Doesn't affirmative action enhance stereotypes in admissions?

[raindropx]

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The only problem is, this action is against the law.
The plans you are referring to are approved by legislative houses, affirmative action for medical school has NEVER been approved. I believe it is highly unfair to applicants, and race/ethnicity should not be considered in the admission process.

well it should be approved as there is research showing that patients feel more comfortable with same-race health care providers as mentioned above.

 

[ranob]

well it should be approved as there is research showing that patients feel more comfortable with same-race health care providers as mentioned above.

"Research" shows patients feel more comfortable when their doctors perform unnecessary tests on them and prescribe them unnecessary treatments. Seriously, please stop with the "patients feel" arguments. The job description is to provide the highest standard of care, not trick patients into thinking they're receiving higher quality care when they're actually not. That's what quacks do. Are you an allopathic premed or aren't you?

 

[raindropx]

"Research" shows patients feel more comfortable when their doctors perform unnecessary tests on them and prescribe them unnecessary treatments. Seriously, please stop with the "patients feel" arguments. The job description is to provide the highest standard of care, not trick patients into thinking they're receiving higher quality care when they're actually not. That's what quacks do. Are you an allopathic premed or aren't you?

Lol this has to be the most ignorant post in this entire thread. Also, please don't talk about research after your previous post you tried to delete where Goro called you out. The job of a health care provider is to make patients feel more comfortable so that accurate patient history and information can be obtained. Of course this makes a huge difference in the level of patient care. Why the hell do you think communication skills are so emphasized? If patients "feelings" did not matter, then we could make robot premeds into doctors and not think twice.

 

[efle]

"Research" shows patients feel more comfortable when their doctors perform unnecessary tests on them and prescribe them unnecessary treatments. Seriously, please stop with the "patients feel" arguments. The job description is to provide the highest standard of care, not trick patients into thinking they're receiving higher quality care when they're actually not. That's what quacks do. Are you an allopathic premed or aren't you?

The patient having a better experience can translate into better health via means other than the placebo effect. In the extreme cases rapport/trust in the physician will change things like whether someone finishes their bout of antibiotics as instructed vs stopping at the disappearance of symptoms to save pills to stockpile, or even taking the pills at all. Willingness to go to the doctor in the first place is perhaps the biggest issue. Race is integral for some people in these scenarios.

And, tone down the condescension, you're wrong far too often to really pull it off

 

[Goro]

Dx: loose cannon
TX: apply Ignore function. You won't feel a thing.

"Research" shows patients feel more comfortable when their doctors perform unnecessary tests on them and prescribe them unnecessary treatments. Seriously, please stop with the "patients feel" arguments. The job description is to provide the highest standard of care, not trick patients into thinking they're receiving higher quality care when they're actually not. That's what quacks do. Are you an allopathic premed or aren't you?

 

[efle]

Dx: loose cannon
TX: apply Ignore function. You won't feel a thing.

Never grow up, Goro 😉

 

[Goro]

Never grow up, Goro 😉

 

[ranob]

Lol this has to be the most ignorant post in this entire thread. Also, please don't talk about research after your previous post you tried to delete where Goro called you out. The job of a health care provider is to make patients feel more comfortable so that accurate patient history and information can be obtained. Of course this makes a huge difference in the level of patient care. Why the hell do you think communication skills are so emphasized? If patients "feelings" did not matter, then we could make robot premeds into doctors and not think twice.

Communication skills are essential to gain information about the patient in order to treat them most effectively. Beyond that, needless conversation is actually discouraged, since the goal is to spend as little time as possible on each patient while still providing them with high quality healthcare. You know, the whole scarce resource thing. Also you might be surprised to learn how big a role "robots" and other such technologies play in surgery...

Dx: loose cannon
TX: apply Ignore function. You won't feel a thing.

I'm kind of surprised you're posting in this thread in the first place. Surely you have better things to do. Feel free ignore me, although you'd probably be better off ignoring this entire thread. There's not a whole lot of useful information in it.

The patient having a better experience can translate into better health via means other than the placebo effect. In the extreme cases rapport/trust in the physician will change things like whether someone finishes their bout of antibiotics as instructed vs stopping at the disappearance of symptoms to save pills to stockpile, or even taking the pills at all. Willingness to go to the doctor in the first place is perhaps the biggest issue. Race is integral for some people in these scenarios.

And, tone down the condescension, you're wrong far too often to really pull it off

Doctors need to turn people away constantly because they're fully booked with patients. But of course, the problem is too few people are willing to go to the doctor. If only we could convince the kind of people that distrust doctors to show up. They would never think of not finishing their bout of antibiotics, now would they? While we're at it, the doctor better make sure that his patients aren't drinking underage. Or hanging out with the wrong crowd. That's clearly part of the job description and is exactly what he signed up for. To help people with their personal problems.

 

[PREDOCSIMP]

Communication skills are essential to gain information about the patient in order to treat them most effectively. Beyond that, needless conversation is actually discouraged, since the goal is to spend as little time as possible on each patient while still providing them with high quality healthcare. You know, the whole scarce resource thing. Also you might be surprised to learn how big a role "robots" and other such technologies play in surgery...


I'm kind of surprised you're posting in this thread in the first place. Surely you have better things to do. Feel free ignore me, although you'd probably be better off ignoring this entire thread. There's not a whole lot of useful information in it.


Doctors need to turn people away constantly because they're fully booked with patients. But of course, the problem is too few people are willing to go to the doctor. If only we could convince the kind of people that distrust doctors to show up. They would never think of not finishing their bout of antibiotics, now would they? While we're at it, the doctor better make sure that his patients aren't drinking underage. Or hanging out with the wrong crowd. That's clearly part of the job description and is exactly what he signed up for. To help people with their personal problems.

"They would never think of not finishing their bout of antibiotics, now would they? While we're at it, the doctor better make sure that his patients aren't drinking underage. Or hanging out with the wrong crowd. That's clearly part of the job description and is exactly what he signed up for. To help people with their personal problems. "

I am missing the point of this section in your post, care to elaborate?

I am not demeaning it, but seriously think that you might pretending to being sarcastic.
please understand 🙂

 

[raindropx]

"They would never think of not finishing their bout of antibiotics, now would they? While we're at it, the doctor better make sure that his patients aren't drinking underage. Or hanging out with the wrong crowd. That's clearly part of the job description and is exactly what he signed up for. To help people with their personal problems. "

I am missing the point of this section in your post, care to elaborate?

I am not demeaning it, but seriously think that you might pretending to being sarcastic.
please understand 🙂

stop trying to understand a troll

 

[ranob]

"They would never think of not finishing their bout of antibiotics, now would they? While we're at it, the doctor better make sure that his patients aren't drinking underage. Or hanging out with the wrong crowd. That's clearly part of the job description and is exactly what he signed up for. To help people with their personal problems. "

I am missing the point of this section in your post, care to elaborate?

