait, skin color. Outside of that, it doesn’t work well to group people together by skin color. Take me, I’m technically Caucasian but my skin is brown and I’m from Mexico. A man from the Middle East could be technically Caucasian but have Brown skin. What does our skin color or us both being Caucasian tell you?

 

[dr_kateb]

Sure, which was my point that it really only works well for identifying one trait, skin color.

It's not just skin color though. Hair thickness and growth rate, eyelid shape, bone shape and density, etc. Not as salient as skin color for obvious reasons but they do exist.

 

[Steve_Zissou]

It's not just skin color though. Hair thickness and growth rate, eyelid shape, bone shape and density, etc. Not as salient as skin color for obvious reasons but they do exist.

See my edit.

I’m sure all white people have similar hair thickness/growth rate, eyelid shape, bone shape, density, etc.

 

[Osminog]

Sure, which was my point that it really only works well for identifying one trait, skin color.

Nobody actually thinks that race is solely based on skin color. There are differences in nose and lip shape, hair texture, skull shape, natural muscle tone, and even smell (due to average differences in number and size of apocrine sweat glands). Most people would be easily able to correctly distinguish between a dark-skinned Indian and an equally dark-skinned black person. Race is a categorization tool that reflects a set of physical features (not just skin color) that strongly correspond to human ancestry. And again, believing that this is the case has almost nothing to do with individual patient care.

 

[Goro]

I’ve never seen a group of people so desperate to be commended for doing their jobs and need to show that they are better than other doctors who supposedly don’t treat the patient holistically. Just because they are active on social media doesn’t really mean anything. I recently read an article on Eugene Gu? Where apparently he’s awkward and creepy in real life, and just spends his day trying to think of viral Tweets.

edit: speak of the devil.... this was tweeted an hour ago lol and also somewhat proving my point of medtwitter’s aura of moral superiority

He has a gift for hyperbole, that's for sure.

 

[Steve_Zissou]

Nobody actually thinks that race is solely based on skin color. There are differences in nose and lip shape, hair texture, skull shape, natural muscle tone, and even smell (due to average differences in number and size of apocrine sweat glands). Most people would be easily able to correctly distinguish between a dark-skinned Indian and an equally dark-skinned black person. Race is a categorization tool that reflects a set of physical features (not just skin color) that strongly correspond to human ancestry. And again, believing that this is the case has almost nothing to do with individual patient care.

So what physical traits do a Japanese person and an Indian person share? What about Congolese and Ethiopian? What about Mexican and Iranian?

It is a social construct used for categorization trying to tie together a whole bunch of localized characteristics into on overarching category of skin color. It’s flawed, weak, and a social construct.

 

[Mass Effect]

It does seem that MedEd is jumping on the SJ pendulum currently swinging into insanity

Nah, what's insane is that all the stuff we're finally noticing has been going on for decades and no one ever did anything about it.

 

[Matthew9Thirtyfive]

So what physical traits do a Japanese person and an Indian person share? What about Congolese and Ethiopian? What about Mexican and Iranian?

It is a social construct used for categorization trying to tie together a whole bunch of localized characteristics into on overarching category of skin color. It’s flawed, weak, and a social construct.

So wait, do you not think that certain races have higher incidences of certain diseases?

 

[Mass Effect]

The problem isn’t teaching you that some people have different social situations (you have to teach patients to navigate their healtj so you need to be aware). The problem is the eventual inclusion in meded that “as a doctor you now are morally obligated to want govt to do x about this”, and that’s inappropriate.

but those who feel that way are vindictive to those who don’t so watch how you admit that in real life

I may agree that things sometimes go too far, but yeah, as a doctor I have to accept that part of medicine IS political. I'm glad the Surgeon General has a warning label on cigarettes. I'm glad the government can't continue to lie about it not being a danger to one's health. I'm glad certain vaccines are required in school. I'm glad sex ed includes how to wear a condom.

Why are people acting like this is all brand new, unprecedented? Politics has always played a role.

