Dispelling a few myths about AA, URMs, and medical admissions

[MissMary]

Shredder: ive had tons of experience in my earlier schooling with minorities--"fun" in other words. im sure much more than yourself. ive ridden buses with gang members and participated in cinco de mayo song and dance, valuable indeed. im not too interested in hearing stories from the hood when i go to med school, i go there to learn medicine. i think intellectual diversity is far more important

I think these types of attitudes are another reason why many minorities are discouraged and choose not to pursue higher degrees or honors courses in high school. Some just don't want to have to battle day in and day out with ppl who think so little of them simply because of their race. Whether or not you believe it, it is a huge deterrent. Please dont mistake me. There are certainly other factors involved and I acknowledge that. But everyone who holds these discriminatory attitudes is collectively responsible (in part, not entirely) for the disadvantages experienced by minorities. And YES, there are more ways than one to be disadvantaged. THIS IS CERTAINLY ONE OF THEM.

I think there are enough intelligent minds in the government who are capable of distinguishing between a BS policy and one that is necessary for the time being. No, it is not the best solution, but the other options that many of you have presented do not serve to eradicate these discriminatory attitudes. Lady J provided a study that showed that students at Standford and UCSF (i think) found racial diveristy to be a blessing. Wouldn't be suprised if these same individuals who found merit in diversity had the same attitude you did at one point in time. I only hope that you're future experiences at a (hopefully) diverse university will change your mind.

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[Shredder]

The fact that your supposed "outliers" are competitive with the outliers of any race is counter to that.

moose some outliers are more outlying than others. for example the guy from (air hits your brain is it? i read it long ago) must be a super outlier, a real rarity and he should be thankful for that blessing. im sure his hard work played into it but also his innate talent, which made it possible to begin with. curves and distributions are really useful when assessing large sets of data, i like them a lot. they dont tell the whole story but they make good guesses at it, the best guesses you can possibly make basically. just like economic analysts make predictions about the future economy--they may not be perfect or they may be flat out bad, but theyre the best method at hand. so no you cant use curves to evaluate individuals, but you can use them fairly well to evaluate groups.

Lj those experiences sound rough, sorry to hear about them. i dont think people should be criticized for things that are out of their control, its unreasonable. at the same time, AA creates tension. i dont like the tension and i wish it werent there. i dont like having to say of a classmate, oh hes smart and highly qualified...for a (x race) person. you should be able to say it without qualification. medical school trains people to save lives, and politics should not put those lives in danger. of all places medical school is the worst to impose double standards.

does anyone think that AA for indians or chinese would get them into the nba, that is the question. and its on that foundation that all AA systems are based. and missmary im not discriminatory, its AA thats discriminatory. i just see things as they are. lately i admire bill cosby a lot, i think hes a real role model that people should heed. you say the ppl running the country are smart and i suspect as much--which is why i also suspect either brainwashing or a conspiracy

 

[QofQuimica]

Exactly my problem. I try not to get worked up when people suggest this, but it just hurts my feelings because this idea is so damaging. When ever I let people know how I did on the MCAT and my GPA, they always try to figure out how a black girl pulled it off. I haven't made anything less than an A- since I decided to pursue medicine Fall Sophomore year. I had a professor at my school tell me that I was lucky for this reason:
I'm part white (My g-ma is 75% French) so I can get high scores on tests and do well in school but since I look mostly black, I can take advantage of AA programs. You know, because that white part of me just jumps right out when I have to take an exam or do some homework. The same guy told me that when he walks into a lecture hall to teach, he sees all the dark faces and knows they will be at the bottom of the class at the end of the semester. If educators feel this way about minority students, it probably effects the caliber of education these students can achieve. I had the highest grade out of 200 students in my orgo class and people were just phucking baffled. Even when I tutored, many students were skeptical about my abilities. I always had to work extra hard to prove I wasn't just BSing my students. When you are an URM, people don't expect certain things from you and its hard to fight those ideas through out your academic career. Since my family is middle class, I know there are things that make the URM experience different from others across all socioeconomic boundaries. There are thing's I've been through that I'm sure others don't have to deal with. Examples:

My Uncle was lynched in Washington County (Texas) when I was 5,
I went to a private (predominantly white) school because the schools in my area didn't even have text books (they had pamphlets. NO JOKE),
In elementary, the other kids used to tell me to paint myself white to be in their clubs or ask me why black people smell so bad
My college roommate asked me to move out for a few days because her G-ma was visiting and she didn't want her to know she was rooming with a black girl.
Most recently, my Grandpa died because no one in Alexandria wanted to give dialysis to a poor Katrina evacuee (sorry, is it refugee?)
I already told you the story about my professor.

The list goes on and on. Don't think that the reason why minorities choose to pursue sports over academics is because they lack the ability to achieve academically. When you are told you aren't smart and the only way for you to be successful is to pick up a football or a b-ball, it really sinks in. Social pressures have a large effect on the choices people make.

I'm sorry about some of these experiences that you've had, Lady, and I echo Moose in saying that you have my respect for your accomplishments. From all I know about you, you are an impressive person, and that would be true no matter what race you were. I for one would be proud to have you as my classmate if we both end up at Baylor.

This issue of changing people's perceptions of URM students' capabilities is an important one. I believe that the most important people whose perceptions need to be changed are the URM students' themselves. A person can't control what other people do or think, but he *can* control what *he* does and thinks. I sometimes do science demos for the kids at the elementary school where I volunteer. I have also discussed with them several times how much education is necessary to become a "research doctor." (We figured out that I am in the 25th grade. ) My group is currently in the fourth grade, and I don't know how many of them will ultimately go to college or even finish high school. Their lives will get much more complicated once they start middle school. But for now, several of them have said that they want to be chemists when they grow up (at least this week ).

