Does your medical school have sickening liberal indoctrination?

[SGuttenberg]

all of the conservative posters here are white men, rich or see medicine as a ticket to wealth.

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[410322]

all of the conservative posters here are white men, rich or see medicine as a ticket to wealth.

Congratulations. This post is even stupider than the "I'm a 4.0/40 MCAT but I think my numbers are too low!!!" posts on SDN.

 

[D elegans]

This thread is clearly headed for

 

[goldenwest]

all of the conservative posters here are white men, rich or see medicine as a ticket to wealth.

 

[Siverhideo1985]

Has anyone really gotten anything out of this thread? Except maybe some narcissistic pleasure over their own mental masturbation and subsequently perceived intellectual superiority over the previous poster?

 

[goldenwest]

Has anyone really gotten anything out of this thread? Except maybe some narcissistic pleasure over their own mental masturbation and subsequently perceived intellectual superiority over the previous poster?

Was there ever any hope of getting anything out of this thread? Aren't you guilty of what you're accusing other posters of?

 

[FIREitUP]

True, but I'll echo it to give you some merit. That said, there is certainly a whole lot of carebear nonsense going on in the first two years of med school that I could do without. If you're not at least able to feign empathy at this point, you're probably antisocial.

yes, this is extremely painful. try to make me into an empathetic human being by requiring lectures and then destroy my empathetic inclinations during third year. makes sense.

 

[NickNaylor]

Hmmm, what would the projects be like in a conservative, affluent, white, male medical school?

-Mammography access near Saks Fifth Avenue on North Michican
-For profit clinics in Chicago
-Indian Hill Golf Club historians
-Erectile dysfunction and other chronic pain diseases
-Whole Foods pantry
-Incarcerated bankers of Chicago

All of this whining about "proselytizing" is unnecessary when you consider several things:

1. The job of the medical profession, as a whole, is to provide medical care to the populace.
2. Underserved groups and areas, including poor neighborhoods and prisons, are the proverbial low-hanging fruit in terms of maximizing impact with minimal investment of resources.
3. Academic medical centers are the biggest players in providing this care, because nobody else is going to step in and do it.
4. Hence, said academic medical centers will actually enable you to someday go into private practice and totally wash your hands of the unwashed masses.

In summary, STFU.

Did you even read my post? I mean, seriously.

 

[NickNaylor]

I'm unsure of what you mean. Are you saying that the fact that black populations have a lower mean socioeconomic status is directly tied to racism? Unless of course you mean that it's the shadow casted from a previous history of racism. With that I agree, but I don't think you can say it's due to present racism.

I think a lower average level of education is directly tied to the increased rate of infant mortality. I don't believe, however, that the lower average level of education is due to present racism. Sure, it's a factor, but how can you quantify that? I obviously don't know what it's like to be black so I'm talking out of my ass, but I've witnessed black preference in my lifetime. Black athletes are preferred. URM students are preferred. I think Obama's race was undoubtedly a factor in his election. For many people it may have been more of a factor than his political ideas. Of course I'm glad that the pendulum has swung, and I'm not ready to say that it's swung too far. I certainly agree that the low socioeconomic status of blacks is in large part due to past racism. The other part would have to do with anthropology involving hereditary economic regression and the fact that races tend to marry themselves which in some cases means the poor proliferate the poor and the rich proliferate the rich.

Oh I have no idea what the causes are, be they racism or something else. However, I find it pretty fascinating that minorities in general, and blacks in particular, are nearly ALWAYS at the bottom in terms of nearly every societal marker: socioeconomic status, level of education, risk for health issues, to name a few. Even when minorities seemingly have the same opportunities as whites, they still don't seem to take advantage of those opportunities, for whatever reason. One study we were shown, for example, demonstrated that blacks utilized significantly less healthcare compared to whites when both groups were given identical levels of insurance coverage and individuals with similar diseases were compared between groups. In other words, lack of coverage/accessibility and genetic disposition for various diseases were largely controlled for, yet a difference/disparity was STILL present that resulted in better outcomes for whites compared to blacks.

Again, I really don't know what the causes are - I'm no sociologist. But studies like that indicate to me that some factor that is very racially biased has a large impact on health outcomes and, I'm sure, other aspects of life.

