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  • #16
    Originally posted by VentAlarm View Post

    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.
    I think you need to see and read better stuff.

    Comment


    • #17
      Originally posted by AR View Post

      I think you need to see and read better stuff.
      Strong argument.

      Comment


      • #18
        Originally posted by VentAlarm View Post

        Strong argument.
        Well, acceptance is the first step. Now you just need to actually do it!

        Comment


        • #19
          Originally posted by AR View Post

          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."
          Maybe a few might admit it in the right circumstances but most probably keep that knowledge to themselves.

          Comment


          • #20
            I have a series of lectures from Dr. Martin Luther King Jr. I purchased in the 1990s. Two different series. They are amazing. Sermons and lectures.

            I think people should go back and listen to what that man had to say.

            Here is a quote from one of his most famous:

            “Let us not wallow in the valley of despair, I say to you today, my friends.
            And so even though we face the difficulties of today and tomorrow, I still have a dream. It is a dream deeply rooted in the American dream.
            I have a dream that one day this nation will rise up and live out the true meaning of its creed: "We hold these truths to be self-evident, that all men are created equal."
            I have a dream that one day on the red hills of Georgia, the sons of former slaves and the sons of former slave owners will be able to sit down together at the table of brotherhood.
            I have a dream that one day even the state of Mississippi, a state sweltering with the heat of injustice, sweltering with the heat of oppression, will be transformed into an oasis of freedom and justice.
            I have a dream that my four little children will one day live in a nation where they will not be judged by the color of their skin but by the content of their character.
            I have a dream today!”

            Look at the highlighted = bolded components. In my mind what he wished for was this: Equal opportunity. Judged by the content of character, not by color of skin.

            Judged based on merit not based on other qualities that are uncontrollable.

            Do you really think that an elite upper class member (of any race / sex / sexual orientation) who was born to a two parent household is at a disadvantage compared to a poor individual born to a single mom hooked on meth in a small rural community (regardless of race / sex / etc. ).

            I am personally in an interracial marriage.

            I would like to think the children born in interracial marriages when asked: "what race are you?" should be able to answer: "It does not matter" , because it really shouldn't. Can they celebrate their heritage? Sure, but they don't need to be labeled.

            Does racism exist? Absolutely.

            Should we fight racism by discrimination against certain races? Would that help?

            OR would it be better just to listen to Dr King and judge everyone based on merit and try to help everyone who grows up in a poor disadvantaged (ex. single parent on meth) household.

            One race = human race. Treat everyone as equal as you possibly can. Do your best. Judge by "content of character". Merit based admission.

            Merit based admission is not racist. It is the opposite.
            Attached Files
            Last edited by Tangler; 12-24-2021, 06:49 AM.

            Comment


            • #21
              I think one thing we have to remember is that while we may all strive to provide all of our patients with good care, the patient's perspective matters. Particularly if the patient isn't from an upper middle class background and has had limited exposure to the world outside their own "place," trust issues may come into play. They may find it easier to be honest and candid when they see a doctor who is more like themselves.

              I had an interesting experience on a cardiology rotation as a medical school. A patient was admitted to the service with severe CHF (his EF was so low he was probably going to be on the transplant list in the not-too-distant future). He was a middle-aged white man from a rural part of Pennsylvania, and he was a sexist and a racist - and by that I mean a full-blown KKK-style racist (not just someone who inadvertently made an insensitive comment or two). And that posed a big problem, because cardiology attending was a black man, the chief resident was a Jewish man (who ware a yarmulke and had an obviously Jewish last name), the intern and I were white women, and the other medical student with me was a Puerto Rican woman.

              Needless to say, none of us liked this patient, though we treated him professionally. But our attending made it a point to remind us of the patient's point of view, telling us "Can you imagine how terrifying it must be to place your life in the hands of a team you absolutely do not trust?" And of course he was right.

              That's an extreme example, but I can see how a patient who comes from a very different background than my own might not be comfortable dealing with an upper-middle class white woman from Midwestern suburbia. Ideally that would not be the case and everyone would be comfortable working with a doctor from any background, but reality isn't an ideal place. That's one reason I'd like to see more diversity in medicine (including more students from rural areas and inner city areas, not just from different ethnic groups).