 

[deleted480308]

I may agree that things sometimes go too far, but yeah, as a doctor I have to accept that part of medicine IS political. I'm glad the Surgeon General has a warning label on cigarettes. I'm glad the government can't continue to lie about it not being a danger to one's health. I'm glad certain vaccines are required in school. I'm glad sex ed includes how to wear a condom.

Why are people acting like this is all brand new, unprecedented? Politics has always played a role.

that’s not a justification to continue or increase

 

[Mass Effect]

You can make it mandatory without having it be indoctrination. We have it incorporated into our clinical reasoning sessions sometimes. When they aren’t adherent to their meds, find out why because it might be that the drug you prescribed them is more than they can afford, and it’s either take that or eat. Stuff like that.

I mean, that's true, you should ask why a patient is non-compliant. That is important and relevant to your care. What to do about it isn't necessarily your problem, but there are ways you can help. They can't afford it? Find a generic, cheaper alternative. They can't get to the pharmacy, send it through delivery services. Other issues? Get social work/case management involved. But knowing the reason is important.

 

[Matthew9Thirtyfive]

I may agree that things sometimes go too far, but yeah, as a doctor I have to accept that part of medicine IS political. I'm glad the Surgeon General has a warning label on cigarettes. I'm glad the government can't continue to lie about it not being a danger to one's health. I'm glad certain vaccines are required in school. I'm glad sex ed includes how to wear a condom.

Why are people acting like this is all brand new, unprecedented? Politics has always played a role.

I think he was saying that it’s inappropriate to teach students that one particular viewpoint is correct and the rest are incorrect morally, etc. There are different ways to address things, and when you teach a class basically implying that one particular ideology is correct, you’re indoctrinating people. That’s not appropriate for med school.

 

[Matthew9Thirtyfive]

I mean, that's true, you should ask why a patient is non-compliant. That is important and relevant to your care. What to do about it isn't necessarily your problem, but there are ways you can help. They can't afford it? Find a generic, cheaper alternative. They can't get to the pharmacy, send it through delivery services. Other issues? Get social work/case management involved. But knowing the reason is important.

That was my point.

 

[Mass Effect]

I think he was saying that it’s inappropriate to teach students that one particular viewpoint is correct and the rest are incorrect morally, etc. There are different ways to address things, and when you teach a class basically implying that one particular ideology is correct, you’re indoctrinating people. That’s not appropriate for med school.

I agree with that, but I disagree that these TOPICS have no place in medical education. They certainly do as they do affect care and outcomes.

 

[VA Hopeful Dr]

So wait, do you not think that certain races have higher incidences of certain diseases?

Race is an imperfect way of determining who has certain genetic predispositions. Its not ideal and often inaccurate, but we have nothing better to determine, say, if someone would likely respond better to CCBs than ARBs.

 

[Mass Effect]

that’s not a justification to continue or increase

Of course it is. Acknowledging the harm of cigarettes DOES deter people from smoking. Teaching sex ed classes with instruction on condom/birth control use DOES reduce number of teen pregnancies. How can that not be justification to continue along that path?

 

[deleted480308]

Of course it is. Putting the warning label on cigarettes DOES deter people from smoking. Teaching sex ed classes with instruction on condom/birth control use DOES reduce number of teen pregnancies. How can that not be justification to continue along that path?

So would killing anyone caught smoking, not all govt intervention is appropriate just because it achieves a desired goal

 

[radsisrad]

Nobody actually thinks that race is solely based on skin color. There are differences in nose and lip shape, hair texture, skull shape, natural muscle tone, and even smell (due to average differences in number and size of apocrine sweat glands). Most people would be easily able to correctly distinguish between a dark-skinned Indian and an equally dark-skinned black person. Race is a categorization tool that reflects a set of physical features (not just skin color) that strongly correspond to human ancestry. And again, believing that this is the case has almost nothing to do with individual patient care.

I once brought up sickle cell anemia during rounds as part of the ddx for a white patient with anemia. When the attending gently reminded me that whites don't get SCA, I retorted that race is a social construct.

Everybody clapped.