SCOTUS Decision

[deleted1135735]

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No one said white doctors are bad for black patients. Diversity improving patient outcomes is backed up by many studies.

Regarding your hypothetical, that’s not what anyone is saying either. Why deny something to a patient that would make them more comfortable? By your logic, should we stop making women patients feel comfortable by providing them with women OB/GYNs when requested? Patient comfort is an important part of treatment.

I personally think women preferring female OBGYN's and physician-patient race concordance are two completely different things. It's just practically instinctual for women to feel uncomfortable and maybe even unsafe when men are performing procedures that are so private and intimate to one's body in private areas; this instinct probably developed for our (women's) safety. I don't think the same argument can be made for race. Also, regarding OBGYN, naturally it is primarily women who are drawn to the field itself, for completely understandable reasons. That isn't the case with race. There are many fewer males going into OBGYN in the first place because they don't want to. I just don't think you can compare patient comfort when dealing with sex-specific private areas of the body to patient comfort related to the amount of melanin in one's skin.

 

[deleted1141182]

I personally think women preferring female OBGYN's and physician-patient race concordance are two completely different things. It's just practically instinctual for women to feel uncomfortable and maybe even unsafe when men are performing procedures that are so private and intimate to one's body in private areas; this instinct probably developed for our (women's) safety. I don't think the same argument can be made for race. Also, regarding OBGYN, naturally it is primarily women who are drawn to the field itself, for completely understandable reasons. That isn't the case with race. There are many fewer males going into OBGYN in the first place because they don't want to. I just don't think you can compare patient comfort when dealing with sex-specific private areas of the body to patient comfort related to the amount of melanin in one's skin.

Semantics.

 

[Just D.O. it]

Semantics.

No, it's really not. Sex is immutable, biological, and well defined. Race is a social construct. Being more comfortable receiving gynaecologic care from another woman seems quite instinctual.

Distrusting someone that is white is not as instinctual and the entire concept of "same race" vs "different race" is a subjective definition.

 

[deleted1141182]

No, it's really not. Sex is immutable, biological, and well defined. Race is a social construct. Being more comfortable receiving gynaecologic care from another woman seems quite instinctual.

Distrusting someone that is white is not as instinctual and the entire concept of "same race" vs "different race" is a subjective definition.

Do you know what else is instinctual? Feeling more comfortable around people that look like you. This is scientifically proven. Please read the literature.

 

[deleted1135735]

Do you know what else is instinctual? Feeling more comfortable around people that look like you. This is scientifically proven. Please read the literature.

But the issue is that females are not given explicit advantages when applying to OBGYN residencies purely because they are females. Males are not inherently disadvantaged in this regard either. The reason there are fewer male OBGYN's is because most men just simply choose to pursue other professions, most likely for their own comfort and their own interests. But with race, certain groups are getting huge advantages in college, medical school, and residency admissions purely because of their race. Not because of their socioeconomic status. Not because of their life experiences. Not because of the hardships they have personally faced, but purely because of their race. A lot of people take issue with that and you need to be able to understand why. Part of having discussions is understanding both points of view. I understand your viewpoints, I really do, and they have actually caused me to think critically a lot about things within even just the past 24 hours. But it seems that you're extremely resistant to considering other people's viewpoints, even in the slightest. For most controversial issues like these, there isn't "one right answer", but rather the true "right answer" is most likely a moderate stance between the two opposing viewpoints. I myself take a moderate stance on this; I think race should definitely matter for some applicants with life-experiences that are highly related to their race that prevented them from having equal educational opportunity (i.e. like Native Americans living on Indian reservations). But if you had equal educational opportunity compared to everyone else (i.e. going to a really expensive private school, having a parent who is a physician, etc.) I don't think it's fair to everyone else in the applicant pool to give you an advantage just because you may be of a certain race. You have to balance "fairness to patients" with "fairness to applicants", and right now there is not really a balance going on. Also to assume that to be "fair" to a minority patient you have to give them a minority doctor does not really make sense. Again, I believe race matters especially in certain circumstances. But you need to be able to maybe achieve a more balanced, moderate stance on things.

