Rationale and Methods for Diversity Efforts in Medicine

[ENT Doc]

In the Wang incident, the paper was retracted and the notice said that he had misquoted and mischaracterized references to distort their meaning.

https://www.ahajournals.org/doi/10.1161/JAHA.119.014602

Wang sued many people and entities, claiming defamation, violation of first amendment rights and other things.

A judge found the descriptions of the misleading citations to be accurate and dismissed those parts of the suit.

A number of other aspects of the suit were also dismissed. Some at least survived that round of legal wrangling.

Taking a step back from the legal case, it strikes me odd that one would claim they can retain their leadership position while working to undermine the policies of the employer. Although there is a state relationship to his medical school , I think his actual employer is a private entity.

Even if it were a state institution, the head of U of Pitt could not expect to publicly disavow its policies and keep their job. For that matter, Janet Yellin could exercise her first amendment right to speak out against Biden's economic policies. However, she could not expect to keep her job if she were to do so.

To your prior post, he didn’t express animosity or say anything racist. The AHA retracted his paper after liberal backlash, not because of source utilization. They said it “wasn’t consistent with their values”.

And to answer your main question, no diversity should have no bearing on admissions. Because that inherently looks at race as a positive or negative attribute. Which is, you know, racist.

[resident_1]

This guy is going against the weight of his medical specialty society and major health system. Respect for standing up to being treated like a doormat by corporate healthcare.
So looks like Dec 21, 2021 some charges were dismissed (https://www.utimes.pitt.edu/news/jud...sses-most-wang)
But looks like last month he filed for violation of 1st and 14th amendments.

https://www.cir-usa.org/case/norman-...of-pittsburgh/

[Tim]

"To your prior post, he didn’t express animosity or say anything racist. The AHA retracted his paper after liberal backlash, not because of source utilization. They said it “wasn’t consistent with their values”.

And to answer your main question, no diversity should have no bearing on admissions. Because that inherently looks at race as a positive or negative attribute. Which is, you know, racist."

"This guy is going against the weight of his medical specialty society and major health system. Respect for standing up to being treated like a doormat by corporate healthcare.
So looks like Dec 21, 2021 some charges were dismissed (https://www.utimes.pitt.edu/news/jud...sses-most-wang)
But looks like last month he filed for violation of 1st and 14th amendments.
https://www.cir-usa.org/case/norman-...of-pittsburgh/ "

Full disclosure: I plead ignorance, like the vast majority of the "deplorables". The extent of the social changes in the society have not really been comprehended by the "silent majority" so to speak. Absolutely no clue. Apologies in advance. We (I use the term for those of us the simply said fine to changes being made as outlined in the paper) never had a clue the extent of the changes taking place in schools, universities and systems. Ignorance is no excuse, but that is a fact from my observations.
That does not mean I am racist, just ignorant.

[nastle]

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.

Agree 100% that rural areas should get more importance
and race gender and religion should have no role in picking candidates
And I belong to a minority group

[paullras]

Elementary school teachers, nurses, nutritionists, all dominated by women. Sexism, yes? We need to start denying women entry into these fields, since it is due to systemic sexism and start studies and outreaches to include more men in these fields, correct?
Obese people receive the same care as more svelte counterparts? How will this be helped when diversity focuses on stressing race and sex?

[snowcanyon]

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!

Outcomes for Black patients are better when treated by Black physicians- why do folks think they are the exception?
Treating everyone the same when they have different life experiences, different fears of medicine, and different social determinants of health is bound to fail. Colorblindness as a strategy has failed repeatedly.

[Tim]

Outcomes for Black patients are better when treated by Black physicians- why do folks think they are the exception?
Treating everyone the same when they have different life experiences, different fears of medicine, and different social determinants of health is bound to fail. Colorblindness as a strategy has failed repeatedly.

So the solution is? Separate but equal? Quota's by race for ms, residencies ? I am not suggesting this, just simply how a plan will work. Or do we simply implicitly encourage separation by race? I think society has tried most of these in one form or another.

HBCU new admissions program: If a student is accepted with at least a 3.0 grade-point average and qualifies for federal financial aid, they can also choose two family members or friends to enroll with them.
Their logic is a support group will help.

What is the plan you suggest? Is it socioeconomic or race that is the only factor. Problem identification seems much easier than the solution. Just saying.

