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Surprised to see some push back on this stuff from staff at an Ivory Tower institution. This Dr. Goldfarb must have tenure to challenge the academic orthodoxy like this and in such a public forum. (Pasted the editorial for those without access to the wsj).


Healthcare is being infected by the radical ideology that has corrupted education and public safety. But while critical race theory and crime waves have been in the news, the public is largely unaware of medicine’s turn toward division and discrimination. Americans deserve to know that their health and well-being are at risk.

At the heart of this is the claim that healthcare is systemically racist—that most physicians are biased and deliver worse care to minorities. Health disparities do exist among racial groups, but physician bias isn’t the cause. The psychological test at the root of this narrative, the 1998 Implicit Association Test, has been widely discredited, and I know from long experience as a medical educator and practitioner that physicians address the needs of each patient, regardless of skin color. Moreover, attacking physicians is dangerous. It degrades minority trust in healthcare while undermining health outcomes for everyone.

Consider what’s happening in medical research. The National Library of Medicine database shows more than 2,700 recent papers on “racism and medicine,” which generally purport to show physician bias leading to racial disparities in health outcomes. Yet the most commonly cited studies are shoddily designed, ignore such critical factors as pre-existing conditions, or reach predetermined and sensationalized conclusions that aren’t supported by reported results. These papers in turn are used to source even more shoddy research. This is a corruption of medical science in service to political ideology.

Prominent medical journals are complicit in the crusade against medical professionals. The New England Journal of Medicine touts its “commitment to understanding and combating racism as a public health and human rights crisis,” while Health Affairs is implementing a strategy to “dismantle racism and increase racial equity” in healthcare. They publish piece after piece calling, explicitly or implicitly, for a fundamental change in the medical profession. They’re also bringing race and other nonacademic factors into the peer-review process, threatening the scientific analysis on which physician practice and patient health depend.

Medical schools increasingly are preparing physicians for social activism at the expense of medical science. Such student groups as White Coats for Black Lives demand that administrators reframe curriculum around reparations for slavery, decarceration of prisoners, and other topics with no bearing on training doctors to care for individual patients. Medical schools and residencies are lowering admissions standards. The result will be fewer talented physicians providing high-quality care to fewer patients.

Physicians are being pushed to discriminate. Hospitals, state health authorities and the federal government have all authorized race-based formulas for rationing Covid treatments. Brigham and Women’s Hospital in Boston (Harvard’s teaching hospital) is moving toward “preferential care based on race” across the board. And the Biden administration is offering higher Medicare reimbursement rates to hospitals and physicians who “create and implement an anti-racism plan.” To fight their supposed bias, physicians are being bribed into discriminating by race.

These policies and practices have no justification. There’s no credible evidence that physicians are racist or that minority patients will benefit if healthcare is built on a race-based foundation. Common sense says that patients of all colors will suffer. The public’s trust in medical institutions, which has already fallen during the pandemic, will fall further and take patient health with it.

Having talked with many physicians, I know that unwarranted accusations of racism are contributing to physician burnout and early retirement, making it harder for patients to receive care, especially in vulnerable communities. Such accusations also sow profound distrust in the treatment room, eroding the doctor-patient relationship that’s crucial to better health outcomes. As race-based ideology dominates ever more of medical research and education, nonscientific factors will increasingly determine what treatments patients receive.

Healthcare is close to a tipping point, but I’m confident a majority of physicians oppose what’s happening to our profession. Many fear speaking out, lest the social-justice mob destroy their careers, but the woke takeover of healthcare will do that anyway. That’s why I’m launching Do No Harm, a nonprofit that will help medical professionals and concerned Americans protect and promote the principles at the heart of healthcare: fairness, equal access, and the best, most personalized treatment for every patient.

Current and future physicians must tell the country that healthcare is being profoundly damaged by a radical and divisive ideology. The health and well-being of every American depend on it.

Dr. Goldfarb, a former associate dean of curriculum at the University of Pennsylvania’s Perelman School of Medicine, is chairman of Do No Harm.
 