 

[MissMary]

Shredder which is why i also suspect either brainwashing or a conspiracy[/B]

Not sure what you mean by a conspiracy? Elaboration...?

 

[LadyJubilee8_18]

Those are tough experiences, but I received a lot of the same kind of treatment as a poor white boy (I don't look Native American). I never had a family member lynched, but everything else is pretty much the same. I got accused of starting fires in grade school and I had to defend myself, because I was the kid in the shabby clothes.

My problem is that I think AA makes it worse and not better. AA basically tells people you're not smart enough. That's already what you're upset about, so how is it helpful?

The professor, what he said was wrong. He probably shouldn't have said that to you about the students at the bottom of the class, but at the same time, an observation isn't necessarily racists if he has seen it over and over. His comments on a white ancestor show that he thought it was genetic, which is stupid, but the simple phenemenon with no cause attributed is just an observation. It shows something needs to be done for those kids earlier, most likely. Maybe they can be helped in college, but help earlier will pay more, because it will keep them from ever getting behind.

I agree that AA is not the ultimate answer to educational disparities, but I don't feel it should be abandoned at this point while nothing else is being done to fix the education system. The physician population needs to be diverse. If there are no other immediate ways to promote diversity, then the ends justify the means in my book. Besides, the thresholds set for MCAT and GPA seem to be doing a decent job of making sure only those who can do the work are accepted. In the long-run, however, something needs to be done to correct educational disparities. These programs should work to improve education from preschool to high school. I think one thing that would help is to get rid of the districting system. If people in the surrounding districts pay to keep the immediate schools open, those schools in poorer areas will receive less funding. Consequently poorer children will get an inferior education. Even though I grew up in a middle-class African American neighborhood, the areas in my school district were much poorer than my neighborhood. Because of this, the high school I would have attended (had my parents not chosen private school) gives its students pamphlets instead of text books.

That being said, one thing I've learned is that racism needs no real excuse. People thought minorities lacked intellectual ability WAY before Affirmative Action. Since these injurious ideas are pervasive in every aspect of society, health care providers, students, teachers and professors have all been indoctrinated with the idea that certain races play specific roles in society. I think this, in and of itself, produces many of the educational disparities in America.

 

[MoosePilot]

I think these types of attitudes are another reason why many minorities are discouraged and choose not to pursue higher degrees or honors courses in high school. Some just don't want to have to battle day in and day out with ppl who think so little of them simply because of their race. Whether or not you believe it, it is a huge deterrent. Please dont mistake me. There are certainly other factors involved and I acknowledge that. But everyone who holds these discriminatory attitudes is collectively responsible (in part, not entirely) for the disadvantages experienced by minorities. And YES, there are more ways than one to be disadvantaged. THIS IS CERTAINLY ONE OF THEM.

I think there are enough intelligent minds in the government who are capable of distinguishing between a BS policy and one that is necessary for the time being. No, it is not the best solution, but the other options that many of you have presented do not serve to eradicate these discriminatory attitudes. Lady J provided a study that showed that students at Standford and UCSF (i think) found racial diveristy to be a blessing. Wouldn't be suprised if these same individuals who found merit in diversity had the same attitude you did at one point in time. I only hope that you're future experiences at a (hopefully) diverse university will change your mind.

I think there are enough intelligent minds in government to have decided that a war in Iraq was the best way to insure our peace and to defeat the terrorists before they have a chance to strike the US directly.

Do you like that argument? What about the US government prior to President Lincoln? I think they had glaring holes in their policies and no amount of respect for their authority will change that.

Stanford and UCSF... intellectual freedom to say anything other than "diversity is wonderful" in a zombie voice? I don't think so...

 

[LadyJubilee8_18]

I think there are enough intelligent minds in government to have decided that a war in Iraq was the best way to insure our peace and to defeat the terrorists before they have a chance to strike the US directly.

Do you like that argument? What about the US government prior to President Lincoln? I think they had glaring holes in their policies and no amount of respect for their authority will change that.

Stanford and UCSF... intellectual freedom to say anything other than "diversity is wonderful" in a zombie voice? I don't think so...

I agree that the example's you bring up represent glaring mistakes on the part of the government, but in those instances, one can identify specific ulterior motives for the government to take those stances. There are many non-PC motives that could have provoked us to go to war in Iraq (I'll leave you to think of those on your own time, don't want to get off topic). Also there were lots of political and economical reasons for the government to preserve slavery. In this case, what is the ulterior motive? What does the government have to gain by promoting diversity in medical school? Why don't you believe having a diverse physician population is best?

 

[MoosePilot]

moose some outliers are more outlying than others. for example the guy from (air hits your brain is it? i read it long ago) must be a super outlier, a real rarity and he should be thankful for that blessing. im sure his hard work played into it but also his innate talent, which made it possible to begin with. curves and distributions are really useful when assessing large sets of data, i like them a lot. they dont tell the whole story but they make good guesses at it, the best guesses you can possibly make basically. just like economic analysts make predictions about the future economy--they may not be perfect or they may be flat out bad, but theyre the best method at hand. so no you cant use curves to evaluate individuals, but you can use them fairly well to evaluate groups.

This one that I just read is "Gifted Hands", but he may well have written the other one, too. It sounds like some of the type of surgery he does.

Statistics are great, but they don't give causes. So the researchers speculate on causes. That's one thing I haven't liked about much of the research LJ has presented. The speculation is taken as scientifically as the facts, but has nothing to back it. Most of the time that means the speculation is politically correct. Your speculation is politically incorrect and I think more erroneous. I used some outliers to show that minorities could reach the intellectual peaks of whites. It might not prove anything, but I think it points to there not being any genetic limitations on minority intelligence.

My personal opinion is mutts will someday rule the world, because genetic diversity is the healthiest. I might be biased, though.