[jfoxcpacfp]

Ladies and gentlemen - as I’m sure you’re aware, we are treading close to the “close” line in this thread. Hatton (appropriately impo) applied grace at Christmas but it’s two months past. This is an interesting thread and, to date, you guys to date have been considerate, showing restraint and tact in your replies. With sincere respect, I’m posting a gentle reminder to continue,

[Ekanive23]

Outcomes for Black patients are better when treated by Black physicians- why do folks think they are the exception?
Treating everyone the same when they have different life experiences, different fears of medicine, and different social determinants of health is bound to fail. Colorblindness as a strategy has failed repeatedly.

I think experience matters more than race in interacting with patient populations. I’m lucky being in medicine gives you a crash course with the rich city folks. My parents were wealthy rural folks and all my friends rural folks of all incomes.

I chose to follow them to the public school nearby which had a 40 percent drop out rate and predominantly Hispanic and African American instead of going to Catholic high school. I attribute my experiences to why I consider myself well to do with Hispanics, African Americans and rural people more than the average doc. Until you have been to a gym class where 3 kids grab your deodorant to “share” you don’t know inner city.

The wealthy/well read people always on my chart and know their labs before I do drive me nuts and I don’t know how to handle them well at all.

[Notsobad]

I think the main reason to have culturally diverse doctors is to have a better connection with those of different backgrounds. But getting the right people into med school is challenging. At my med school, the Harvard grads were smart, but not more than the state school grads. The smartest students in classes were not necessarily the best clinically.

I am glad I don’t have to sift through all those applications, mostly stellar I am sure, to attempt to find out who will have the smarts, compassion, temperament and judgement, to make good medical decisions and communicate them to the patient so might be able to participate properly in their care.

[afan]

Good point. One has to be smart enough to learn the material. Beyond that, conscientiousness is worth more than IQ points.

Speaking of Harvard, as best I can tell, the average IQ of Harvard undergrad students is about 8-10 points above the mean for physicians. That may be why so many go into medicine. I have not seen data for mean IQ of Harvard med students. If we assume it is at least as high as for H undergrads, then the HMS grads should be smarter than the average doc. Are they better doctors? Those who use their intelligence appropriately probably are.

But being smart does not rule out dishonest, lazy, careless or self-centered. Everyone knows some very bad docs who had high grades and test scores. Going only for grades and scores would be a huge mistake.

Still hoping someone will propose an approach to the poor care of minorities when they have no minority docs. If the solution is not "more minority docs", what is it?

One could say "less racism in medicine". That would be great. How do we get there?

[afan]

Wang did not lose his job. He still works there.

He lost his leadership position. Which anyone would expect if they go about espousing policies at odds with their employer.

[Tangler]

Heard this today. Interesting views on race by an African American women who grew up in jim crow Alabama in the 1950s. She is brilliant.
https://podcasts.apple.com/us/podcas...=1000551866282

[VentAlarm]

Good point. One has to be smart enough to learn the material. Beyond that, conscientiousness is worth more than IQ points.

Speaking of Harvard, as best I can tell, the average IQ of Harvard undergrad students is about 8-10 points above the mean for physicians. That may be why so many go into medicine. I have not seen data for mean IQ of Harvard med students. If we assume it is at least as high as for H undergrads, then the HMS grads should be smarter than the average doc. Are they better doctors? Those who use their intelligence appropriately probably are.

But being smart does not rule out dishonest, lazy, careless or self-centered. Everyone knows some very bad docs who had high grades and test scores. Going only for grades and scores would be a huge mistake.

Still hoping someone will propose an approach to the poor care of minorities when they have no minority docs. If the solution is not "more minority docs", what is it?

One could say "less racism in medicine". That would be great. How do we get there?

My neighbor growing up (who was an OB/gyn who seemed a million years old when I was a kid) told me that the top third of med students go into academics, the next third made the best doctors, and the bottom third made the most money. I don’t know that there’s a lot of truth in it, but I found it amusing.

[HikingDO]

My neighbor growing up (who was an OB/gyn who seemed a million years old when I was a kid) told me that the top third of med students go into academics, the next third made the best doctors, and the bottom third made the most money. I don’t know that there’s a lot of truth in it, but I found it amusing.

An attending in med school 25 years ago told us the same thing, and I think it’s true.