Safe to say I know where his political views are:


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If I dig a little deeper, I might be seeing his name prescribing oncovorin.
Guessing he's a card carrying NRA member

 
Guessing he's a card carrying NRA member

I am a centrist/clinton democrat and fully agree with everything he says. Eg. I am opposed to guns, but believe that anti gun advocacy has not role in medical school curriculum. I very much doubt he owns a gun.
 
I am a centrist/clinton democrat and fully agree with everything he says. Eg. I am opposed to guns, but believe that anti gun advocacy has not role in medical school curriculum.
Oh please your nuanced perspective has no place in such discussions
 
I am a centrist/clinton democrat and fully agree with everything he says. Eg. I am opposed to guns, but believe that anti gun advocacy has no role in medical school curriculum.
Haven't voted GOP in awhile now either myself, but i think the pediatricians would disagree with you there


 
"Goldfarb did not dispute that some of what he called social justice issues were worthwhile, but he warned that any time spent teaching them in medical school meant less time for clinical care."

Oh no, I can't imagine where I'd be today without having memorized all the lysosomal storage diseases, or VDJ recombination, or any of the other esoteric facts that show up on med school exams and (occasionally) on Step 1.
 
"Goldfarb did not dispute that some of what he called social justice issues were worthwhile, but he warned that any time spent teaching them in medical school meant less time for clinical care."

Oh no, I can't imagine where I'd be today without having memorized all the lysosomal storage diseases, or VDJ recombination, or any of the other esoteric facts that show up on med school exams and (occasionally) on Step 1.
Ok, and what can medschool possibly teach you abt gun violence or racism?
 
Many things that have been heavily politicized (what hasn’t) are certainly health concerns.

They can and should be taught as such. Guns being one of those things.

You don’t need to spend a semester on gun violence/accidents but they definitely should be mentioned in the same kind of social history type deal as seat belts, tobacco, and alcohol.
 
And Vice versa… many things taught in med school (masks, vaccines) are politicized.

We shouldn’t run from education or hide ignorance behind political beliefs, religion, etc.
 
What about racism. Do blacks have adverse health outcomes because the health care system is racist. Should this be taught as fact?
 
What about racism. Do blacks have adverse health outcomes because the health care system is racist. Should this be taught as fact?
Very loaded question but I wouldn’t recommend putting our heads in the sand, covering our ears and pretend that the system is perfect.
 
Do they get the same level of care? What would you call that if they don't?
Tough discussion , because on average, it would by my guess that more money is spent on them than say it in a European system on its own population. I am of the view that healthcare above a basic certain level has a very minor/if any effect on life or health span.
 
Tough discussion , because on average, it would by my guess that more money is spent on them than say it in a European system on its own population. I am of the view that healthcare above a basic certain level has a very minor/if any effect on life or health span.
A very dangerous “guess” in my opinion. Hence, why we need education. Just because we believe in equality doesn’t mean it exist.
 
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A very dangerous “guess” in my opinion. Hence, why we need education.
Plenty of populations in sh-t holes like Cuba or the Gaza Strip (where very little per year per person is spent on health care) have equivalent life expectancies to urm in America. To me this means health care system is not the major contributor to lifespan.
 
It’s actually not. Plenty of populations in sh-t holes like Cuba or the Gaza Strip (where 100 bucks per year per person are spent on health care) have equivalent life expectancies to urm in America. To me this means health care system is not the major contributor to lifespan.
So why are we still spending billions of dollars? That tells me the system is very inefficient to say the least.
 
So why are we still spending billions of dollars? That tells me the system is very inefficient to say the least.not only is the healthcare system broken, it’s corrupt.
Agreed. Trillions. To be clear, there is inequality, but have been involved in research that shows it doesn’t make much of a diffference. Looked at stage 3 lung cancer pts outcomes in one of the worst neighborhoods in America. They were slightly better than at the rich nci center 10 miles away.
If we had very effective but very expensive treatments for most cancers, I think you would see a meaningful disparity difference when it comes to cancer. Unfortunately, guys like John McCain can be treated at the Mayo clinic vs charity NO hospital and outcome would be identically ****ty.
 