 

[MoosePilot]

I agree that the example's you bring up represent glaring mistakes on the part of the government, but in those instances, one can identify specific ulterior motives for the government to take those stances. There are many non-PC motives that could have provoked us to go to war in Iraq (I'll leave you to think of those on your own time, don't want to get off topic). Also there were lots of political and economical reasons for the government to preserve slavery. In this case, what is the ulterior motive? What does the government have to gain by promoting diversity in medical school? Why don't you believe having a diverse physician population is best?

Votes. Whites aren't voting against politicians due to AA, but minorities will vote for politicians they think support them most strongly.

Because in the tradeoff between highest achievement (standard adcom measures of acceptance minus racially based AA) and an artificial mix of racial backgrounds, I favor highest achivement. I thought that was pretty apparent.

 

[MissMary]

No I don't agree with all the decisions the government has made, but I don't think that necesarily discredits every decision they have ever made. The war in Iraq is a very different subject. The war in iraq was based on faulty documents and hidden agendas. AA policies have been supported time and time again by research and statistics. Furthermore, the need for it is evidenced in ppl's racists/prejudicial attitudes . Eliminating AA now, during a time when medicine still lacks racial diversity and ppl think all minorities are gang bangers and incapable of contributing to an intelligent environment, would certainly be dangerous. I think encouraging non-URMs to work alongside URMs can minimize these attitudes. We can all learn a lot from each other.

 

[MissMary]

Moosepilot but minorities will vote for politicians they think support them most strongly.

seems like a real roundabout way to secure votes, and as long as AA has been in use, can't say that it's been all that effective. there's no real proof that even minorities, who do not benefit from AA, actually vote for these government officals. i cant recall a time that AA was used as part of a political campaign (correct me if im wrong), so how would they know who to vote for?

and with so few minorities even pursing medical school (or other universities for that matter), why would this be a logical way to secure votes? not a whole lot of ppl "benefitting" from it

 

[MoosePilot]

No I don't agree with all the decisions the government has made, but I don't think that necesarily discredits every decision they have ever made. The war in Iraq is a very different subject. The war in iraq was based on faulty documents and hidden agendas. AA policies have been supported time and time again by research and statistics. Furthermore, the need for it is evidenced in ppl's racists/prejudicial attitudes . Eliminating AA now, during a time when medicine still lacks racial diversity and ppl think all minorities are gang bangers and incapable of contributing to an intelligent environment, would certainly be dangerous. I think encouraging non-URMs to work alongside URMs can minimize these attitudes. We can all learn a lot from each other.

Oh, so you're saying each decision the government makes should be evaluated on it's own merits? I agree.

You seem to define "racist" as anyone who doesn't agree with you. So as long as there is disagreement, you're going to call for AA.

I wonder why people think minorities are gang bangers? The same reason people think Iraqis are insurgents or Arabs are terrorists? There are genuine problems that need to be fixed that aren't non-minorities faults and which AA isn't going to fix. Promoting minorities ahead of non-minorities with better qualifications isn't going to erase racism, because it is racism and inspires more.

 

[MoosePilot]

seems like a real roundabout way to secure votes, and as long as AA has been in use, can't say that it's been all that effective. there's no real proof that even minorities, who do not benefit from AA, actually vote for these government officals. i cant recall a time that AA was used as part of a political campaign (correct me if im wrong), so how would they know who to vote for?

and with so few minorities even pursing medical school (or other universities for that matter), why would this be a logical way to secure votes? not a whole lot of ppl "benefitting" from it

AA is wide spectrum of programs. Opposition to AA programs is news, people see it, and there are political ramifications. Politicians take care of themselves, so unfortunately, this never gets addressed.

It's not only pre-meds who vote based on AA. I think most minorities vote mostly on racial issues or pet issues (immigration, Cuba, etc.). That's why they, like women, are courted as a voting block and not as individuals.

 

[LadyJubilee8_18]

Votes. Whites aren't voting against politicians due to AA, but minorities will vote for politicians they think support them most strongly.

Because in the tradeoff between highest achievement (standard adcom measures of acceptance minus racially based AA) and an artificial mix of racial backgrounds, I favor highest achivement. I thought that was pretty apparent.

You know, only 56% of minorities voted in last presidential election. As we all know, presidential elections command the highest voter turnout, so it follows that fewer minorities vote in other elections. So you are suggesting AA is a massive ploy for politicians to secure (at best) half of the votes of 30% of the population? Also, the AMA, AAMC, NIH, and Congress along with countless academic institutions have all fabricated statistics showing that diversity is needed in the medical/professional community. Furthermore, these prominent individuals allocate large sums of money and hold yearly conferences aimed at finding solutions to increase diversity--all as part of a massive conspiracy to secure the minority vote. Please forgive me if I'm not able to suspend my disbelief.

Many of the studies I posted did have statistics backing them. The ones that didn't show the numbers are studies that I'd have to buy in order to share them with you. I refuse to spend my money to "prove a point" that will never be accepted (most people probably wouldn't even read the studies). As I posted before, studies show that only 26% of the variation regarding who gets accepted and who does not can be accounted for by MCAT and GPA. It seems from our discussion that you believe best qualified= highest numbers. I have also posted evidence showing that most schools use thresholds because students who can score above a certain threshold will probably succeed in medical school. It seems pretty clear that non-number based qualifications are coveted by adcoms also. Ethnic diversity just happens to be one of those qualifications. Also, as I posted before, people who score the highest on the MCAT are only 2.5% likely to choose a primary care specialty. Choosing people with only extremely high numbers would result in an over saturation of highly specialized residency programs while draining primary care of qualified physicians. This would reduce access to healthcare. Eventually, there would have to be more economic incentives for physicians to work in primary care which would drive up the cost of health care. This would again reduce accessibility. Tell me again why choosing those with the highest numbers is better?