 

[goldenwest]

Oh I have no idea what the causes are, be they racism or something else. However, I find it pretty fascinating that minorities in general, and blacks in particular, are nearly ALWAYS at the bottom in terms of nearly every societal marker: socioeconomic status, level of education, risk for health issues, to name a few. Even when minorities seemingly have the same opportunities as whites, they still don't seem to take advantage of those opportunities, for whatever reason. One study we were shown, for example, demonstrated that blacks utilized significantly less healthcare compared to whites when both groups were given identical levels of insurance coverage and individuals with similar diseases were compared between groups. In other words, lack of coverage/accessibility and genetic disposition for various diseases were largely controlled for, yet a difference/disparity was STILL present that resulted in better outcomes for whites compared to blacks.

Again, I really don't know what the causes are - I'm no sociologist. But studies like that indicate to me that some factor that is very racially biased has a large impact on health outcomes and, I'm sure, other aspects of life.

Eh, sociology is mostly speculation anyway, so I'll bite. I think it's about fighting against the factors you're born into. I know blacks still encounter racism today, but it's nothing like it used to be. The main factor to overcome for many blacks is simply the fact that they do come from humble beginnings (poverty, parents with limited or no education, gang life in some instances, etc). That's one of the reasons URM exists - it's hard to pull yourself up out of the low end. For example, if you had a middle class white person and an impoverished black person with the exact same intelligence and they were both applying for a job, simply the likelihood that the white person's parents went to college, had money to buy him/her nice clothes for the interview, and taught him/her the general do's and do nots of business interaction puts the white person in a favorable situation. Of course I'm talking in vast generalizations here... it could be the exact opposite depending on the persons. The point is that because blacks have always been on the low end of those statistics it's hard to recover.

 

[phltz]

Oh I have no idea what the causes are, be they racism or something else. However, I find it pretty fascinating that minorities in general, and blacks in particular, are nearly ALWAYS at the bottom in terms of nearly every societal marker: socioeconomic status, level of education, risk for health issues, to name a few. Even when minorities seemingly have the same opportunities as whites, they still don't seem to take advantage of those opportunities, for whatever reason. One study we were shown, for example, demonstrated that blacks utilized significantly less healthcare compared to whites when both groups were given identical levels of insurance coverage and individuals with similar diseases were compared between groups. In other words, lack of coverage/accessibility and genetic disposition for various diseases were largely controlled for, yet a difference/disparity was STILL present that resulted in better outcomes for whites compared to blacks.

Again, I really don't know what the causes are - I'm no sociologist. But studies like that indicate to me that some factor that is very racially biased has a large impact on health outcomes and, I'm sure, other aspects of life.

This seems like the perfect example of just the sort of thing that doctors should be made aware of in their training.

 

[Siverhideo1985]

Was there ever any hope of getting anything out of this thread? Aren't you guilty of what you're accusing other posters of?

actually if you look at the three posts I have in this thread...I did get something out of it...if nothing more than a contact in a specialty that I am interested in

But, please, continue the overall argument. Clearly, it is getting somewhere now.

 

[NickNaylor]

This seems like the perfect example of just the sort of thing that doctors should be made aware of in their training.

Exactly - and I'm now aware of that due to our rather broad disparities course. I have no problem learning about these things in a lecture. Why is it necessary to go on these field trips to poor clinics, hospitals, etc. and/or complete these projects that are more or less a dumbed down version of community activism when you've already showed me that disparities exist via peer-reviewed articles and given me possible sources for those disparities, though?

I have no problem learning about disparities. I just think it's a bit ridiculous that, in order to pass our disparities course, we have to be involved in what falls just short of social activism, in my opinion. The former is helpful and informative. The latter seems over-the-top, and I struggle to find the necessity for it other than guilt tripping you into demonstrating that disparities exist - something we've been made keenly aware of over the last few weeks through many lectures on various disparities issues - and yelling, "SEE, SEE, THESE DISPARITIES EXIST, LOOK AT HOW HORRIBLE THIS IS, YOU SHOULD DEDICATE YOUR LIFE TO FIXING THIS."