I am not demeaning it, but seriously think that you might pretending to being sarcastic.
please understand 🙂

No problem. I'll provide a non-sarcastic response below:

The patient having a better experience can translate into better health via means other than the placebo effect. In the extreme cases rapport/trust in the physician will change things like whether someone finishes their bout of antibiotics as instructed vs stopping at the disappearance of symptoms to save pills to stockpile, or even taking the pills at all. Willingness to go to the doctor in the first place is perhaps the biggest issue. Race is integral for some people in these scenarios.

And, tone down the condescension, you're wrong far too often to really pull it off

I do not see willingness to go to the doctor in the first place as an issue. Many people are unwilling to go to doctors because they distrust them. These same people are the ones who, when forced to go by others, will refuse to follow their doctors' instructions, because they don't trust them. Resulting in suboptimal outcomes. For instance, the anti-vac crowd. No matter how many doctors you force them to see, they're still going to refuse vaccinations. Instead of forcing them to see a doctor, which wastes both their time and the doctor's time, you should let them be. That way, when they decide of their own volition to see a doctor, they will be much more likely to follow the doctor's advice. Doctors should spend their time treating patients that want to be treated instead of chasing after the ones that don't. You want someone to talk to about personal issues, go to a priest/counselor/whatever. You want medical treatment, go to a doctor.

 

[efle]

There is a difference between a physician being able to book a few days solid ahead of time, and people staying home for long periods suffering from the onset of diabetes or arterial diseases or several rounds of respiratory infection or other readily managed disorders.

You are right that it is often the patient's fault. They behave stupidly, irresponsibly, sometimes even as racists and bigots. They choose to stay home. This does not change the moral prerogative to bring health and happiness to as many people as possible. Would you refuse to pull the bullet out of a drug dealing gang member that rolled into your ER? Your role is to heal, without judgement.

 

[raindropx]

There is a difference between a physician being able to book a few days solid ahead of time, and people staying home for long periods suffering from the onset of diabetes or arterial diseases or several rounds of respiratory infection or other readily managed disorders.

You are right that it is often the patient's fault. They behave stupidly, irresponsibly, sometimes even as racists and bigots. They choose to stay home. This does not change the moral prerogative to bring health and happiness to as many people as possible. Would you refuse to pull the bullet out of a drug dealing gang member that rolled into your ER? Your role is to heal, without judgement.

but what of someone convicted of serious crimes such as murder

 

[ZedsDed]

but what of someone convicted of serious crimes such as murder

"Healing without judgement" is a given in this profession. I believe all of us need to accept this, period.

 

[efle]

but what of someone convicted of serious crimes such as murder

Not your concern. The legal system deals punishment, not you.

 

[ranob]

Race is integral for some people in these scenarios

There is a difference between a physician being able to book a few days solid ahead of time, and people staying home for long periods suffering from the onset of diabetes or arterial diseases or several rounds of respiratory infection or other readily managed disorders.

You are right that it is often the patient's fault. They behave stupidly, irresponsibly, sometimes even as racists and bigots. They choose to stay home. This does not change the moral prerogative to bring health and happiness to as many people as possible. Would you refuse to pull the bullet out of a drug dealing gang member that rolled into your ER? Your role is to heal, without judgement.

A doctor's role is to heal those that want to be healed. I will never refer my black patients to inferior black specialists just because they have better communication skills and can use their race to establish rapport/trust with the patients. I will refer all of them to the highest quality specialists I know, regardless of race. If that results in worse outcomes for a few of them, so be it. It is their choice whether to follow their doctors' recommendations or not. I don't believe in providing minorities with inferior treatment options compared to whites just because that way, they're more willing to follow through on the treatment resulting in more lives saved overall (keeping in mind, the individual lives saved in each case are different).

It seems you have no such reservations, what with your moral prerogative to bring health and happiness to as many people as possible, regardless of whether or not they even want your help in the first place. If a drug dealer demands I help assist him in suicide, I see no reason to bother saving his life, only for him to commit suicide (without my help) right after.

"Healing without judgement" is a given in this profession. I believe all of us need to accept this, period.

Yup. Always heal before judging. When the patient solicits your help.

 

[Holmwood]

but what of someone convicted of serious crimes such as murder

Be the physician we need but do not deserve....

BE BATMAN.

 

[efle]

The people who stay home do not do so because they desire to suffer. They do it because they do not believe they will get relief from going to get care, they do not trust physicians they see as an Other to do anything but take their money. If you can coax them in by providing someone with their skin color, you do so, because that does a better job of preventing their suffering. If someone truly understands and believes that a treatment will help them, and they then refuse it, of course I have no grounds to force it on them - because then it is not bringing them a way to happiness, it is bringing them unhappiness.

I will never refer my black patients to inferior black specialists just because they have better communication skills and can use their race to establish rapport/trust with the patients...

This argument is terrifically misguided. The patients are not malicious or immoral. They are not advancing some self-destructive racist agenda. They act as they do out of fear and ignorance and a long history of abuse. You don't need to be the best specialist in the world to prescribe some antibiotics for a bad case of pneumonia. An anywhere near decent doctor will make the diagnosis, and what matters then is if the patients trust that the instructions will help them.

Honestly you sort of read as a moral satire. "It's most moral to provide healthcare to the highest bidders" "It's their own damn fault if minorities distrust ORM physicians, I'd see them suffer for it rather than depart at all from meritocracy" "Patients must not want to be healed if they are not going to white doctors". Medicine simply is just not built as you cast it. It is not meant to be given as reward to students for being smart or hardworking, or intended to reward patients for having money, or the right opinions about other races.

 

[ranob]

If you can coax them in by providing someone with their skin color, you do so, because that does a better job of preventing their suffering.

I didn't sign up to be a doctor to reinforce the racist behavior of racists. That's not part of my job description. If you're a racist, either get with the times, or find another doctor to help you out. In this day and age, racism is not considered to be acceptable behavior. And that's exactly what providing racist patients with someone of their skin color does: it helps reinforce their racist fears. The better approach is to refer them to the most qualified specialist. That way, if they care about their health, they just might listen to you, receive treatment, and overcome any racist fears due to the positive experience they have with this specialist. Win-win.

If someone truly understands and believes that a treatment will help them, and they then refuse it, of course I have no grounds to force it on them - because then it is not bringing them a way to happiness, it is bringing them unhappiness.

Happiness and health are not always compatible. Sometimes, you have to make your patient suffer to cure them. Like with chemo. It's great when the two are compatible, but if you prioritize happiness over health when they're not, you're not much of a doctor. You're just a quack then. Sounds like you'd be up for giving terminally ill patients herbal remedies costing tens of thousands of dollars because that'll give them hope and make them happy. And have no other impact on their health whatsoever.

This argument is terrifically misguided. The patients are not malicious or immoral. They are not advancing some self-destructive racist agenda. They act as they do out of fear and ignorance and a long history of abuse. You don't need to be the best specialist in the world to prescribe some antibiotics for a bad case of pneumonia. An anywhere near decent doctor will make the diagnosis, and what matters then is if the patients trust that the instructions will help them.