Also, you call my studies pure speculation and at the same time, you spout off unsupported arguments. Aren't your arguments speculation? You haven't even tried to back your opinions with fact because THEY don’t want you to know that all this diversity crap is BS. So why should I believe your grandiose conspiracy theory? I don't need some study to prove to me that there are racially related educational disparities because I've lived it. For the benefit of others, however, I've posted the studies and for some reason they have been deemed insufficient. Again I say to you, prove to me you are right and I am wrong. At least try.

 

[MissMary]

i don't think every idea that is contra to my own is racist. i think assuming every minority you meet is a gang banger is racist. that's my opinion. we'll just have to agree to disagree.

Beyond that, I agree with you somewhat. There are problems that need to be fixed, yes. The assumptions that have been made about Arabs and Iraqis are equally racist and inappropriate. But you dont hold individuals accountable for making these assumptions. How can that be? You can make the choice to educate yourself about other cultures/people and learn from them. Society does not coerce individuals to feel a certain way about a class of ppl. Ultimately, it is a choice.

Secondly, I don't think AA is about promoting unqualified URMs and I really resent that ppl feel that way particularly since Lady J has already made the argument that threshold values are used to ensure that all accepted candidates (URM and non-URM) are capable of handling the med school curriculum and becoming competent doctors. No unqualified URMs are getting into medical school, so please for the luv of God let that go.

Have you thought for a moment that other non-URMS who dont have great scores might be "bumping" ( to use your term) other non-URMs with higher stats because they have the potential to contribute to the diversity of medicine in some other way? Med schools like to diversify on many levels. nonURMs who have gone thru some sort of adversity and who have lower scores are getting in instead of higher scoring nonURMs, yet this doesnt seem to bother you. How can we say that the adversity this nonURM person experienced is much more significant than the adversity experienced by URMs on a daily basis?

Finally, I think we are forgetting that AA was created not just for minorities but women as well. It is not used as much now b.c women make up nearly 50% of most med schools and make up a good portion of the workforce. I'm sure that certain qualified women were given a second look PARTLY because of the diversity they would be adding. Was this use of AA wrong as well? AA based on race will be phased out when it is no longer needed (much in the same way AA based on gender was/is).


affirmative action, in the United States, programs to overcome the effects of past societal discrimination by allocating jobs and resources to members of specific groups, such as minorities and women.

 

[DrBowtie]

Also, as I posted before, people who score the highest on the MCAT are only 2.5% likely to choose a primary care specialty. Choosing people with only extremely high numbers would result in an over saturation of highly specialized residency programs while draining primary care of qualified physicians. This would reduce access to healthcare.

Maybe it is time to reconsider the role of a doctor as a PCP. PA's and other mid-level providers are already infringing on the territory.

Perhaps we change the role of physicians to being specialists only and pass the torch of FP to PA's. FP are already the least filled residencies. I'm sure it wouldn't be popular with many docs in PCP but a PA is cheaper and easier to train and does much of the same work. That would increase access.

 

[MissMary]

Maybe it is time to reconsider the role of a doctor as a PCP. PA's and other mid-level providers are already infringing on the territory.

Perhaps we change the role of physicians to being specialists only and pass the torch of FP to PA's. FP are already the least filled residencies. I'm sure it wouldn't be popular with many docs in PCP but a PA is cheaper and easier to train and does much of the same work. That would increase access.

but would a PA be willing to go thru the years of training? Granted much of what medical personnel learn is on the job (reading cases in a textbook is nothing compared to experiencing them), but I like the idea that my FP went thru the rigors of medical school and may very well be more informed. I understand that PAs do much of what doctors do, but I don't know that a lot of ppl would buy that idea as much sense as it may make.

 

[DrBowtie]

but would a PA be willing to go thru the years of training? Granted much of what medical personnel learn is on the job (reading cases in a textbook is nothing compared to experiencing them), but I like the idea that my FP went thru the rigors of medical school and may very well be more informed. I understand that PAs do much of what doctors do, but I don't know that a lot of ppl would buy that idea as much sense as it may make.

For FP, there are two types of patients it seems.
The people who have a cold, want their Z pack and want to get on their way b/c they are busy.

The others are the "boutique" patients that want to spend a lot of time with their doc and establish a relationship.

PA's or NP's could def. serve the first type.

 

[LadyJubilee8_18]

Maybe it is time to reconsider the role of a doctor as a PCP. PA's and other mid-level providers are already infringing on the territory.

Perhaps we change the role of physicians to being specialists only and pass the torch of FP PA's. FP are already the least filled residencies. I'm sure it wouldn't be popular with many docs in PCP but a PA is cheaper and easier to train and does much of the same work. That would increase access.

This is an interesting idea. Lots of the reasons for limited access is because the number of practicing doctors is artificially limited by the relative scarcity of medical school seats. I believe the US has the lowest doctor to patient ratio of any first-world nation. Also, those who want to be primary care specialist could seek training as PAs instead of going to medical school. This would be cheaper for them and put less application pressure on medical school admissions. Less application pressure= easier to get in= less animosity against groups who are thought to have an advantage. I've never considered this, but it seems like a good solution to relieve some of the pressure and provide better health care.

 

[MissMary]

This is an interesting idea. Lots of the reasons for limited access is because the number of practicing doctors is artificially limited by the relative scarcity of medical school seats. I believe the US has the lowest doctor to patient ratio of any first-world nation. Also, those who want to be primary care specialist could seek training as PAs instead of going to medical school. This would be cheaper for them and put less application pressure on medical school admissions. Less application pressure= easier to get in= less animosity against groups who are thought to have an advantage. I've never considered this, but it seems like a good solution to relieve some of the pressure and provide better health care.

i agree that it does hold some merit, but I dont know.....think many ppl would still be opposed to this. Some ppl will prefer seeing a medical doctor for their ailments, no matter how small. Would these PAs, who have less training than FPs, be referring their patients to specialists? Do PAs who are doing the work of an FP want to make PA money?