 

[Slack3r]

Oh I have no idea what the causes are, be they racism or something else. However, I find it pretty fascinating that minorities in general, and blacks in particular, are nearly ALWAYS at the bottom in terms of nearly every societal marker: socioeconomic status, level of education, risk for health issues, to name a few. Even when minorities seemingly have the same opportunities as whites, they still don't seem to take advantage of those opportunities, for whatever reason. One study we were shown, for example, demonstrated that blacks utilized significantly less healthcare compared to whites when both groups were given identical levels of insurance coverage and individuals with similar diseases were compared between groups. In other words, lack of coverage/accessibility and genetic disposition for various diseases were largely controlled for, yet a difference/disparity was STILL present that resulted in better outcomes for whites compared to blacks.

Again, I really don't know what the causes are - I'm no sociologist. But studies like that indicate to me that some factor that is very racially biased has a large impact on health outcomes and, I'm sure, other aspects of life.

May have a cultural component as well. Generally speaking, Hispanic cultures, primarily Latin Americans, are distrusting of doctors. They also seem to have a "suck-it-up" mentality in lieu of seeking medical care.

 

[Crow King]

Did you even read my post? I mean, seriously.

awww, the doc didn't like what you said.

So you should, like, you know, STFU.

Hey doc, we ain't in the hospital right now. Shove it up your ass.

 

[Jack is Back]

Oh I have no idea what the causes are, be they racism or something else. However, I find it pretty fascinating that minorities in general, and blacks in particular, are nearly ALWAYS at the bottom in terms of nearly every societal marker: socioeconomic status, level of education, risk for health issues, to name a few. Even when minorities seemingly have the same opportunities as whites, they still don't seem to take advantage of those opportunities, for whatever reason. One study we were shown, for example, demonstrated that blacks utilized significantly less healthcare compared to whites when both groups were given identical levels of insurance coverage and individuals with similar diseases were compared between groups. In other words, lack of coverage/accessibility and genetic disposition for various diseases were largely controlled for, yet a difference/disparity was STILL present that resulted in better outcomes for whites compared to blacks.

Again, I really don't know what the causes are - I'm no sociologist. But studies like that indicate to me that some factor that is very racially biased has a large impact on health outcomes and, I'm sure, other aspects of life.

I would guess it is socialization. Role models, leaders, stereotypes, etc. These all have an effect on behavior and psychology.

 

[Gut Shot]

Did you even read my post?

Unfortunately, yes.

 

[NickNaylor]

Unfortunately, yes.

And what exactly did you get out of it? Because it seems to me that you 1) didn't understand what I wrote, 2) selectively read what I wrote in an attempt to make me some like an elitist that doesn't care at all for health disparities, 3) are intentionally trying to start an argument, and/or 4) are dumb.

Your post seemed to imply that I don't think there's any value in the projects that I mentioned, or that I somehow don't think those things are important or relevant. I didn't say anything - or even imply anything - that supports that. In fact, if you had actually read my post, I said that I thought those things should be pursued by those that have an interest in social activism or want to do research in those areas because they ARE important things that should be looked into. I don't fit in either of those categories, however, and considering we get 2-3 hours of lecture per day on health disparities, these trips/projects seem superfluous and, to me, support an agenda of pushing social activism on students.

So what did your post have anything to do with any of that, again? Oh, sorry - I forgot that your status says "attending" and everything you say is the word of God. My bad.

 

[Gut Shot]

And what exactly did you get out of it? Because it seems to me that you 1) didn't understand what I wrote, 2) selectively read what I wrote in an attempt to make me some like an elitist that doesn't care at all for health disparities, 3) are intentionally trying to start an argument, and/or 4) are dumb.

Your post seemed to imply that I don't think there's any value in the projects that I mentioned, or that I somehow don't think those things are important or relevant. I didn't say anything - or even imply anything - that supports that. In fact, if you had actually read my post, I said that I thought those things should be pursued by those that have an interest in social activism or want to do research in those areas because they ARE important things that should be looked into. I don't fit in either of those categories, however, and considering we get 2-3 hours of lecture per day on health disparities, these trips/projects seem superfluous and, to me, support an agenda of pushing social activism on students.