Ignorance does not excuse racism. Sorry. It's easy to get informed. If you actually believe that the skill level of the surgeon does not matter to the patient undergoing surgery, then you are terribly ignorant. Get informed on surgery outcomes. They vary from surgeon to surgeon by a lot, for the exact same surgery. Surgery is not the only field in which this is the case either.

Honestly you sort of read as a moral satire. "It's most moral to provide healthcare to the highest bidders" "It's their own damn fault if minorities distrust ORM physicians, I'd see them suffer for it rather than depart at all from meritocracy" "Patients must not want to be healed if they are not going to white doctors". Medicine simply is just not built as you cast it. It is not meant to be given as reward to students for being smart or hardworking, or intended to reward patients for having money, or the right opinions about other races.

I have two words for you: invisible hand. My moral views take into account human nature. The way people act instead of the way they ought to act, they way you'd like them to act. You come across as overly idealistic to me though, with your single payer system and free government-provided healthcare for all arguments. Oh, and the whole spiel about how you'd personally accept a pay cut as a doctor to reduce the cost of healthcare. I agree it would be great if we could cure all ailments, but ultimately, healthcare's scarcity necessitates a market (a market, not necessarily a free one). Meaning talent absolutely is rewarded (in terms of pay), and patients absolutely benefit from having money (they can pay for experimental/expensive treatments not available to the general public even under your single payer system). And yes, the invisible hand does act on those with the wrong opinions about other races (an excellent euphemism for "racists") to punish them. This cannot be prevented without banning people from paying for healthcare.

I have a feeling you'll change your mind on a lot of these issues after med school. Or after taking intro economics.

"Patients must not want to be healed if they are not going to white doctors"

Racism is often incompatible with health care. If you want quality care, and all the black dermatologists are on vacation or busy seeing patients, you're going to have to see a white one. There's no getting around that fact. If you let racist fears get in the way of your desire to seek help, that means you don't really want to be healed and doctors shouldn't waste their time on you, especially when there are tons of other patients currently requesting the doctors' services.

 

[raindropx]

I didn't sign up to be a doctor to reinforce the racist behavior of racists. That's not part of my job description. If you're a racist, either get with the times, or find another doctor to help you out. In this day and age, racism is not considered to be acceptable behavior. And that's exactly what providing racist patients with someone of their skin color does. The better approach is to refer them to the most qualified specialist. That way, if they care about their health, they just might listen to you, receive treatment, and overcome any racist fears due to the positive experience they have with this specialist. Win-win.



Happiness and health are not always compatible. Sometimes, you have to make your patient suffer to cure them. Like with chemo. It's great when the two are compatible, but if you prioritize happiness over health when they're not, you're not much of a doctor. You're just a quack then. Sounds like you'd be up for giving terminally ill patients herbal remedies costing tens of thousands of dollars because that'll give them hope and make them happy. And have no other impact on their health whatsoever.



Ignorance does not excuse racism. Sorry. It's easy to get informed. If you actually believe that the skill level of the surgeon does not matter to the patient undergoing surgery, then you are terribly ignorant. Get informed on surgery outcomes. They vary from surgeon to surgeon by a lot, for the exact same surgery. Surgery is not the only field in which this is the case either.



I have two words for you: invisible hand. My moral views take into account human nature. The way people act instead of the way they ought to act, they way you'd like them to act. You come across as overly idealistic to me though, with your single payer system and free government-provided healthcare for all arguments. Oh, and the whole spiel about how you'd personally accept a pay cut as a doctor to reduce the cost of healthcare. I agree it would be great if we could cure all ailments, but ultimately, healthcare's scarcity necessitates a market (a market, not necessarily a free one). Meaning talent absolutely is rewarded (in terms of pay), and patients absolutely benefit from having money (they can pay for experimental/expensive treatments not available to the general public even under your single payer system). And yes, the invisible hand does act on those with the wrong opinions about other races (an excellent euphemism for "racists") to punish them. This cannot be prevented without banning people from paying for healthcare.

I have a feeling you'll change your mind on a lot of these issues after med school. Or after taking intro economics.


Racism is often incompatible with health care. If you want quality care, and all the black dermatologists are on vacation or busy seeing patients, you're going to have to see a white one. There's no getting around that fact. If you let racist fears get in the way of your desire to seek help, that means you don't really want to be healed and doctors shouldn't waste there time on you, especially when there are tons of other patients currently requesting the doctors' services.

Honestly you keep harping on about job description but hopefully you never become a physician..your opinions are disturbing

 

[ranob]

Honestly you keep harping on about job description but hopefully you never become a physician..your opinions are disturbing

If you say so. It seem I have offended your sensibilities. A pity.

 

[raindropx]

If you say so. It seem I have offended your sensibilities. A pity.

yes, I do say so. Go into a job where you don't work with people. weirdo

 

[ranob]

yes, I do say so. Go into a job where you don't work with people. weirdo

Might I ask which portion of my post you found offensive? Or would that be too presumptuous of me, what with your sensibilities offended and all.

 

[raindropx]

Might I ask which portion of my post you found offensive? Or would that be too presumptuous of me, what with your sensibilities offended and all.

Too many to count. Maybe the one where you wonder why anyone would support a health care system where doctors' salaries are reduced, or where you think AA is promoting racism, or how you think only the highest bidder deserves quality health care (lol), or how y0u can't comprehend that minorities feel most comfortable with their own race people and that's why AA would benefit them in healthcare. Take your pick.

 

[efle]

I didn't sign up to be a doctor to reinforce the racist behavior of racists. That's not part of my job description. If you're a racist, either get with the times, or find another doctor to help you out. In this day and age, racism is not considered to be acceptable behavior. And that's exactly what providing racist patients with someone of their skin color does: it helps reinforce their racist fears. The better approach is to refer them to the most qualified specialist. That way, if they care about their health, they just might listen to you, receive treatment, and overcome any racist fears due to the positive experience they have with this specialist. Win-win.



Happiness and health are not always compatible. Sometimes, you have to make your patient suffer to cure them. Like with chemo. It's great when the two are compatible, but if you prioritize happiness over health when they're not, you're not much of a doctor. You're just a quack then. Sounds like you'd be up for giving terminally ill patients herbal remedies costing tens of thousands of dollars because that'll give them hope and make them happy. And have no other impact on their health whatsoever.



Ignorance does not excuse racism. Sorry. It's easy to get informed. If you actually believe that the skill level of the surgeon does not matter to the patient undergoing surgery, then you are terribly ignorant. Get informed on surgery outcomes. They vary from surgeon to surgeon by a lot, for the exact same surgery. Surgery is not the only field in which this is the case either.