Brett: There are already little boutiques in place that are staffed by RNs and PAs who see patients who just want to come in for their Z pack. Some of these boutiques are in supermarkets. I even read the other day in the paper that an over-the phone system like this is in place. Things like this are already popping up. What about the other ppl, like myself, who appreciate a good relationship with my FP? and who want dont want to go to a little boutique?

Would patient care suffer? PAs, i think, are just as competent as FPs (to some extent...i guess), but if patients are allowed to decide for themselves which type of care they want 1. some quick pick u your med place or 2. an FP that knows their history, has a strong TRUSTING relationship with them (which, to me, is more likely to translate into better care), dont you think there is the potential for health care to suffer?

 

[DrBowtie]

Brett: There are already little boutiques in place that are staffed by RNs and PAs who see patients who just want to come in for their Z pack. Some of these boutiques are in supermarkets. I even read the other day in the paper that an over-the phone system like this is in place. Things like this are already popping up. What about the other ppl, like myself, who appreciate a good relationship with my FP? and who want dont want to go to a little boutique?

You mixed the two. The places you stop in the supermarket aren't the boutiques. Those are where I see PC medicine going since sadly many people value their time more than their health. Deciding on a check up while already out to the grocery might actually be a good thing for public health.

A boutique (like in the fashion stores) would be smaller establishments where the owner creates a good relationship with and caters to the clientele.

I'm sure there is some discepancies in the training of a PA and a primary care doc. Perhaps maybe a PA fellowship in FP to get script rights? The pay scale would be determined by patient load and procedures not so much the "salary of a FP doc."

There is also at atleast one med school an option to forgo your forth year of med and enter the first year of FP residency thus finishing it all in 6 rather than 7.

 

[LadyJubilee8_18]

i agree that it does hold some merit, but I dont know.....think many ppl would still be opposed to this. Some ppl will prefer seeing a medical doctor for their ailments, no matter how small. Would these PAs, who have less training than FPs, be referring their patients to specialists? Do PAs who are doing the work of an FP want to make PA money?

Brett: There are already little boutiques in place that are staffed by RNs and PAs who see patients who just want to come in for their Z pack. Some of these boutiques are in supermarkets. I even read the other day in the paper that an over-the phone system like this is in place. Things like this are already popping up. What about the other ppl, like myself, who appreciate a good relationship with my FP? and who want dont want to go to a little boutique?

Would patient care suffer? PAs, i think, are just as competent as FPs (to some extent...i guess), but if patients are allowed to decide for themselves which type of care they want 1. some quick pick u your med place or 2. an FP that knows their history, has a strong TRUSTING relationship with them (which, to me, is more likely to translate into better care), dont you think there is the potential for health care to suffer?

Maybe the solution is to offer both. Do not make the FP physician obsolete, but have more clinics where PAs can perform simple procedures that FPs would normally perform. If the PA can't handle something, he or she could refer patients to a FP doc or a specialist as needed. FPs (having more training) could command more money while the PAs could give people more economically sensible options. Its a good way to provide people with basic health care and maybe it will keep people who don't have insurance out of emergency rooms when they are really seeking primary care. I think another good idea is to open more student run clinics. Many medical schools have started free student run clinics in communities where many can't afford health care. The students get a great learning tool that will not only grant them more hands-on experience but teach them cultural competence. In exchange, the community has its health care needs taken care of for free. Enough programs like these could take some of the burden off the uninsured populations.

 

[MissMary]

if we keep both PC-PAs and FP, we are taking a huge source of income away from FPs. I dont know about you, but I have dealt with too many FPs who are forever rushing me out. They try to cramp in as many ppl as they can. Some of this is a desire to make that "Doctor's Salary" and the other part of it is the high costs (liability insurance and other overhead) that they have to deal with. I can't envision a good result from this. Furthermore, there would be too many middlemen. PC-PA refers to FP who refers to Specialist. Too much i think. I think there are too many factors to take into consideration. not being pessimistic, just cautious.

Brett: You mixed the two.

true. true.


and i agree with you on making PC more accessible. Maybe this needs to be the focus and not dividing FP into two personnel. Free clinics, supermarket PC etc.....

What's the education requirement for RNs and PAs? Which one gets Rx rights? I forget...

 

[DrBowtie]

if we keep both PC-PAs and FP, we are taking a huge source of income away from FPs. I dont know about you, but I have dealt with too many FPs who are forever rushing me out. They try to cramp in as many ppl as they can. Some of this is a desire to make that "Doctor's Salary" and the other part of it is the high costs (liability insurance and other overhead) that they have to deal with. I can't envision a good result from this. Furthermore, there would be too many middlemen. PC-PA refers to FP who refers to Specialist. Too much i think. I think there are too many factors to take into consideration. not being pessimistic, just cautious.

true. true.


and i agree with you on making PC more accessible. Maybe this needs to be the focus and not dividing FP into two personnel. Free clinics, supermarket PC etc.....

What's the education requirement for RNs and PAs? Which one gets Rx rights? I forget...

The thing is that in FP it is getting harder to make a "doctor's salary". After 7 years of med school/residency, they have loans to pay and such and aren't making the kind of money they should be to justify the debt.

The malpractice and overhead are minor compared to other specialties. There isn't anything more than an exam table and a diagnostic set in most exam rooms.

RN is 4 years. PA I'm unsure of. Take into account though these degrees are very specialized as opposed to the general liberal arts degrees that pre-meds do. They learn job skills while in their schooling.

 

[MissMary]

wait! why dont FP just get paid more? I think this could solve a lot of problems: 1. less economic pressure to see 100 Pts a day, so they send more time with Pts and can provide more thorough care and 2. more ppl would want to go into PC. althought most docs want to help ppl, they also want to be adequately compensated for the time they put in. plus they deserve it, they have to know so much more about basic care 3. more FPs =more americans with access to PC....