Yeah, that's great and all, it's just hard to admit these things are "important" and "relevant" (see above) but simultaneously unworthy of inclusion as a miniscule portion of your medical school curriculum. It sounds more like your conservative sensibilities are quite fragile, and you are disappointed to discover that your profession isn't wall-to-wall country clubbers.

Oh, sorry - I forgot that your status says "attending" and everything you say is the word of God. My bad.

My status is attending because I am an attending. If you would like me to change it to something inaccurate so you won't be intimidated please let me know.

 

[2012mdc]

Exactly - and I'm now aware of that due to our rather broad disparities course. I have no problem learning about these things in a lecture. Why is it necessary to go on these field trips to poor clinics, hospitals, etc. and/or complete these projects that are more or less a dumbed down version of community activism when you've already showed me that disparities exist via peer-reviewed articles and given me possible sources for those disparities, though?

I have no problem learning about disparities. I just think it's a bit ridiculous that, in order to pass our disparities course, we have to be involved in what falls just short of social activism, in my opinion. The former is helpful and informative. The latter seems over-the-top, and I struggle to find the necessity for it other than guilt tripping you into demonstrating that disparities exist - something we've been made keenly aware of over the last few weeks through many lectures on various disparities issues - and yelling, "SEE, SEE, THESE DISPARITIES EXIST, LOOK AT HOW HORRIBLE THIS IS, YOU SHOULD DEDICATE YOUR LIFE TO FIXING THIS."

Just count your blessings that you do not attend my school. You would have died during M1

 

[NickNaylor]

Yeah, that's great and all, it's just hard to admit these things are "important" and "relevant" (see above) but simultaneously unworthy of inclusion as a miniscule portion of your medical school curriculum. It sounds more like your conservative sensibilities are quite fragile, and you are disappointed to discover that your profession isn't wall-to-wall country clubbers.

My status is attending because I am an attending. If you would like me to change it to something inaccurate so you won't be intimidated please let me know.

Because it serves almost no benefit. Why not make this stuff available on a volunteer basis? I'm sure MANY people would gladly volunteer to do work with these groups. I'd much rather have that time to myself to study or do other things that I'm interested in. Again, I don't need to be shown these things to believe they exist - they've got me hook, line, and sinker after their lectures. The rest of your post is nonsense and based on absolutely nothing except for your delusional idea that I'm attempting to be ignorant of the social context of medicine.

And trust me, the absolute last thing I feel from you is intimidation. Unfortunately becoming an attending doesn't preclude childish behavior in an otherwise civil discussion - I would expect much better from you.

 

[Gut Shot]

Because it serves almost no benefit. Why not make this stuff available on a volunteer basis? I'm sure MANY people would gladly volunteer to do work with these groups. I'd much rather have that time to myself to study or do other things that I'm interested in.

Yes, that describes a good chunk the medical school experience for all of us, but one man's baby is another man's bathwater. Instead of bleating about it in here, why not just absorb any useful information, use it to consider the validity of your own perspective, and quietly move on?

And trust me, the absolute last thing I feel from you is intimidation.

Good for you. So why bring up my status at all?

 

[2012mdc]

Why don't you just not show up to these things? Seems like you could just skip it. They going to kick you out or something?

At my school almost all of that type of stuff was required and much of it was graded. I personally enjoyed aspects of it but also wished it wasn't shoved down our throats

 

[phltz]

Because it serves almost no benefit. Why not make this stuff available on a volunteer basis? I'm sure MANY people would gladly volunteer to do work with these groups. I'd much rather have that time to myself to study or do other things that I'm interested in. Again, I don't need to be shown these things to believe they exist - they've got me hook, line, and sinker after their lectures. The rest of your post is nonsense and based on absolutely nothing except for your delusional idea that I'm attempting to be ignorant of the social context of medicine.

And trust me, the absolute last thing I feel from you is intimidation. Unfortunately becoming an attending doesn't preclude childish behavior in an otherwise civil discussion - I would expect much better from you.

After going through your anatomy lectures/atlas/textbook, do you still need to actually be shown a spinal cord in order to believe it exists?

 

[NickNaylor]

Why don't you just not show up to these things? Seems like you could just skip it. They going to kick you out or something?