 

[Just D.O. it]

No one said white doctors are bad for black patients. Diversity improving patient outcomes is backed up by many studies.

Regarding your hypothetical, that’s not what anyone is saying either. Why deny something to a patient that would make them more comfortable? By your logic, should we stop making women patients feel comfortable by providing them with women OB/GYNs when requested? Patient comfort is an important part of treatment.

Regarding my hypothetical, you didn't actually give an answer. If it truly is about patient comfort and preference, then explain why my hypothetical white patient would likely be met with scorn.

Surveys proving that black people are more open and compliant with black doctors do not prove that we need less white doctors, and in fact, this initial concept suggests that the few studies indicating marginally better outcomes from same race doctors is likely not a result of anything in the physicians' medical decision making or sincerity.

It instead proves we need initiatives to help the public understand that white doctors are not less caring towards their patients due to race and we need to work on diminishing race based bias on BOTH ends.

I'm not disputing the studies at all, but it seems you are trying to pretend the only possible conclusion that can be drawn from the findings is the one you prefer, and that's simply not true.

 

[Just D.O. it]

Do you know what else is instinctual? Feeling more comfortable around people that look like you. This is scientifically proven. Please read the literature.

Cool. So what blood quantums would you suggest to make sure black applicants truly "look the part"? How about quotas based on skin darkness? If we are really here to maximize outcomes based on that premise why did we stop at a simple self-reported checkbox?

and once again, if it is about people who look like you, why is the hypothetical white patient not shown the same courtesy?

In fact, why not separate all industries by race so people can be more comfortable around those that "look like them".
couldve sworn they had a name for that....

 

[deleted1141182]

@Swimmer567 (sorry for some reason can’t quote your post)

I understand your points as well, but my point is that the two (helping SES and helping UiM) are not mutually exclusive. Maybe I have not expressed this enough, but there is room for both in admissions. Being Black and Mexican in the United States is an experience just as growing up poor is. Many of my Mexican friends of various SES have reported being pulled over and being given a hard time by police officers. These cultures are also fundamentally different in their value systems. Understanding these cultural differences and values helps a lot when trying to treat a patient who, say, may distrust the medical system due to past experiences or who doesn’t want to give up certain foods that are part of their culture. We don’t have to put down poor people to support UiM, we can do both, and schools take this into account by asking for financial info and the disadvantage statement.

 

[deleted1141182]

Cool. So what blood quantums would you suggest to make sure black applicants truly "look the part"? How about quotas based on skin darkness? If we are really here to maximize outcomes based on that premise why did we stop at a simple self-reported checkbox?

and once again, if it is about people who look like you, why is the hypothetical white patient not shown the same courtesy?

Did I pinch a nerve? You need to relax. We can agree to disagree.

 

[Just D.O. it]

Did I pinch a nerve? You need to relax. We can agree to disagree.

I'm not hostile or offended. I'm simply taking your stated premise to its logical conclusion and it seems that it's not making you look very smart.

 

[deleted1135735]

@Swimmer567 (sorry for some reason can’t quote your post)

I understand your points as well, but my point is that the two (helping SES and helping UiM) are not mutually exclusive. Maybe I have not expressed this enough, but there is room for both in admissions. Being Black and Mexican in the United States is an experience just as growing up poor is. Many of my Mexican friends of various SES have reported being pulled over and being given a hard time by police officers. These cultures are also fundamentally different in their value systems. Understanding these cultural differences and values helps a lot when trying to treat a patient who, say, may distrust the medical system due to past experiences or who doesn’t want to give up certain foods that are part of their culture. We don’t have to put down poor people to support UiM, we can do both, and schools take this into account by asking for financial info and the disadvantage statement.