 

[DrBowtie]

wait! why dont FP just get paid more? I think this could solve a lot of problems: 1. less economic pressure to see 100 Pts a day, so they send more time with Pts and can provide more thorough care and 2. more ppl would want to go into PC. althought most docs want to help ppl, they also want to be adequately compensated for the time they put in. plus they deserve it, they have to know so much more about basic care 3. more FPs =more americans with access to PC....

Each procedure has a certain compensation. FP's just don't do the high ticket procedures.

 

[LadyJubilee8_18]

The thing is that in FP it is getting harder to make a "doctor's salary". After 7 years of med school/residency, they have loans to pay and such and aren't making the kind of money they should be to justify the debt.

The malpractice and overhead are minor compared to other specialties. There isn't anything more than an exam table and a diagnostic set in most exam rooms.

RN is 4 years. PA I'm unsure of. Take into account though these degrees are very specialized as opposed to the general liberal arts degrees that pre-meds do. They learn job skills while in their schooling.

You know, Brett, I've read your post before in other threads on SDN and I always thought you were an ass. Even though I'm pretty sure you don't agree with AA, you haven't been disrespectful at all. It turns out, you're a really reasonable and intelligent guy. I am also very impressed with bananaface (even though she doesn't agree with AA either). Guess this thread is also dispelling a few myths about SDNers.

edit: sorry bananaface

 

[MoosePilot]

Threshold values = approximately what I got on my two best sections = worthless. Someone can succeed in med school because they can get a 25?

That's the sort of BS that I'm talking about. It manages to get the program through a court that said strict racial quotas weren't allowed, but it doesn't mean anything.

To reiterate:

I don't think there's a vast conspiracy, but if politicians can support AA and get 15% of the vote at minor to no expense of the majority vote, yes, I think they'll do it.

I think that Arabs and Iraqis have done a lot to earn the current distrust they suffer under. Gang members have done a lot to ruin the reputation of minorities, just like the Klan has done for whites. It's no surprise that gangs are associated with minorities. Don't blame people who see an obvious association, blame the gang members and work towards a solution to street crime.

The whole argument has reached the point of agree to disagree. I don't think anything beyond qualifications should be looked at and I don't think skin color counts as a qualification. If an adopted white child grew up in a black household, would he add to diversity? Would AA help him? Ask yourself that and then ask whether it's a good policy or not.

 

[MoosePilot]

wait! why dont FP just get paid more? I think this could solve a lot of problems: 1. less economic pressure to see 100 Pts a day, so they send more time with Pts and can provide more thorough care and 2. more ppl would want to go into PC. althought most docs want to help ppl, they also want to be adequately compensated for the time they put in. plus they deserve it, they have to know so much more about basic care 3. more FPs =more americans with access to PC....

Economic incentives are a solution I proposed pages ago.

 

[DrBowtie]

You know, Brett, I've read your post before in other threads on SDN and I always thought you were an ass. Even though I'm pretty sure you don't agree with AA, you haven't been disrespectful at all. It turns out, you're a really reasonable and intelligent guy. I am also very impressed with bananaface (even though he doesn't agree with AA either). Guess this thread is also dispelling a few myths about SDNers.

I think I hold a perspective that isn't common on SDN.
I'm an acquired taste.

 

[MoosePilot]

You know, Brett, I've read your post before in other threads on SDN and I always thought you were an ass. Even though I'm pretty sure you don't agree with AA, you haven't been disrespectful at all. It turns out, you're a really reasonable and intelligent guy. I am also very impressed with bananaface (even though he doesn't agree with AA either). Guess this thread is also dispelling a few myths about SDNers.

That's funny. Brett is usually one of the more well liked pre-allo posters that I've seen. Bananaface is a female. She was a pharmacy mod and now is a super moderator. She's so inoffensive it's not even funny (except to Okies who abhore her evil liberal ways).

 

[LadyJubilee8_18]

Threshold values = approximately what I got on my two best sections = worthless. Someone can succeed in med school because they can get a 25?

That's the sort of BS that I'm talking about. It manages to get the program through a court that said strict racial quotas weren't allowed, but it doesn't mean anything.

To reiterate:

I don't think there's a vast conspiracy, but if politicians can support AA and get 15% of the vote at minor to no expense of the majority vote, yes, I think they'll do it.

I think that Arabs and Iraqis have done a lot to earn the current distrust they suffer under. Gang members have done a lot to ruin the reputation of minorities, just like the Klan has done for whites. It's no surprise that gangs are associated with minorities. Don't blame people who see an obvious association, blame the gang members and work towards a solution to street crime.

The whole argument has reached the point of agree to disagree. I don't think anything beyond qualifications should be looked at and I don't think skin color counts as a qualification. If an adopted white child grew up in a black household, would he add to diversity? Would AA help him? Ask yourself that and then ask whether it's a good policy or not.

Why do you laugh at the notion that people who get 25s can succeed in medical school? Researchers noted the correlation between the passing value for important medical school exams and certain MCAT scores. The data is based on what happens in real-life medical schools. The requirement for extremely high MCAT scores has been artificially inflated by application pressure; you don't need a 40 and a 4.0 to succeed in medical school. You may think this notion is laughable, but considering actually studied data it seems to be true. If you find a better source that proves other wise, I'm all ears.