Required attendance unfortunately. Really it doesn't bother me all that much - I mean, it's a little irritating, but I'm not fuming about it. I just brought it up because I thought this line of discussion was interesting.

After going through your anatomy lectures/atlas/textbook, do you still need to actually be shown a spinal cord in order to believe it exists?

Entirely different things, for very obvious reasons.

 

[Brigade4Radiant]

I'm unsure of what you mean. Are you saying that the fact that black populations have a lower mean socioeconomic status is directly tied to racism? Unless of course you mean that it's the shadow casted from a previous history of racism. With that I agree, but I don't think you can say it's due to present racism.

I think a lower average level of education is directly tied to the increased rate of infant mortality. I don't believe, however, that the lower average level of education is due to present racism. Sure, it's a factor, but how can you quantify that? I obviously don't know what it's like to be black so I'm talking out of my ass, but I've witnessed black preference in my lifetime. Black athletes are preferred. URM students are preferred. I think Obama's race was undoubtedly a factor in his election. For many people it may have been more of a factor than his political ideas. Of course I'm glad that the pendulum has swung, and I'm not ready to say that it's swung too far. I certainly agree that the low socioeconomic status of blacks is in large part due to past racism. The other part would have to do with anthropology involving hereditary economic regression and the fact that races tend to marry themselves which in some cases means the poor proliferate the poor and the rich proliferate the rich.

Why is it that black college graduates have higher unemployement rates compared to whites with the same GPA? You talk about URM advantage but why not bring up that black patients are less likely to get adequate healthcare? And what do you mean Black athletes are preferred? And Obama's race has played a factor in the amount of hatred he gets and in support.

Also white populations with low education levels do not have nearly as high as an infant mortality as predominatly black areas such as Memphis.

 

[goldenwest]

Why is it that black college graduates have higher unemployement rates compared to whites with the same GPA? You talk about URM advantage but why not bring up that black patients are less likely to get adequate healthcare? And what do you mean Black athletes are preferred? And Obama's race has played a factor in the amount of hatred he gets and in support.

Also white populations with low education levels do not have nearly as high as an infant mortality as predominatly black areas such as Memphis.

I think racism is a factor in each of those; I was never denying that. I was also talking specifically about that infant mortality chart that was posted. As far as athletics, I don't know much of anything for certain, but it's been expressed to me by more than one person that in their high school athletics programs they found it was hard to be white and successful in certain sports, even if you're good. Of course, a lot of people think they are better than they really are so that could be way off base. Also, those persons may be disgruntled racists. However, there is a common understanding amongst most people that blacks are often very athletic and skilled. I can see how that assumption could work in their favor in getting the starter position, etc.

I agree that Obama has received hatred as well as support due to his race. But while I agree that racism is still around and prevalent, I think that the pendulum has swung so that now racial tolerance is (along with being right) the trendy thing to do. I think people that support blacks just because they're black and homosexuals just because they're homosexual (other characteristics aside) now outnumber people that hate others just because they're black or homosexual. It's favorable to root for the "underdog" (though that's not what they should be, it is the common mindset). I don't have any numbers to support this, and perhaps my perspective is tainted by my main associations being with the educated. That's just what I've experienced.

As far as the comparison between poor black and white communities, I would like to see some numbers to see just how much different they are. I'm not surprised though that blacks have higher infant mortality rates in those instances and I would accredit that to many factors including racism.

 

[WellWornLad]

Free speech means filtering your own god-damned information for relevance. Liberals may whine, but only conservatives seem to regard just the exposure to different ideas as a punch in the face.

 

[NickNaylor]

Free speech means filtering your own god-damned information for relevance. Liberals may whine, but only conservatives seem to regard just the exposure to different ideas as a punch in the face.

There are *****s in all parts of the political spectrum. Believe it or not, there are liberal equivalents of Michelle Bachmann that call people who don't support nationalized healthcare stupid, uncompassionate, racist, etc..

Let's not be hyperbolic.

 

[sanityonleave]

First things first: SGuttenberg, please stop. As someone who considers themselves to be relatively liberal (though very moderate by med school standards), you're not doing the left-of-center crowd any favors by your nonsensical ranting (and you make it look like we're all that disconnected from reality).