I have two words for you: invisible hand. My moral views take into account human nature. The way people act instead of the way they ought to act, they way you'd like them to act. You come across as overly idealistic to me though, with your single payer system and free government-provided healthcare for all arguments. Oh, and the whole spiel about how you'd personally accept a pay cut as a doctor to reduce the cost of healthcare. I agree it would be great if we could cure all ailments, but ultimately, healthcare's scarcity necessitates a market (a market, not necessarily a free one). Meaning talent absolutely is rewarded (in terms of pay), and patients absolutely benefit from having money (they can pay for experimental/expensive treatments not available to the general public even under your single payer system). And yes, the invisible hand does act on those with the wrong opinions about other races (an excellent euphemism for "racists") to punish them. This cannot be prevented without banning people from paying for healthcare.

I have a feeling you'll change your mind on a lot of these issues after med school. Or after taking intro economics.


Racism is often incompatible with health care. If you want quality care, and all the black dermatologists are on vacation or busy seeing patients, you're going to have to see a white one. There's no getting around that fact. If you let racist fears get in the way of your desire to seek help, that means you don't really want to be healed and doctors shouldn't waste their time on you, especially when there are tons of other patients currently requesting the doctors' services.

I've already addressed this. The key difference is that they are not seeking to oppress anyone; they are mistrustful due to past and continued wrongs. They are not immoral for behaving as they do, and do not deserve to be punished or allowed to suffer. Your logic of "let the racists die off for all I care" is punishing people who have not acted maliciously towards anyone.

I'm a consequentialist, a utilitarian, a hedonist by axiology. Happiness always wins, with healthiness as a means to it. Chemo makes sense when the net gain of happiness is positive in the cancer-free years that follow the pain of treatments. This is also why it does not make sense to force treatment; health that does not lead to happiness is not something to be protected.

If one of us is misinformed in this regard, it's you. Surgery is not the great issue faced in minority healthcare. Neither is any specialty, in fact. It is poor access and use of primary care that does the real damage, and primary care does not demand the very sharpest of minds to serve the communities well. As I mentioned before, we're talking about things like going with unmanaged diabetes or arterial diseases, not black patients coming into the ER and refusing to let an Asian pull out the bullet.

You speak as if you have not already been proved wrong by the success of the Scandinavian system. Their healthcare is both cheaper and better, and people share in equal quality of care. Doctors are salaried, with all specialties paying similarly, and primary care is highly sought and competitive while specialties like derm are less so, as it should be according to the importance of each in keeping society the healthiest. Their society is thriving and among the happiest on earth. Where is the Armageddon? How is their system failing? In what way has employing the ideals I have, gone wrong in this very clear and well documented case study of success with a single-payer system?

Again, it is not that they believe a white doctor will help, but choose not to go because he's white. They honestly do not think they will be treated well, dealt with honestly, helped. You are becoming redundant in some of these points. I do not know how I can make the reason your logic is flawed any clearer: They are not refusing to get help from a white person. Rather, they do not believe there is help to be found.

 

[ranob]

del

 

[mikil100]

Why is the thread title using the term affirmative action? Doesn't that have nothing to do with Medical schools selecting URM over ORM with better stats?

 

[raindropx]

Why is the thread title using the term affirmative action? Doesn't that have nothing to do with Medical schools selecting URM over ORM with better stats?

well that is the definition of AA.

 

[mikil100]

well that is the definition of AA.

But it has a completely different intention than what AA does in undergraduate institutions, right?

 

[raindropx]

I've already addressed this. The key difference is that they are not seeking to oppress anyone; they are mistrustful due to past and continued wrongs. They are not immoral for behaving as they do, and do not deserve to be punished or allowed to suffer. Your logic of "let the racists die off for all I care" is punishing people who have not acted maliciously towards anyone.

I'm a consequentialist, a utilitarian, a hedonist by axiology. Happiness always wins, with healthiness as a means to it. Chemo makes sense when the net gain of happiness is positive in the cancer-free years that follow the pain of treatments. This is also why it does not make sense to force treatment; health that does not lead to happiness is not something to be protected.

If one of us is misinformed in this regard, it's you. Surgery is not the great issue faced in minority healthcare. Neither is any specialty, in fact. It is poor access and use of primary care that does the real damage, and primary care does not demand the very sharpest of minds to serve the communities well. As I mentioned before, we're talking about things like going with unmanaged diabetes or arterial diseases, not black patients coming into the ER and refusing to let an Asian pull out the bullet.

You speak as if you have not already been proved wrong by the success of the Scandinavian system. Their healthcare is both cheaper and better, and people share in equal quality of care. Doctors are salaried, with all specialties paying similarly, and primary care is highly sought and competitive while specialties like derm are less so, as it should be according to the importance of each in keeping society the healthiest. Their society is thriving and among the happiest on earth. Where is the Armageddon? How is their system failing? In what way has employing the ideals I have, gone wrong in this very clear and well documented case study of success with a single-payer system?

Again, it is not that they believe a white doctor will help, but choose not to go because he's white. They honestly do not think they will be treated well, dealt with honestly, helped. You are becoming redundant in some of these points. I do not know how I can make the reason your logic is flawed any clearer: They are not refusing to get help from a white person. Rather, they do not believe there is help to be found.

Hold on, all specialties are paid the same? Do their hours matter at all? And wouldn't it lead to shortage of specialties where there is a worse work/life balance? I know that these individuals would have to be interested in the specialty to go into it, but the balance still matters no?

 

[raindropx]

del

at last, you made a wise decision

 

[ranob]

I'm a consequentialist, a utilitarian, a hedonist by axiology.

Enough said. I'm a deontologist. Lets just agree to disagree. Normally I'd like to continue this discussion, but I'd rather not offend raindropx's sensibilities any more, so lets just leave it at this. If it's alright with you though, I'd like to send you a PM later.

Edit:

No, say it publicly, I don't want to miss out on the fun. I'll control my sensibilities, promise

Quoted for the record. Not my fault if he's inadvertently offended again.

 

[raindropx]

Enough said. I'm a deontologist. Lets just agree to disagree. Normally I'd like to continue this discussion, but I'd rather not offend raindropx's sensibilities any more, so lets just leave it at this. If it's alright with you though, I'd like to send you a PM later though.

No, say it publicly, I don't want to miss out on the fun. I'll control my sensibilities, promise

 

[efle]

But it has a completely different intention than what AA does in undergraduate institutions, right?

Correct. In med admissions the aim is to provide minority doctors to serve minority patients, since many minority patients are less likely to seek and follow medical advice when it comes from a doctor that isn't their race.

For undergrad, it is practiced for 1) increasing representation of minorities in areas where they would otherwise be under-repped and 2) "Diversity"
In the case of 1, it is actually counterproductive to the stated aims. Sending minority students with lower academic readiness (test scores, grades, etc) in to compete against a student body of significantly higher ability causes a drastically higher weedout rate among the minority students. The best way to increase minority representation in areas like STEM is actually to remove AA and send them to places where they are of similar academic ability to their peers and will survive weedout in higher numbers. Source from this phenomenon observed at Duke, and it's also been studied in the UC system with similar conlcusion.