              Comment


              • #22
                Originally posted by AR View Post

                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 agree. This is discussed in the book Blind Spot

                https://smile.amazon.com/gp/product/...?ie=UTF8&psc=1

                Click image for larger version

Name:	Blind Spot.jpg
Views:	410
Size:	25.6 KB
ID:	309767

                There are links in the book to Implicit Association Tests, which try to uncover hidden associations in automatic responses. While the Implicit Association Test is far from perfect, I found it interesting to do the 2 tests below. The first link looks at flowers vs insects and pleasant vs unpleasant and this serves as a good way to see how the test works without inducing any self doubt or stress (if there are any entomologists in the group then this could get confusing). This 2nd link is race and pleasant vs unpleasant. Each one takes less than 5 minutes and much of that time is just getting used to how to do the test.

                https://implicit.harvard.edu/implici...owerinsect.htm

                https://implicit.harvard.edu/implici...exracekids.htm

                Comment


                • #23
                  For sure, implicit bias exists. Also no doubt that our brains are poor at deciphering it (if I may bring this back, tangentially, to a financial perspective and mention the work of behavioral economists such as Kahneman). But I always find it an interesting--and amusing--state of affairs when it is brought up in the same discussion of explicit bias.

                  Again, not saying that grades/scores are needed to be a good doctor. But how do we determine if someone "deserves" that spot in medical school. And if it isn't numbers, then what's next? Shall we ignore someone's qualitative achievements as well, marking that off as a byproduct of systemic racism?

                  Deep issues, no doubt.

                  Comment


                  • #24
                    Originally posted by AR View Post

                    Well, acceptance is the first step. Now you just need to actually do it!
                    Everything I’ve read on implicit association makes it look like the ESR of behavioral science. Do you have any high quality suggesting it is reliable? I am asking in all seriousness. Everything I’ve read makes it look like trash that would have been published in medical journals in the 80s but would have been triaged for the past 20 years. I am a scientist who reviews grants and have noticed a significant bias towards funding and publishing these sort of fluff studies. When someone wants to do a study on race or gender (without an underlying reasonable hypothesis supported by secondary analysis of something else), everyone seems to collectively decide to ignore the fact that the proposals lack appropriate methods, or a power calculations, or statistical support, or some other critical component.

                    Comment


                    • #25
                      Originally posted by Tangler View Post
                      I have a series of lectures from Dr. Martin Luther King Jr. I purchased in the 1990s. Two different series. They are amazing. Sermons and lectures.

                      I think people should go back and listen to what that man had to say.

                      Here is a quote from one of his most famous:

                      “Let us not wallow in the valley of despair, I say to you today, my friends.
                      And so even though we face the difficulties of today and tomorrow, I still have a dream. It is a dream deeply rooted in the American dream.
                      I have a dream that one day this nation will rise up and live out the true meaning of its creed: "We hold these truths to be self-evident, that all men are created equal."
                      I have a dream that one day on the red hills of Georgia, the sons of former slaves and the sons of former slave owners will be able to sit down together at the table of brotherhood.
                      I have a dream that one day even the state of Mississippi, a state sweltering with the heat of injustice, sweltering with the heat of oppression, will be transformed into an oasis of freedom and justice.
                      I have a dream that my four little children will one day live in a nation where they will not be judged by the color of their skin but by the content of their character.
                      I have a dream today!”

                      Look at the highlighted = bolded components. In my mind what he wished for was this: Equal opportunity. Judged by the content of character, not by color of skin.

                      Judged based on merit not based on other qualities that are uncontrollable.

                      Do you really think that an elite upper class member (of any race / sex / sexual orientation) who was born to a two parent household is at a disadvantage compared to a poor individual born to a single mom hooked on meth in a small rural community (regardless of race / sex / etc. ).

                      I am personally in an interracial marriage.

                      I would like to think the children born in interracial marriages when asked: "what race are you?" should be able to answer: "It does not matter" , because it really shouldn't. Can they celebrate their heritage? Sure, but they don't need to be labeled.

                      Does racism exist? Absolutely.

                      Should we fight racism by discrimination against certain races? Would that help?

                      OR would it be better just to listen to Dr King and judge everyone based on merit and try to help everyone who grows up in a poor disadvantaged (ex. single parent on meth) household.

                      One race = human race. Treat everyone as equal as you possibly can. Do your best. Judge by "content of character". Merit based admission.