I already said indoctrination is not the right term. It is bullying. That is really want I wanted to talk about. Although indoctrination is still applicable.

It started in the application process. Every school wants you to write an essay about the diversity you bring to their school or how much you value diversity.

I don't think diversity is a strength at all. Probably the greatest countries (economically, and DEFINITELY scientifically) from Europe and Asia are Germany and Japan. They are historically homogeneous societies with xenophobic tendencies. Even today.

Even skirting this issue on applications for the sake of being more honest on an admissions essay, you are expected to love diversity. I do not. This puts me at odds with a lot of people in the medical community (and liberal academia, and elsewhere of course).

This will get you labeled a racist or white supremacist (although today they are the same thing). The social consequences of this label are enormous.

Yea, I hate the fact that I can't be a white supremacist without being labeled racist...

How did we all skirt over the whole: I'm a white supremacist, and it frustrates me that I have to wait until I'm out of the medical education system to be openly racist? That comment should have run the thread on its own... At the risk of being part of the "sickening liberal indoctrination", I'm going to flat out say that as a white supremacist, you should not be allowed to be a physician. Unfortunately, that's not my call.

2) Evidence-Based Medicine...which is obviously "geared toward health economists, policymakers and managers, to whom it appears useful for measuring performance and rationing resources."

I hate it when they try and make us fool around with that pesky "science" in medical school. If what you meant was quality improvement or some iteration thereof, then you might have an argument. I still don't agree with you. EBM involves things like... not using steroids for Guillain-Barre because they haven't been shown to help, and using ACE inhibitors for SLE renal crises because it reduces mortality by 80%. I hope you're okay with EBM.

 

[Crow King]

Yea, I hate the fact that I can't be a white supremacist without being labeled racist...

How did we all skirt over the whole: I'm a white supremacist, and it frustrates me that I have to wait until I'm out of the medical education system to be openly racist? That comment should have run the thread on its own... At the risk of being part of the "sickening liberal indoctrination", I'm going to flat out say that as a white supremacist, you should not be allowed to be a physician. Unfortunately, that's not my call.

Do most white supremacists name themselves after Native American war heroes?

 

[Instatewaiter]

Free speech means filtering your own god-damned information for relevance. Liberals may whine, but only conservatives seem to regard just the exposure to different ideas as a punch in the face.

In this case, conservatives feel that jamming ideas down a class' throat is a punch in the face.

Now if a medical school did the same thing on the conservative side of things (for instance that nationalized health care is completely economically untenable and the ideas behind it- socialist in nature- have caused the economic crisis in Europe and in part the debt crisis in this country) you would have people up in arms and the press would be there in an instant. So don't give me this holier-than-thou bull****. Actually, it seems that liberals tend to have this attitude in general. Pragmatism tends to work better, because is is focused on functionality and economic tenability.

I still don't agree with you. EBM involves things like... not using steroids for Guillain-Barre because they haven't been shown to help, and using ACE inhibitors for SLE renal crises because it reduces mortality by 80%. I hope you're okay with EBM.

I think you mean scleroderma renal crisis. Perhaps you should actually read the EBM rather than pass judgment on others.

 

[Morsetlis]

Actually having to pay for medical school = conservative indoctrination

 

[sanityonleave]

In this case, conservatives feel that jamming ideas down a class' throat is a punch in the face.

Now if a medical school did the same thing on the conservative side of things (for instance that nationalized health care is completely economically untenable and the ideas behind it- socialist in nature- have caused the economic crisis in Europe and in part the debt crisis in this country) you would have people up in arms and the press would be there in an instant. So don't give me this holier-than-thou bull****. Actually, it seems that liberals tend to have this attitude in general. Pragmatism tends to work better, because is is focused on functionality and economic tenability.



I think you mean scleroderma renal crisis. Perhaps you should actually read the EBM rather than pass judgment on others.

You're right -- I screwed that up. My head's swimming a bit in the middle of neuro, so I apologize. That said, you didn't address my point at all. Do you really think EBM is a bad thing? I wasn't attempting to pass judgment, but I did come off that way. I think I was just stunned that someone really disliked the idea of evidence-based medicine. I can't imagine returning to a time in medicine where the way you treated patients was based on the way whoever trained you treated them and your personal experience and not based off of large scale research trials when possible.