About the mass voter grab: The minority vote is split anyway. Blacks vote D. because democrats pushed the majority of the important civil rights legislation. Most minorities who actually vote are old enough to remember this. This is why Dems don't work to court the black vote--they know they already have it. Republicans don't try to court the black vote because to most blacks, Rep= racist. Reps would have to spend too much time, energy, and money for very little pay off. As for Hispanics, they tend to vote on morality issues because most Hispanics are Catholic. The abortion issue is what seals their loyalty to the right. Politicians do not need to cling to AA in order to secure votes. This notion is laughable; might I add

You really lost me at the gang member, terrorist, KKK comments. The vast majority Arabs and Iraqis do not deserve to be treated like terrorist despite the actions of a few deranged individuals on 911. Likewise, equating all minorities with violent gang members is just racism--its not a valid observation. Contrary to popular belief, most minorities are not selling crack and hanging out of low-rider windows with various automatic weapons. Its interesting how you use the example of the KKK. People aren't scared for their lives because they think every white person who passes by is a KKK member. Though minority groups are associated with a few irrational and injurious individuals, somehow whites escape this stereotype despite the existence of the KKK. When it comes down to it, noting that some destructive individuals happen to be of certain ethnic backgrounds does not give you the right to assume all members of that background are destructive. This reminds me of justification of hate crimes against gays because, "If they weren't gay, people wouldn't be so hateful." When it comes down to it, the problem is not with different ethnic groups, but with the bigotry/racism.

 

[MissMary]

MossePilot Economic incentives are a solution I proposed pages ago.

opps..must have overlooked that one.

I don't think there's a vast conspiracy, but if politicians can support AA and get 15% of the vote at minor to no expense of the majority vote, yes, I think they'll do it.

I would agree with you if I actually thought AA was a huge issue in campaigns like RELIGION has been in the past several elections. It hasn't been. So I'm not really following you here.

I think that Arabs and Iraqis have done a lot to earn the current distrust they suffer under. Gang members have done a lot to ruin the reputation of minorities, just like the Klan has done for whites. It's no surprise that gangs are associated with minorities. Don't blame people who see an obvious association, blame the gang members and work towards a solution to street crime.

wow. like i've said before: i take personal responsibility seriously. i think all blacks should be held accountable for their own actions as well as the assumptions they make about groups of ppl. i dont think all white are evil b.c the KKK is. its a faction with views that are not necessarily representative of the views held by all whites. i really dont think all ppl should suffer b/c there are groups within their population that do things and say things that are radical and outrageous. i'm not sure why you would feel that way. and you ought to know, that a solution does not come with denoucing every other member of that population or justifying the negative views about them.

I don't think anything beyond qualifications should be looked at and I don't think skin color counts as a qualification.

well the ppl that matter in this admission process do.

If an adopted white child grew up in a black household, would he add to diversity? Would AA help him? Ask yourself that and then ask whether it's a good policy or not.

AA wont help him, but that doesnt mean that his unique situation wont make an impression on adcoms. i think adcoms will consider whether this is a worth or unworthy quality for diversification. understand that not all minorites are "helped" by AA, not all of them get in or even have the chance of getting in. only the QUALIFIED applicants are. he would need to be qualified first and foremost

 

[LadyJubilee8_18]

That's funny. Brett is usually one of the more well liked pre-allo posters that I've seen. Bananaface is a female. She was a pharmacy mod and now is a super moderator. She's so inoffensive it's not even funny (except to Okies who abhore her evil liberal ways).

Yeah? I think I just got the wrong idea about him. I should have known bananaface is female, no male could possibly be that rational

 

[MissMary]

Additionally Moosepilot: I would like to know your views on AA's role in encouraging women into the workforce and into institutions of higher learning. I'm sure women had to go thru the same things minorities are going thru now with proving themselves and discrediting faulty claims, but they persevered and now they have come much further than they were 50 years ago.

 

[DrBowtie]

LJ,
Although you have the studies, I will point out two issues I have with the assertion of the minimum criteria.

A) DO schools have averages of less than the 25 Minimum MCAT yet don't have 50% failure rates.

B) Yes the 25 MCAT is the minimum MCAT to pass, but I would like to think people aren't expected to "just pass". I realize that someone always has to be at the bottom, but that is almost expecting mediocrity out of those people.

 

[MissMary]

Brett:DO schools have averages of less than the 25 Minimum MCAT yet don't have 50% failure rates.

A) are you suggesting that URMs have a 50% failure rate? i must have missed that in her research. please enlighten me.

B) is the assumption that those ppl who are "just passing" are URMs? i think data that explores how well these ppl with around 25s on their MCAT are doing in med school would be more telling. Regardless, i think the pass/fail system used in most med schools allows high MCATers to "just pass" and still become doctors. nearly the same thing to me

 

[LadyJubilee8_18]

LJ,
Although you have the studies, I will point out two issues I have with the assertion of the minimum criteria.

A) DO schools have averages of less than the 25 Minimum MCAT yet don't have 50% failure rates.

B) Yes the 25 MCAT is the minimum MCAT to pass, but I would like to think people aren't expected to "just pass". I realize that someone always has to be at the bottom, but that is almost expecting mediocrity out of those people.

I believe what the study is trying to say is that within a reasonable confidence interval, one can assume that those with at least a 25 on the MCAT can pass their exams and go on to be practicing physicians. I think the fact that DO schools often have averages below 25 yet they don't have 50% failure rates reiterates the fact that individuals with 25s can do well in medical school. Just because someone got a 25 on the MCAT does not necessarily mean that they will barely pass their exams. I think med schools use thresholds to make sure people who are admitted can at least handle the work load. I don't think the students with lower MCAT scores are expected to then be mediocre students (in fact MCAT scores probably don't matter at all once you are already in), but the probability that they will make lower passing scores on the boards is higher. This does not mean that these students will necessarily make poorer clinicians since it takes different skills to be a clinician than it takes to succeed at basic sciences. It seems the best predictor of how well students will do on exams during the clinical years is the MCAT writing sample. There are thresholds for that too. I think the purpose of the minimum requirements is to separate those who can cut it and those who cant. After that distinction is made, adcoms are free to look at other qualities they feel are desirable for that specific class.

 

[DrBowtie]

A) are you suggesting that URMs have a 50% failure rate? i must have missed that in her research. please enlighten me.

