Rationale and Methods for Diversity Efforts in Medicine

[afan]

The interesting "Kids, education and generational wealth" thread got hijacked into another interesting discussion of whether medical schools, and by extension organized medicine more broadly, should do anything to address the large differences between the racial and ethnic makeup of the country and that of the profession.

This got into several questions
1. Should medical schools attempt to do anything about it at all?
2. Should medical schools admit students SOLELY on the basis of MCAT and GPA?
3. Do patients who are members of minority groups get systematically worse care?
4. Does having such patients treated as least in part by physicians who are themselves members of minority groups help improve the care given?
5. Do GPA and MCAT scores predict how well people will perform as physicians?
6. Are there other legitimate considerations, aside from diversity, for medical schools using factors other than grades and test scores in admissions?

Some of it was philosophy and some of it was data driven.
However, participants in that thread correctly pointed out that the discussions were off topic for "kids, education and generational wealth".

So I am starting this thread to continue the discussion.
For those of you just joining, you could read the KEGW thread first to catch up.
ENT and Doc Turf Doc were engaged. I hope they will join this new thread.

[afan]

Link to the other thread for background
https://forum.whitecoatinvestor.com/...-wealth/page12

[afan]

Taking a clue from ENT Doc's handle, I found this article of interest

"Increasing the Number of Black Otolaryngologists RSS Download PDF
Erin K. O’Brien MD, Dontre’ M. Douse MD, Semirra L. Bayan MD, Janalee K. Stokken MD and Kathryn M. Van Abel MD
Otolaryngologic Clinics of North America, The, 2021-04-01, Volume 54, Issue 2, Pages 457-470"

Apparently blacks represent 5% of all physicians but 0.8% of otolaryngologists.

[G]

Steph Curry is 6'2" but still 96th percentile for height.

I wanted to point that out in the other thread, but it was still off topic.

No, height ain't the only thing that matters when playing basketball. Just as performing well on a standardized test or doing well in multiple years of college ain't the only thing that matters in being a doctor. But in both cases, they represent a good starting point to weed out the over abundance of applicants.

And FWIW this still isn't a financial conversation. The mods are either slacking or enjoying the melee.

[afan]

Yep. 6'2".

Which was too short for a major program to offer him a scholarship. Still a pretty good basketball player. Which was exactly the point.

True, not a financial topic, but this is:

"The Lounge
Non-financial topics."

We should be safe.

[G]

Clearly we are talking past each other. You say too short, I say 2.5 standard deviations above the mean.

That's all, checking out now

[afan]

Too short in the opinion of the coaches who declined to offer him scholarships. And told him that was the reason.

[Lordosis]

1. no. I think med schools should take the best applicants and race, gender and sexual orientation should not play a role
people who grew up rural are underrepresented as well. I would like to see that evened out prior to anything else. Might actually help get more rural physicians.

2. No. Nobody goes solely on scores. There has to be a cutoff to get the pool down to a reasonable number and it can play a factor after that but lots of other things go into the decision. Awards, honors, experience, volunteering, research, teaching, extracurricular clubs and sports, leadership roles, past careers, etc.

3. Not from me but I am sure it happens. Forcing more minorities into medicine is not the answer.

4. I don't think so. I think they're sucky doctors in all races.

5. Scores predict how well you will do on test. It also correlates with how smart you are. This is where the basketball analogy holds up. Tall people generally are better at basketball and if you know nothing else pick the tall people. Somebody with a crappy score on the MCAT or a poor GPA is not going to make a good doctor. Somebody with a good GPA and then get score may or may not make a good doctor.

6. I mentioned several other factors above.
I don't think location gets enough credit. Not only rural versus Urban but certain states are in more need than others. If you want more doctors to work in Mississippi get more med students that grew up in mississippi. I'm at school class in upstate New York was about 20% california. State School by the way. And I don't know any of them that stayed in New York state afterwards.

However I'm not really for picking a student based on their location. It just seems to me a better idea then racial or ethnic diversity. I still think the best applicant should get the job.