Hold on, all specialties are paid the same? Do their hours matter at all? And wouldn't it lead to shortage of specialties where there is a worse work/life balance? I know that these individuals would have to be interested in the specialty to go into it, but the balance still matters no?

The hours worked are also the same, and are technically 37 hours per week (many work more voluntarily, but only into the 40s, as workweeks of 50+ hours are considered basically insane and unethical over there). Interest is first and foremost in what people want to specialize in, and many many people want to work with high independence in a primary care setting rather than in hospitals looking at funky skin.

 

[raindropx]

Correct. In med admissions the aim is to provide minority doctors to serve minority patients, since many minority patients are less likely to seek and follow medical advice when it comes from a doctor that isn't their race.

For undergrad, it is practiced for 1) increasing representation of minorities in areas where they would otherwise be under-repped and 2) "Diversity"
In the case of 1, it is actually counterproductive to the stated aims. Sending minority students with lower academic readiness (test scores, grades, etc) in to compete against a student body of significantly higher ability causes a drastically higher weedout rate among the minority students. The best way to increase minority representation in areas like STEM is actually to remove AA and send them to places where they are of similar academic ability to their peers and will survive weedout in higher numbers. Source from this phenomenon observed at Duke, and it's also been studied in the UC system with similar conlcusion.


The hours worked are also the same, and are technically 37 hours per week (many work more voluntarily, but only into the 40s, as workweeks of 50+ hours are considered basically insane and unethical over there). Interest is first and foremost in what people want to specialize in, and many many people want to work with high independence in a primary care setting rather than in hospitals looking at funky skin.

Surgeon working 37 hours 😱
How do they stay on call. Maybe this is a good system as it also increases the number of doctors necessary and gives more jobs.
I would also rather go into primary than look at "funky skin"


Also, if everyone goes into specialty of interest, wouldn't it lead to shortage of those who have much higher malpractice or risk

 

[raindropx]

Enough said. I'm a deontologist. Lets just agree to disagree. Normally I'd like to continue this discussion, but I'd rather not offend raindropx's sensibilities any more, so lets just leave it at this. If it's alright with you though, I'd like to send you a PM later.

Edit:
Quoted for the record. Not my fault if he's inadvertently offended again.

she*

I'll make sure to use ignore function if it gets too much, no worries

 

[efle]

Enough said. I'm a deontologist. Lets just agree to disagree. Normally I'd like to continue this discussion, but I'd rather not offend raindropx's sensibilities any more, so lets just leave it at this. If it's alright with you though, I'd like to send you a PM later.

Edit:
Quoted for the record. Not my fault if he's inadvertently offended again.

Feel free. I've had many good debates on SDN that eventually turn into discussions of axiology/ethics. In this case I don't think being a deontologist is supportive of a different stance than being a consequentialist however, since the categorical imperative doesn't imply that racism should be met with passivity to suffering. Rather just the opposite - the behavior of the patients doesn't matter, even the rights of the most racist and ignorant bigots must be respected, and you must treat them as you would see all man treat each other. Being motivated by greatest happiness, and by utmost respect towards fellow man regardless of their behaviors, each point towards doing all you can to provide for those who are afraid and skeptical towards all but a small group of physicians.

 

[efle]

Surgeon working 37 hours 😱
How do they stay on call. Maybe this is a good system as it also increases the number of doctors necessary and gives more jobs.
I would also rather go into primary than look at "funky skin"


Also, if everyone goes into specialty of interest, wouldn't it lead to shortage of those who have much higher malpractice or risk

Same as we do call here, only fewer call shifts! Derm has its reputation for a good reason - nobody is that fascinated by leather

There is still competition, with some people simply not being able to go into their interest area and choosing other areas instead, much like here. PC is extremely competitive and very high quality, while specialties like derm there tend to be much more accessible. Essentially an inversion of what is seen here.

As an aside, both of you guys need to chill out and stop harshing my mellow. You can disagree with someone and even take some jabs at each other in good fun, no need to get flamed

 

[raindropx]

Same as we do call here, only fewer call shifts! Derm has its reputation for a good reason - nobody is that fascinated by leather

There is still competition, with some people simply not being able to go into their interest area and choosing other areas instead, much like here. PC is extremely competitive and very high quality, while specialties like derm there tend to be much more accessible. Essentially an inversion of what is seen here.

As an aside, both of you guys need to chill out and stop harshing my mellow. You can disagree with someone and even take some jabs at each other in good fun, no need to get flamed

This system actually ensures that we have around the right number of people in each specialty
and I'm not getting flamed! except in the literal fever sense lol

 

[ranob]

Too many to count. Maybe the one where you wonder why anyone would support a health care system where doctors' salaries are reduced, or where you think AA is promoting racism, or how you think only the highest bidder deserves quality health care (lol)

I don't think AA is promoting racism. In fact, I support AA for med schools. On the other hand, I do believe racists are promoting AA. Make of that what you will.

how y0u can't comprehend that minorities feel most comfortable with their own race people and that's why AA would benefit them in healthcare

Again, I support AA. I get that minorities feel most comfortable with people of their own race. I have no wish to punish them for that. The invisible hand thinks differently however. The many whites that pick top doctors without taking race into outcome, receive top tier treatment. Blacks that pick top tier black doctors, also receive top tier treatment. Those that blindly follow the advice of underqualified black doctors (and refuse to see white specialists), on the other hand, receive worse treatment than their white counterparts. In this way, they are punished by the invisible hand.

I've already addressed this. The key difference is that they are not seeking to oppress anyone; they are mistrustful due to past and continued wrongs. They are not immoral for behaving as they do, and do not deserve to be punished or allowed to suffer. Your logic of "let the racists die off for all I care" is punishing people who have not acted maliciously towards anyone.

I guess I should clarify: I wouldn't be punishing anyone here. I'd merely be protecting my own integrity by referring all my patients to the same top-tier specialists instead of referring minorities to lower-tier minority specialists. To do otherwise would be racist on my behalf. If this ends up harming the patients, blame it on the invisible hand. Even if they "do not deserve to be punished or allowed to suffer," there's nothing anyone can do about it short of forcing doctors to provide different treatments to different races, which, ironically enough, lends credence to the arguments of those that believe that minorities receive inferior treatment. I'm curious if and how you'd justify forcing doctors to refer minority patients to minority specialists under utilitarian ethics.

If one of us is misinformed in this regard, it's you. Surgery is not the great issue faced in minority healthcare. Neither is any specialty, in fact. It is poor access and use of primary care that does the real damage, and primary care does not demand the very sharpest of minds to serve the communities well. As I mentioned before, we're talking about things like going with unmanaged diabetes or arterial diseases, not black patients coming into the ER and refusing to let an Asian pull out the bullet.