B) is the assumption that those ppl who are "just passing" are URMs? i think data that explores how well these ppl with around 25s on their MCAT are doing in med school would be more telling. Regardless, i think the pass/fail system used in most med schools allows high MCATers to "just pass" and still become doctors. nearly the same thing to me

It had no relation to URMs. Only to the provided study saying the minimum for success in medical school.

 

[DrBowtie]

I believe what the study is trying to say is that within a reasonable confidence interval, one can assume that those with at least a 25 on the MCAT can pass their exams and go on to be practicing physicians. I think the fact that DO schools often have averages below 25 yet they don't have 50% failure rates reiterates the fact that individuals with 25s can do well in medical school. Just because someone got a 25 on the MCAT does not necessarily mean that they will barely pass their exams. I think med schools use thresholds to make sure people who are admitted can at least handle the work load. I don't think the students with lower MCAT scores are expected to then be mediocre students (in fact MCAT scores probably don't matter at all once you are already in), but the probability that they will make lower passing scores on the boards is higher. This does not mean that these students will necessarily make poorer clinicians since it takes different skills to be a clinician than it takes to succeed at basic sciences. It seems the best predictor of how well students will do on exams during the clinical years is the MCAT writing sample. There are thresholds for that too. I think the purpose of the minimum requirements is to separate those who can cut it and those who cant. After that distinction is made, adcoms are free to look at other qualities they feel are desirable for that specific class.

Another study correlated MCAT performance to performance in the first two years and on the USMLE.

By drawing conclusions wouldn't that mean that most likely the people who score lower on the MCAT score lower on their exams?

Also, it seems that clinical years don't determine the quality of the physician since you are still not in the leadership role.

Residency performance would much better correlate to your term "poorer clinicians"

 

[MissMary]

It had no relation to URMs. Only to the provided study saying the minimum for success in medical school.

ooooooooooo

 

[LadyJubilee8_18]

Another study correlated MCAT performance to performance in the first two years and on the USMLE.

By drawing conclusions wouldn't that mean that most likely the people who score lower on the MCAT score lower on their exams?

They are statistically more likely to score lower on their exams, yes, but they are still very very likely to pass the exams. This correlation does not mean that everyone who got a 25 on the MCAT will barely scrape by on the boards. Using my SAT score as a predictor, I should have gotten a 28 on the MCAT but really I scored much higher than that. Even if they can "just pass" they can still go on to practice medicine. I hardly think anyone who can pass the USMLE is unintelligent.

 

[DrBowtie]

They are statistically more likely to score lower on their exams, yes, but they are still very very likely to pass the exams. This correlation does not mean that everyone who got a 25 on the MCAT will barely scrape by on the boards. Using my SAT score as a predictor, I should have gotten a 28 on the MCAT but really I scored much higher than that. Even if they can "just pass" they can still go on to practice medicine. I hardly think anyone who can pass the USMLE is unintelligent.

I added onto my post you quoted.
I would like to see your comments on the addition.

 

[LadyJubilee8_18]

Another study correlated MCAT performance to performance in the first two years and on the USMLE.

By drawing conclusions wouldn't that mean that most likely the people who score lower on the MCAT score lower on their exams?

Also, it seems that clinical years don't determine the quality of the physician since you are still not in the leadership role.

Residency performance would much better correlate to your term "poorer clinicians"

That's probably true, residency data would serve us better than assuming the MCAT determines achievement in all facets of medicine. I also think that at a certain point, high MCAT scores have diminishing marginal returns. Maybe there's a big difference between a 25 and a 28 but is there really much of a difference between a 35 and a 38? Is the student with the 38 much more qualified? I wish I had the full study about thresholds, but I don't want to pay $24. I'm broke

 

[bananaface]

For FP, there are two types of patients it seems.
The people who have a cold, want their Z pack and want to get on their way b/c they are busy.

The others are the "boutique" patients that want to spend a lot of time with their doc and establish a relationship.

PA's or NP's could def. serve the first type.

Hell, I could serve the first type. No antibiotics for you! Move along!

 

[DrBowtie]

That's probably true, residency data would serve us better than assuming the MCAT determines achievement in all facets of medicine. I also think that at a certain point, high MCAT scores have diminishing marginal returns. Maybe there's a big difference between a 25 and a 28 but is there really much of a difference between a 35 and a 38? Is the student with the 38 much more qualified? I wish I had the full study about thresholds, but I don't want to pay $24. I'm broke

No doubt there is diminishing return. In verbal the difference between a few points can be only 5% more correct.

 

[bananaface]

You know, Brett, I've read your post before in other threads on SDN and I always thought you were an ass. Even though I'm pretty sure you don't agree with AA, you haven't been disrespectful at all. It turns out, you're a really reasonable and intelligent guy. I am also very impressed with bananaface (even though she doesn't agree with AA either). Guess this thread is also dispelling a few myths about SDNers.

edit: sorry bananaface

 

[LadyJubilee8_18]

No doubt there is diminishing return. In verbal the difference between a few points can be only 5% more correct.

I think this also takes away from the "highest score wins" notion. At a certain point, I think its safe to say that student will make a quality physician. Filling a class with 40+ MCATers who have few non-numerical qualifications or who are not very diverse (ethnically or otherwise) is probably not more effective than admitting students with slightly lower scores who are more well-rounded.

 

[DrBowtie]

I think this also takes away from the "highest score wins" notion. At a certain point, I think its safe to say that student will make a quality physician. Filling a class with 40+ MCATers who have few non-numerical qualifications or who are not very diverse (ethnically or otherwise) is probably not more effective than admitting students with slightly lower scores who are more well-rounded.

What scale are you measuring this "effective" quality?

 

[LadyJubilee8_18]

What scale are you measuring this "effective" quality?

I guess by effective I mean a physician population that is culturally competent, well educated, empathetic, and competent. In my book, "effective" means as close to ideal as possible.