[AR]

I have definitely seen people allude to studies and existing data on #3, #4, and #5. If someone has some links handy, I'd be very interested in seeing what data currently exists with regard to these issues.

[AR]

Not from me but I am sure it happens.

That's literally what everyone who is truly responsible for it happening would say. And I don't mean that they're lying. Most of them would truly believe it as I'm sure you do. Unfortunately the biases at play are too deep seated for anyone to be able to self-diagnose on this issue.

[Lordosis]

That's literally what everyone who is truly responsible for it happening would say. And I don't mean that they're lying. Most of them would truly believe it as I'm sure you do. Unfortunately the biases at play are too deep seated for anyone to be able to self-diagnose on this issue.

I beg to differ. I strive to treat everyone the same. White or not. Man or woman. Gay or straight. Rich or poor. I don't see how any deep bias really can effect my treatment. If so by what method? Do I not treat their diabetes as aggressively? Do I not push as hard for vaccination? If so you are right that I do not recognize it.

I do believe that there are people out there who are inherently racist and actually treat people differently but I feel it is less than you would think. Most of the barriers to care are long before they walk in my door and are well out of my control.

I do have a mal practice attorney on my panel. I might spend a few extra minutes on his chart making sure my Ts are crossed. But everyone else gets the same care!

[AR]

I beg to differ. I strive to treat everyone the same. White or not. Man or woman. Gay or straight. Rich or poor. I don't see how any deep bias really can effect my treatment. If so by what method? Do I not treat their diabetes as aggressively? Do I not push as hard for vaccination? If so you are right that I do not recognize it.

I do believe that there are people out there who are inherently racist and actually treat people differently but I feel it is less than you would think. Most of the barriers to care are long before they walk in my door and are well out of my control.

I do have a mal practice attorney on my panel. I might spend a few extra minutes on his chart making sure my Ts are crossed. But everyone else gets the same care!

Ok, so what you're telling me is that there are are plenty of docs out there who say, "Yes. I do provide minorities with poorer care."

[pitt1166]

I beg to differ. I strive to treat everyone the same. White or not. Man or woman. Gay or straight. Rich or poor. I don't see how any deep bias really can effect my treatment. If so by what method? Do I not treat their diabetes as aggressively? Do I not push as hard for vaccination? If so you are right that I do not recognize it.

I do believe that there are people out there who are inherently racist and actually treat people differently but I feel it is less than you would think. Most of the barriers to care are long before they walk in my door and are well out of my control.

I do have a mal practice attorney on my panel. I might spend a few extra minutes on his chart making sure my Ts are crossed. But everyone else gets the same care!

jeez man, you need to read up on unconscious biases if you really think that.

[VentAlarm]

jeez man, you need to read up on unconscious biases if you really think that.

Most of the stuff I’ve seen on unconscious bias is trash that should get rejected from a decent journal. I’m going to stop here because I’m not trying to get cancelled.

[Turf Doc]

Was gonna post this in the other thread

See above

Yes, I mean what race would you rather be born into if youre singular goal was to be a physician. I'm glad you agree with me. the z axis argument doesnt make sense to me because its not like everyone has the exact same experience and resources and then checks a different box when they apply. Like you say there are many other things that are more or less correlated with race. And many of those things make it more difficult to get to the place where you even apply, much less be competitive.

You talk about competence as it relates to GPA and MCAT, so your argument is basically that the difference in median matriculant MCATS and GPAs between matriculants of different races actually mattes in producing competent physicians, right? The higher the MCAT and GPA the more qualified the person and better the doctor theyll be?

Are harvard grads better than others? Are MDs better doctors than DOs?

Average matriculant MCAT for Black/AAs is 506 and for hispanics 507, average for asians is 515 and whites 513. AAMC says 500 suggests competence. I think its a giant completely unsubstantiated claim that the difference matters.

Btw, speaking as someone whose #1 skill in this rat race is taking standardized tests. But i can still acknowledge its not going to make me a better doctor.