The argument regarding specialist referrals can be applied to primary care just as easily. Surgery was just an example. I see how under a consequential framework, you could justify advising black people to see a black primary care provider with limited skills since more patients would show up to see the PCP, resulting in better outcomes overall. However, looking at it deontologically, it's more important to save lives that want to be saved than those that don't. Point being, if you advised the same black people in the previous example to see a more skilled, white PCP instead, then very few would show up. Suppose very early stage cancer was detected in one of the patients by the PCP. The kind of cancer that can easily pass by undetected and would not have been found by the black PCP. In this case, I consider it a better deal to save the life of that one patient than diagnosing the others that did not show up, since this patient cared about their health much more than the others (if they really cared, they would've shown up). For this reason, I don't feel that doctors (or anyone, really) should be giving out "racist" advice on which PCPs to see because on an individual level, it directly harms those that care about their health and are not irrationally fearful of seeing a PCP from another race. As doctors it is particular egregious because it is expected that they will refer patients to the best medical practitioners they know, given their credentials and the hippocratic oath.

You speak as if you have not already been proved wrong by the success of the Scandinavian system. Their healthcare is both cheaper and better, and people share in equal quality of care. Doctors are salaried, with all specialties paying similarly, and primary care is highly sought and competitive while specialties like derm are less so, as it should be according to the importance of each in keeping society the healthiest. Their society is thriving and among the happiest on earth. Where is the Armageddon? How is their system failing? In what way has employing the ideals I have, gone wrong in this very clear and well documented case study of success with a single-payer system?

Denmark and the US are different countries. I don't doubt that your ideals are ideal. I do, however, doubt that enough doctors are as willing to act against their own self-interests as raindropx and you, seeing as what you're proposing necessitates lower salaries for them. Along with all the other people that have vested interests (insurance companies, etc)

Again, it is not that they believe a white doctor will help, but choose not to go because he's white. They honestly do not think they will be treated well, dealt with honestly, helped. You are becoming redundant in some of these points. I do not know how I can make the reason your logic is flawed any clearer: They are not refusing to get help from a white person. Rather, they do not believe there is help to be found.

Sounds to me like you're just making excuses for their ignorance. Fact is, they have a higher chance of being treated well, dealt with honestly, and helped if they pick a white doctor than if they pick a URM one. If they do not believe there is help to be found, period, then there's not much anyone can do for them. Actually there is something that can be done. They can be convinced to set aside their fears and give doctors of other races a chance. Or you can refer them to a URM doctor. You're not really enabling their ignorance; you're just looking out for their best interests. That's the ticket. They'll have a much more pleasant experience communicating with the doctor too, even if he messes up the diagnosis.

 

[efle]

I don't think AA is promoting racism. In fact, I support AA for med schools. On the other hand, I do believe racists are promoting AA. Make of that what you will.



Again, I support AA. I get that minorities feel most comfortable with people of their own race. I have no wish to punish them for that. The invisible hand thinks differently however. The many whites that pick top doctors without taking race into outcome, receive top tier treatment. Blacks that pick top tier black doctors, also receive top tier treatment. Those that blindly follow the advice of underqualified black doctors (and refuse to see white specialists), on the other hand, receive worse treatment than their white counterparts. In this way, they are punished by the invisible hand.



I guess I should clarify: I wouldn't be punishing anyone here. I'd merely be protecting my own integrity by referring all my patients to the same top-tier specialists instead of referring minorities to lower-tier minority specialists. To do otherwise would be racist on my behalf. If this ends up harming the patients, blame it on the invisible hand. Even if they "do not deserve to be punished or allowed to suffer," there's nothing anyone can do about it short of forcing doctors to provide different treatments to different races, which, ironically enough, lends credence to the arguments of those that believe that minorities receive inferior treatment. I'm curious if and how you'd justify forcing doctors to refer minority patients to minority specialists under utilitarian ethics.



The argument regarding specialist referrals can be applied to primary care just as easily. Surgery was just an example. I see how under a consequential framework, you could justify advising black people to see a black primary care provider with limited skills since more patients would show up to see the PCP, resulting in better outcomes overall. However, looking at it deontologically, it's more important to save lives that want to be saved than those that don't. Point being, if you advised the same black people in the previous example to see a more skilled, white PCP instead, then very few would show up. Suppose very early stage cancer was detected in one of the patients by the PCP. The kind of cancer that can easily pass by undetected and would not have been found by the black PCP. In this case, I consider it a better deal to save the life of that one patient than diagnosing the others that did not show up, since this patient cared about their health much more than the others (if they really cared, they would've shown up). For this reason, I don't feel that doctors (or anyone, really) should be giving out "racist" advice on which PCPs to see because on an individual level, it directly harms those that care about their health and are not irrationally fearful of seeing a PCP from another race. As doctors it is particular egregious because it is expected that they will refer patients to the best medical practitioners they know, given their credentials and the hippocratic oath.



Denmark and the US are different countries. I don't doubt that your ideals are ideal. I do, however, doubt that enough doctors are as willing to act against their own self-interests as raindropx and you, seeing as what you're proposing necessitates lower salaries for them. Along with all the other people that have vested interests (insurance companies, etc)



Sounds to me like you're just making excuses for their ignorance. Fact is, they have a higher chance of being treated well, dealt with honestly, and helped if they pick a white doctor than if they pick a URM one. If they do not believe there is help to be found, period, then there's not much anyone can do for them. Actually there is something that can be done. They can be convinced to set aside their fears and give doctors of other races a chance. Or you can refer them to a URM doctor. You're not really enabling their ignorance; you're just looking out for their best interests. That's the ticket. They'll have a much more pleasant experience communicating with the doctor too, even if he messes up the diagnosis.

We agree here. I thought earlier you were supporting removal of AA and felt that no care for racist patients > care for racist patients through departure from true meritocracy.

I don't believe in forcing doctors to refer any certain way. Again this is not an issue so much with referral though. The biggest problems are from people with extremely common, easily diagnosed, easily managed diseases staying home instead of going to PC, and if having same-race PC available makes them more likely to go, it is pretty clear how utilitarian ethics would want to require that same-race PC be available.

I would challenge you to find me some evidence of black PCPs doing a worse job of diagnosing early cancer, or a multitude of other problems (early COPD, onset of dementia, whatever). I don't think we can take for granted that a few points lower MCATs makes for primary care physicians less able to handle the very basics. And again it's a bit of a moot point because I think your core argument, "it's more important to save lives that want to be saved than those that don't" rings false. This requires that they know they can be saved or better treated and opt not to because of the physician race. It's instead that they don't think they will be helped. Those expressing this behavior clearly do still want to be helped/saved, because they do seek help when they can see a same-race physician, and thus can believe they will be treated well and helped.

I again agree that doctors are not willing to act against their interest, just like industry in the early industrial era was not willing to act against their interests to stop employing children for such long shifts in factories that they couldn't attend school. We needed change then, intervention from the rest of society to enact labor laws, and I view healthcare similarly. It's broken now, serving too few and doing too little with each dollar. I don't expect those benefiting to change things from the inside, I expect society to force change from without.