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Agreed. Trillions. To be clear, there is inequality, but have been involved in research that shows it doesn’t make much of a diffference. Looked at stage 3 lung cancer pts outcomes in one of the worst neighborhoods in America. They were slightly better than at the rich nci center 10 miles away.
Don’t tell that to places like MSKCC and MD Anderson!
 
Don’t tell that to places like MSKCC and MD Anderson!
That’s why it’s so evil that they charge 20x what a hospital in England or Germany charges for same cancer care and outcomes. We could be using that money to buy more F35s and aircraft carriers to stimulate the economy.
 
It has been some time since I looked at the numbers, but my understanding is that overall lifespan is now abt 78 years in the USA.

Very broadly speaking, Public health (sewage, clean water), vaccines and antibiotics brought us into low to mid 70s and modern hospitals/ health care adds 2 or 3 years ( with very basic health care services contributing at least half of that).
 
It has been some time since I looked at the numbers, but my understanding is that overall lifespan is now abt 78 years in the USA.

Very broadly speaking, Public health (sewage, clean water), vaccines and antibiotics brought us into low to mid 70s and modern hospitals/ health care adds 2 or 3 years ( with very basic health care services contributing at least half of that).
I think it's lower than that now, post covid
 
Plenty of populations in sh-t holes like Cuba or the Gaza Strip (where very little per year per person is spent on health care) have equivalent life expectancies to urm in America. To me this means health care system is not the major contributor to lifespan.

Don’t tell @OTN!
 
Is any component of health due to personal choices or is it just societal failure?
Both! Mainly personal choices but education and lack of resources could also be a reason. A person may not be able to see a doc due to personal or work related commitments vs someone who hates seeing doctors. I’ve seen some “educated” people make terrible health decisions.
 
of course personal choices are at play, but also lots of situations where personal choices are NOT at play - so trying to tease between the two to theoretically allow it to guide policy to me is a fool's errand and can start to get into cruel territory.
 
When you are shot and killed at random in the subway, your health is adversely impacted not by a personal choice; rather a complete societal failure on gun regulation.

I think it’s fine for docs to be as against guns as cigarettes, for example.

‘You made the choice to go out at night, so thus we are not covering your Trauma ICU stay’ - insurance companies if you let them!

Nothing gets them more erect.
 
'AETNA continues to examine statistics regarding time of night, crime per zip code, and weather patterns. At this time we are not able to cover your expenses as your our guidelines do not support this. We are committed to our policyholders and will continue to assess these needs on an ongoing annual basis'
 
'AETNA continues to examine statistics regarding time of night, crime per zip code, and weather patterns. At this time we are not able to cover your expenses as your our guidelines do not support this. We are committed to our policyholders and will continue to assess these needs on an ongoing annual basis'
Evicore won’t give auth if you are diagnosed with cancer under the age of 50.
 
Number one cause of death and morbidity worldwide starting about 4 years ago is obesity. (Surrogates for excess nutrition include niddm and metabolic syndrome). dei disparity research wich implies the health care system is so racist that urm would be better off gettin 0 health care/banned from hospitals because the detriment to their health is greater than what modern health care adds to life expectancy!
 
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No one is dismissing personal choices. You smoke, you drink, you don’t wear a seatbelt, you don’t vax? Bad choices dude. Docs are against them.
JD just dismissed personal choice - trying to tease it out could be cruel - I'm not straw manning. I'm responding to specifics.
 
When you look at disparities in health outcomes you can:

1. Play the eugenics game. Let’s just all advise against that.

2. Take the pessimistic view that people of a certain zip code or certain color or certain whatever are just hopelessly bad decision makers and that they are irredeemably causing their own health issues.

3. Take the optimistic view that no certain collection of people want to be chronically unhealthy and there are indeed systemic factors that push them toward poor health choices. Things like access to healthy food or primary care physicians. Things like low crime rates and quality education. If you take this view point, you believe you can impact health on a large scale.
 
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