 

[jdh71]

I think you mean scleroderma renal crisis. Perhaps you should actually read the EBM rather than pass judgment on others.

That was embarrassing.

 

[jdh71]

You're right -- I screwed that up. My head's swimming a bit in the middle of neuro, so I apologize. That said, you didn't address my point at all. Do you really think EBM is a bad thing? I wasn't attempting to pass judgment, but I did come off that way. I think I was just stunned that someone really disliked the idea of evidence-based medicine. I can't imagine returning to a time in medicine where the way you treated patients was based on the way whoever trained you treated them and your personal experience and not based off of large scale research trials when possible.

It's not the EMB is "bad" per se, it's just used wrongly much of the time and usually studies such a strictly controlled patient population as to be problematic at best to extrapolate out to all comers. Too many people allow it to be used to 1) take the thinking out of medicine, and 2) allow insurers and regulators dictate medical practice outside of proper context.

Any doc that can be replaced by a computer algorithm, should be.

Take a look at this recent study in the NEJM, it's on COPD exacerbations and steroids. What is the evidence telling us we should do here? It's not a trick question, nor am I looking for a "journal club" type of break down (though you are free to do so if you like) - this is not a "gotcha!". First blush. How do you read it?

 

[NickNaylor]

The paper supports COPD treatment with the drug.

Now what's the gotcha?

 

[jdh71]

The paper supports COPD treatment with the drug.

Now what's the gotcha?

Does it?

 

[Instatewaiter]

Do you really think EBM is a bad thing? I wasn't attempting to pass judgment, but I did come off that way. I think I was just stunned that someone really disliked the idea of evidence-based medicine. I can't imagine returning to a time in medicine where the way you treated patients was based on the way whoever trained you treated them and your personal experience and not based off of large scale research trials when possible.

That question wasn't originally directed at me- but to answer your question, often times it is used incorrectly and is often incomplete. Look at my location and my avatar to figure out where I am and then ask yourself if you think I have been trained to like EBM.

You'll realize that most of the treatments you will deliver as a doctor are not evidence based. So really, medicine is practiced very much based on how your mentors treat patients. Really Onc, the ICU and Cards are the places you will find a lot of EBM. Even there, most therapies aren't evidence based.

 

[NickNaylor]

Does it?

Did I miss somethint? I read the article on my phone on the bus. Me no get it.

 

[isoquin]

Crow King, when you say things like "you liberals" or make broad sweeping generalizations of a vague medical population deemed "those liberals" it sounds like bad movie script writing. I just watched Star Wars episode III the other day, and was speechless at the line "If you're not with me, then you're my enemy!" This is like 2nd grade reasoning. I would recommend you try to support a valid claim instead of name calling, whilst complaining about "bullying."

Is that you Glen Beck? Shouldnt you be stocking up on gold bullion and guns?

zing!

It started in the application process. Every school wants you to write an essay about the diversity you bring to their school or how much you value diversity.

Yes. Because diversity matters. Especially in medicine. Did you not realize that choosing a specialty is diversification? Did you not realize that you will be seeing a variety of cultures and backgrounds? If you are inexperienced with being able to deal with opinions that are different than your own, from people who look different than you, chances are you're not the strongest med school applicant. With that being said, I think it's a gross misinterpretation to only see diversity as which box you checked off under the field "Ethnicity." My class has lawyers, businessmen, physicists, nurses, etc, and it creates a fantastic diversity. Sometimes it's about what you can bring to the table. Because no, AdComs are not interested in having 100+ of the exact same med student.

I don't see you as racist for disliking diversity. I just think you are at a disadvantage to practice medicine in the real world compared to others who have better experience interacting with a diverse population.

So far I've read one example of this "liberal agenda" bullied into med students. I welcome you to try supporting your argument further with other examples or areas. You should however consider the fact that you have entered a career that demands professionalism, which means you need to leave your personal biases at the door.

 

[Instatewaiter]

First, any idiot can deal with people of other cultures/races. You know what it takes? Treating them like they are a person. Not exactly a news flash.