They do not actually have a higher chance of being treated well, dealt with honestly, etc. Don't have time to find right now but one study that comes to mind found that white physicians, when speaking to minority patients, were less likely to explain their rational for prescribing something or to explain how what was prescribed worked. It is not entirely perceived differences in treatment. Some differences are there.

 

[ranob]

I don't believe in forcing doctors to refer any certain way. Again this is not an issue so much with referral though. The biggest problems are from people with extremely common, easily diagnosed, easily managed diseases staying home instead of going to PC, and if having same-race PC available makes them more likely to go, it is pretty clear how utilitarian ethics would want to require that same-race PC be available.

Seems we've reached the same conclusion in different ways. You're looking at it from the perspective of the patient, while I'm considering that of the doctor (having URM doctors increases minority trust in all doctors and in the medical system overall). It seems you're also unwilling to go one step further and mandate URM doctors practice in areas with minorities.

I would challenge you to find me some evidence of black PCPs doing a worse job of diagnosing early cancer, or a multitude of other problems (early COPD, onset of dementia, whatever). I don't think we can take for granted that a few points lower MCATs makes for primary care physicians less able to handle the very basics. And again it's a bit of a moot point because I think your core argument, "it's more important to save lives that want to be saved than those that don't" rings false. This requires that they know they can be saved or better treated and opt not to because of the physician race. It's instead that they don't think they will be helped. Those expressing this behavior clearly do still want to be helped/saved, because they do seek help when they can see a same-race physician, and thus can believe they will be treated well and helped.

Fair enough. Saving lives that first and foremost wish to be saved and saving those that are more concerned with the race of the person treating them than with getting help are usually compatible goals, at least in primary care. However sometimes, under extenuating circumstance, it's necessary to prioritize one over the other. It seems you're fine with this in surgery and other such fields, but make an exception for primary care because skill level isn't as important there.

They do not actually have a higher chance of being treated well, dealt with honestly, etc. Don't have time to find right now but one study that comes to mind found that white physicians, when speaking to minority patients, were less likely to explain their rational for prescribing something or to explain how what was prescribed worked. It is not entirely perceived differences in treatment. Some differences are there.

It's a cascading effect. Those that come in with lower mcat scores often score worse on USMLE exams. Those that score worse on USMLE exams often proceed to perform worse on patients. 13% of blacks and 19% of latinos prefer to avoid minority physicians. For comparison, just 11% of whites prefer to avoid white physicians[1]. The reason so many minorities avoid minority physicians, despite being able to communicate better with them, just might have something to do with the fact that they have a higher chance of being treated well and dealt with honestly, when sticking to white physicians. If you happen to find any studies to the contrary, feel free to share them.

[1]http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1466852/

 

[efle]

It would be detrimental to mandate anything, as people could end up absolutely miserable and hating their lives, with crushing debt forcing them to continue working in an area / with people they don't care for. There must always be the option to change your mind. I think the best system is to very heavily select for people that have demonstrated a desire to serve the underserved, without locking them into it, and that is exactly what's practiced at a lot of programs such as the HBCs.

It's more that the same effect isn't seen in surgery or specialties than any notions I have about skill levels. Black people don't say "no thanks Dr. Asian, please leave the femur sticking out until a black surgeon can get here". It's a special case for PC because the most burdensome diseases are very slow in onset, allowing a long span where people begin to feel progressively more suffering but not acutely enough to rush in to see anybody they can. This is the period where it's critical to encourage people to seek medical advice / attend yearly checkups and actually listen to the doctor etc, as the diseases are so much more cost-effectively managed and the lifespan so much more prolonged if they can be caught early.

That same study makes my counterargument for me: awareness of AA may drive more avoidance of minority doctors, but this portion desiring to avoid is dwarfed by the portion preferring to match in race. And in the former case (unlike the latter) there is really no issue presented by the preference, as ORM doctors are so ubiquitous; people demanding ORM doctors still have their needs met just fine with AA in place.

 

[Womb Raider]

You speak as if you have not already been proved wrong by the success of the Scandinavian system. Their healthcare is both cheaper and better, and people share in equal quality of care. Doctors are salaried, with all specialties paying similarly, and primary care is highly sought and competitive while specialties like derm are less so, as it should be according to the importance of each in keeping society the healthiest. Their society is thriving and among the happiest on earth. Where is the Armageddon? How is their system failing? In what way has employing the ideals I have, gone wrong in this very clear and well documented case study of success with a single-payer system?

LOL another person comparing the Scandinavian health care system to America. You can't compare the two...

A) Let's look for a second at the population of these countries.
Norway: 5 million
Sweden: 9.5 million
Denmark 5.6 million
America: 320 million

These systems are contingent on having a small, manageable population. Let's not also forget about the plethora of illegals here in the US driving up costs.

B) Socialism might work if our leaders / politicians weren't corrupt slimeballs. Unfortunately they are. Do you see this changing anytime soon? That's what I thought.

C) Last, and probably most important - people in Scandinavia aren't nearly as fat as Americans. The average family there doesn't go buy 10 big macs with xtra-large fries and drink soda 24/7. You can't eat hot dogs and drink coke and have cheap health care.

I'm tired of hearing this BS praising other health care systems. If America adopted the Scandinavian system we'd still be screwed.

Sure, it doesn't seem right that people should go bankrupt when they get cancer. But it also doesn't seem right that everyone should be paying for people to live longer who treat their bodies like absolute crap. Scandinavia isn't there yet (Europe is getting fatter, it'll hit them eventually).

 

[raindropx]

LOL another person comparing the Scandinavian health care system to America. You can't compare the two...

A) Let's look for a second at the population of these countries.
Norway: 5 million
Sweden: 9.5 million
Denmark 5.6 million
America: 320 million

These systems are contingent on having a small, manageable population. Let's not also forget about the plethora of illegals here in the US driving up costs.

B) Socialism might work if our leaders / politicians weren't corrupt slimeballs. Unfortunately they are. Do you see this changing anytime soon? That's what I thought.

C) Last, and probably most important - people in Scandinavia aren't nearly as fat as Americans. The average family there doesn't go buy 10 big macs with xtra-large fries and drink soda 24/7. You can't eat hot dogs and drink coke and have cheap health care.

I'm tired of hearing this BS praising other health care systems. If America adopted the Scandinavian system we'd still be screwed.

Why specifically wouldn't it work for a larger population?

 

[efle]

LOL another person comparing the Scandinavian health care system to America. You can't compare the two...

A) Let's look for a second at the population of these countries.
Norway: 5 million
Sweden: 9.5 million
Denmark 5.6 million
America: 320 million

These systems are contingent on having a small, manageable population. Let's not also forget about the plethora of illegals here in the US driving up costs.

B) Socialism might work if our leaders / politicians weren't corrupt slimeballs. Unfortunately they are. Do you see this changing anytime soon? That's what I thought.