                      Merit based admission is not racist. It is the opposite.
                      too many people are only familiar with that one speech from MLK. there is much more to him than that. don't cherry pick one speech.

                      suggesting that MLK was against what we call affirmative action is not accurate.

                      king encouraged the use of racial quotas in hiring practices.

                      in his book "why we can't wait" king said...

                      "Whenever the issue of compensatory treatment for the Negro is raised, some of our friends recoil in horror. The Negro should be granted equality, they agree; but he should ask nothing more. On the surface, this appears reasonable, but it is not realistic."

                      King also said ""A society that has done something special against the Negro for hundreds of years must now do something special for the Negro."

                      there are multiple other instances of MLK supporting what would be considered affirmative action and racial quotoas for hiring practices. i could include more but it would be redundant.

                      if you have truly read up on MLK, his view on these issues we are discussing is pretty clear.

                      Comment


                      • #26
                        Originally posted by pitt1166 View Post

                        too many people are only familiar with that one speech from MLK. there is much more to him than that. don't cherry pick one speech.

                        suggesting that MLK was against what we call affirmative action is not accurate.

                        king encouraged the use of racial quotas in hiring practices.

                        in his book "why we can't wait" king said...

                        "Whenever the issue of compensatory treatment for the Negro is raised, some of our friends recoil in horror. The Negro should be granted equality, they agree; but he should ask nothing more. On the surface, this appears reasonable, but it is not realistic."

                        King also said ""A society that has done something special against the Negro for hundreds of years must now do something special for the Negro."

                        there are multiple other instances of MLK supporting what would be considered affirmative action and racial quotoas for hiring practices. i could include more but it would be redundant.

                        if you have truly read up on MLK, his view on these issues we are discussing is pretty clear.
                        I was really bummed. Audible had a collections of speeches he’d given - the audio quality was so poor as to make it unlistenable.

                        Comment


                        • #27
                          Dr king was a great man.
                          Non-violent resistance.
                          Huge advocate for the golden rule.
                          Equal treatment for all.
                          His sermon on loving your enemies is perhaps the best ever.
                          I have my views on what Dr King would think now and you have yours.
                          Unfortunately he is not with us to clarify.
                          I have said my opinion.

                          Not getting into a pissing match about that great man.

                          The problem with any type of discrimination based on race / religion /sex / etc. is that it is inherently wrong.

                          If orange people were treated poorly by green people for years the answer is NOT to treat green people poorly but rather to treat both orange and green people fairly.

                          Discrimination against anyone is wrong.

                          Merit and objective scores are the best anyone can do.

                          Have a good day and a happy holiday!

                          Comment


                          • #28
                            Originally posted by VentAlarm View Post

                            Everything I’ve read on implicit association makes it look like the ESR of behavioral science. Do you have any high quality suggesting it is reliable? I am asking in all seriousness. Everything I’ve read makes it look like trash that would have been published in medical journals in the 80s but would have been triaged for the past 20 years. I am a scientist who reviews grants and have noticed a significant bias towards funding and publishing these sort of fluff studies. When someone wants to do a study on race or gender (without an underlying reasonable hypothesis supported by secondary analysis of something else), everyone seems to collectively decide to ignore the fact that the proposals lack appropriate methods, or a power calculations, or statistical support, or some other critical component.
                            Among the most convincing studies on implicit bias are those resume studies where they send out identical resumes but just change names so some are sound white and others sound black. Spoiler alert: Despite identical resumes, they don't get the same results.

                            Comment


                            • #29
                              Originally posted by Lordosis View Post

                              Maybe a few might admit it in the right circumstances but most probably keep that knowledge to themselves.
                              I see, so they would claim exactly what you're claiming (i.e., I'm sure it happens, just not from me").

                              Comment


                              • #30
                                Originally posted by AR View Post

                                I see, so they would claim exactly what you're claiming (i.e., I'm sure it happens, just not from me").
                                These sorts of arguments are unhelpful. Your making an unrefutable claim, not because it’s obviously true, but because of the structure of your argument - you’re essentially just saying “I’m right.”

                                Also, I would suggest that the above example is pretty overt racism, not the sort of “subtle” nonsense argued with the stupid “if you click too slowly you’re racist.”

                                Comment

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