I hate to break your bubble but racial diversity doesn't matter. Diversity of ideas does. Sometimes that comes with racial diversity often it doesn't. Ironically, most universities are putting out students who think just like the professors and those who don't are chastised. It is one of the most impressive ironies- that universities are "interested" in diversity yet are stamping out true diversity in their students.

Almost every training program is full of a diverse patient populations. So you'll get the same experience with "the real world" whether you drink the cool-aid or not.

 

[jdh71]

Did I miss somethint? I read the article on my phone on the bus. Me no get it.

Look at table 2, let me know if you see anything interesting

 

[surftheiop]

First, any idiot can deal with people of other cultures/races. You know what it takes? Treating them like they are a person. Not exactly a news flash.

I hate to break your bubble but racial diversity doesn't matter. Diversity of ideas does. Sometimes that comes with racial diversity often it doesn't. Ironically, most universities are putting out students who think just like the professors and those who don't are chastised. It is one of the most impressive ironies- that universities are "interested" in diversity yet are stamping out true diversity in their students.

Almost every training program is full of a diverse patient populations. So you'll get the same experience with "the real world" whether you drink the cool-aid or not.

Just because you say it, doesn't make it true. Also I dont know about your experiences, but I seem to remember in undergrad all departments would have professors of with differing opinions about things and often their disagreements would be pretty well known. I even remember going to see a couple debates between professors about various topics.

 

[Jack is Back]

Sorry, but other than medical school faculty, no one in medicine gives two craps about "diversity." They may make practical adjustments to improve patient care (eg - learn Spanish), but the allure of diversity and tolerance dissipates pretty quickly once you get to residency.

You mean that you don't and most the people you know don't.

There are plenty of people who care about diversity.

Paul Farmer is a well respected physican who cares about diversity. Good thing people like him didn't buy into the philosophy you're selling. Good thing for the hundreds of thousands of lives he's impacted.

Your reality =/= everyone in medicine's

 

[Jack is Back]

Btw, I agree with the original idea that this stuff should be elective. You can't force people to be enthusiastic about service or equality, it has to be natural.

 

[surftheiop]

Btw, I agree with the original idea that this stuff should be elective. You can't force people to be enthusiastic about service or equality, it has to be natural.

Applying to medschool was optional, and these days medschools advertise their curriculum enough that you can know exactly what your getting into.

I liked Emory's interview day, I remember after we toured Grady one of our interviewers said "Serving these who might be impoverished, imprisoned, uneducated, violent, etc. is part of who we are at Emory, if that is not part of your goal in medical education, then don't come here"

(I ended up turning them down b/c of my wife's career, but I really appreciated how straightforward they were about what they value as an institution and it really "clicked" with me there)

 

[410322]

Just because you say it, doesn't make it true. Also I dont know about your experiences, but I seem to remember in undergrad all departments would have professors of with differing opinions about things and often their disagreements would be pretty well known. I even remember going to see a couple debates between professors about various topics.

And how often were you graded worse for having an opinion that directly opposed your professor/PhD's/TA's? Professors often want their students to share their same bias, or they'll neg you hard for it, brah.

 

[surftheiop]

And how often were you graded worse for having an opinion that directly opposed your professor/PhD's/TA's? Professors often want their students to share their same bias, or they'll neg you hard for it, brah.

I really never found this to be true, I think this is an excuse people who suck at writing make.

 

[Salpingo]

I feel that med school, by the clinical years, turns you either into a d-bag conservative or d-bag liberal. Or maybe just a d-bag somewhere in the middle of the spectrum. (Are we allowed to say d-bag? I need to re-read the terms of agreement).

You either see all the people with preventable illnesses crowding into the clinic and ER, and think to yourself "Why aren't these people preventing there illnesses?!? What's wrong with them?" or you think to yourself "These are people! Why isn't anyone preventing their illnesses?!?" I think I've swung from libertarian to socialist three or four times during the day, depending on how sweet/annoying the patient was.

Generally, the people that are stuck on the more individualist end of the spectrum end up in private practice, while the altruists end up in academics. So its no surprise that med school has a liberal swing.

That, and liberal doctors get sued less.