C) Last, and probably most important - people in Scandinavia aren't near as fat as Americans. The average family there doesn't go buy 10 big macs with xtra-large fries and drink soda 24/7. You can't eat hot dogs and drink coke and have cheap health care.

I'm tired of hearing this BS praising other health care systems. If America adopted the Scandinavian system we'd still be screwed.

I've lived in Scandinavia. The cultural differences are not the ultimate stopping force that some free market fans try to claim. I agree in addition to purely administrative / insurance changes you'd want to add much more progressive and transparent politics and anti obesity measures like sugar tax, greater school related activity/sports, etc, plus lowered work hours, subsidy for healthy foods, and increased membership in the SES groups that can afford to eat well. We would do well to adopt more than just singlepayer. Size is a very odd argument to make, I don't really see how that changes much about how a given hospital would operate and bill.

 

[efle]

And if course the most obvious response: you may very well be right that things like greater numbers of illegals would hold us back from ever hitting Scandinavian levels, but that's irrelevant. All that matters is that it would be a huge advancement from how things are now. Still screwed, maybe, but less screwed.

 

[ranob]

It would be detrimental to mandate anything, as people could end up absolutely miserable and hating their lives, with crushing debt forcing them to continue working in an area / with people they don't care for. There must always be the option to change your mind. I think the best system is to very heavily select for people that have demonstrated a desire to serve the underserved, without locking them into it, and that is exactly what's practiced at a lot of programs such as the HBCs.

Agreed. For the record, SES has absolutely nothing to do with demonstrating this desire.

It's more that the same effect isn't seen in surgery or specialties than any notions I have about skill levels. Black people don't say "no thanks Dr. Asian, please leave the femur sticking out until a black surgeon can get here". It's a special case for PC because the most burdensome diseases are very slow in onset, allowing a long span where people begin to feel progressively more suffering but not acutely enough to rush in to see anybody they can. This is the period where it's critical to encourage people to seek medical advice / attend yearly checkups and actually listen to the doctor etc, as the diseases are so much more cost-effectively managed and the lifespan so much more prolonged if they can be caught early.

Seems the difference in opinion is a matter of degree. Seems you agree that if (hypothetically, this is unlikely to actually happen) black patients were to refuse emergency treatment from white surgeons. Then the hospital would be perfectly justified in prioritizing the lives of the white patients that the black surgeons were currently operating on rather than pulling one aside and forcing him to operate on the black patients. Justified in providing other patients that are willing to undergo surgery right away instead of waiting for a black surgeon, and consequentially have higher odds of survival, with more hospital resources.

The difference is, I care about the hypothetical patients harmed by bad policy even when they don't exist. Because I'm a deontologist, not a consequentialist. So if black people were to ask me for advice regarding good PCPs, I'd refer them to the best PCPs I knew. Even if they were not black. Because as a deontologist, I care more for that hypothetical person that would benefit from such advice (in the 13% of blacks or 19% of latinos), no matter how little he benefits from it (yes, I understand it's more difficult to find URM doctors than white ones) and even if he doesn't end up existing, than for all the ignorant minorities that would suffer suboptimal outcomes due to such advice (their ignorance has consequences. I see it as immoral to attempt to mitigate the impact of their ill-conceived choices, when doing so could potentially negatively impact non-ignorant minorities (in other words, any benefits to ignorant minorities members would come at the expense of non-ignorant ones). As mentioned earlier, if they want to, it's easy for them to get informed and stop being ignorant).

This argument is obviously predicated upon the assertion that minorities have as good or better chances of being treated well (strictly in a medical context), dealt with honestly, and helped (again, strictly in a medical context) if they pick a white doctor instead of a URM one. In the absence of evidence either way, we'll just have to agree to disagree on whether the perception that minorities experience substandard treatment at the hands of white doctors is ignorant or factual. Although it does beg the question: do you personally see doctors that are of the same race as yourself, or is this the kind of argument you make on forums exclusively?

it would be a huge advancement from how things are now

Not for doctors it wouldn't. The current system is far superior as far as physician salaries are concerned. Most doctors care quite a bit about their salaries

 

[Krabbeman]

Agreed. For the record, SES has absolutely nothing to do with demonstrating this desire.

are you low SES?

 

[efle]

Agreed. For the record, SES has absolutely nothing to do with demonstrating this desire.



Seems the difference in opinion is a matter of degree. Seems you agree that if (hypothetically, this is unlikely to actually happen) black patients were to refuse emergency treatment from white surgeons. Then the hospital would be perfectly justified in prioritizing the lives of the white patients that the black surgeons were currently operating on rather than pulling one aside and forcing him to operate on the black patients. Justified in providing other patients that are willing to undergo surgery right away instead of waiting for a black surgeon, and consequentially have higher odds of survival, with more hospital resources.

The difference is, I care about the hypothetical patients harmed by bad policy even when they don't exist. Because I'm a deontologist, not a consequentialist. So if black people were to ask me for advice regarding good PCPs, I'd refer them to the best PCPs I knew. Even if they were not black. Because as a deontologist, I care more for that hypothetical person that would benefit from such advice (in the 13% of blacks or 19% of latinos), no matter how little he benefits from it (yes, I understand it's more difficult to find URM doctors than white ones) and even if he doesn't end up existing, than for all the ignorant minorities that would suffer suboptimal outcomes due to such advice (their ignorance has consequences. I see it as immoral to attempt to mitigate the impact of their ill-conceived choices, when doing so could potentially negatively impact non-ignorant minorities (in other words, any benefits to ignorant minorities members would come at the expense of non-ignorant ones). As mentioned earlier, if they want to, it's easy for them to get informed and stop being ignorant).

This argument is obviously predicated upon the assertion that minorities have as good or better chances of being treated well (strictly in a medical context), dealt with honestly, and helped (again, strictly in a medical context) if they pick a white doctor instead of a URM one. In the absence of evidence either way, we'll just have to agree to disagree on whether the perception that minorities experience substandard treatment at the hands of white doctors is ignorant or factual. Although it does beg the question: do you personally see doctors that are of the same race as yourself, or is this the kind of argument you make on forums exclusively?


Not for doctors it wouldn't. The current system is far superior as far as physician salaries are concerned. Most doctors care quite a bit about their salaries

Iirc, identifying with a race and being from lower SES both strongly predict returning to serve those demographics.

I would not agree with the hospital in this hypothetical, though I agree a deontologist would.

As I mentioned, there is evidence that there is substandard treatment. My healthcare assigns me my PC doc (HMO) and I have never switched.

It's not required to be bad news for doctors. Their egalitarian ideology leads to extremely flat wages, but that's not necessarily attached to the idea of an insurance revamp. Physician compensation is a very tiny fraction of healthcare expenses, and switching to singlepayer while keeping doc compensation the same would still be a huge improvement.

Time matters so much more than money beyond middle class for happiness for many people