I understand that race just by itself can create experiences, but in terms of medical school admissions, what really matters is educational opportunity. While you cite the example of being pulled over by police officers, I am not sure how that relates explicitly to educational opportunity. Also, if you are Black, you can absolutely be a victim of police brutality. But your chances of being a victim of this are much higher if you live in a segregated over-policed neighborhood, which statistically, generational African Americans are much more likely to face than wealthier African immigrants. I could say as a female I am much more likely to be a victim of violence in dating and relationships, but I don't think that means that I inherently deserve an advantage over everyone else because I am female. That doesn't mean that I think I deserve to be able to get into medical school with lower GPA's and MCAT's. Because facing violence in dating and relationships does not really relate at all to educational opportunity. However, there could be a case in which relationship violence did really affect me, and I could of course right about it in a personal statement and try to relate it to my other experiences (i.e. speaking from a hypothetical standpoint, volunteering at a women's shelter). But if a man experienced relationship violence and integrated that experience well into his essay, our two applications should absolutely be held to the same standard. My issue is that people are not getting advantages for their life experiences, but they are getting advantages because of their race. For example, consider the situation of an Asian applicant who's home was destroyed by a catastrophic weather event, and as a result, her family lost everything. Is this not as an impactful experience to her as someone "being given a hard time by police officers"? Again, it should be about the life experience itself, not one's race in many circumstances (although I have listed explicit examples many times in this discussion in which I think race should be used as an explicit factor when it relates to one's lack of educational opportunities, like for example a Native American living on an under-resourced Indian reservation with little school funding).

 

[deleted1141182]

I'm not hostile or offended. I'm simply taking your stated premise to its logical conclusion and it seems that it's not making you look very smart.

I don’t think you understand what “logical”, “conclusion”, or “offended” means. Read a book.

 

[deleted1141182]

I understand that race just by itself can create experiences, but in terms of medical school admissions, what really matters is educational opportunity. While you cite the example of being pulled over by police officers, I am not sure how that relates explicitly to educational opportunity. Also, if you are Black, you can absolutely be a victim of police brutality. But your chances of being a victim of this are much higher if you live in a segregated over-policed neighborhood, which statistically, generational African Americans are much more likely to face than wealthier African immigrants. I could say as a female I am much more likely to be a victim of violence in dating and relationships, but I don't think that means that I inherently deserve an advantage over everyone else because I am female. That doesn't mean that I think I deserve to be able to get into medical school with lower GPA's and MCAT's. Because facing violence in dating and relationships does not really relate at all to educational opportunity. However, there could be a case in which relationship violence did really affect me, and I could of course right about it in a personal statement and try to relate it to my other experiences (i.e. speaking from a hypothetical standpoint, volunteering at a women's shelter). But if a man experienced relationship violence and integrated that experience well into his essay, our two applications should absolutely be held to the same standard. My issue is that people are not getting advantages for their life experiences, but they are getting advantages because of their race. For example, consider the situation of an Asian applicant who's home was destroyed by a catastrophic weather event, and as a result, her family lost everything. Is this not as an impactful experience to her as someone "being given a hard time by police officers"? Again, it should be about the life experience itself, not one's race in many circumstances (although I have listed explicit examples many times in this discussion in which I think race should be used as an explicit factor when it relates to one's lack of educational opportunities, like for example a Native American living on an under-resourced Indian reservation with little school funding).

Sure. I agree with what you say completely. I’m not involved in admissions, so I can only speculate, but I think that story about the Asian applicant who lost everything would be particularly impactful. The problem is we don’t know how big a boost of UiM vs SES disadvantaged/tragic backstory is. The real problem is the curtain that’s pulled over the admissions process honestly.

 

[deleted1135735]

Sure. I agree with what you say completely. I’m not involved in admissions, so I can only speculate, but I think that story about the Asian applicant who lost everything would be particularly impactful. The problem is we don’t know how big a boost of UiM vs SES disadvantaged/tragic backstory is. The real problem is the curtain that’s pulled over the admissions process honestly.

I agree that a huge problem with this whole process (particularly with Harvard college admissions) is that these institutions's practices are shrouded in secrecy, which allows for affirmative action to be used without any checks or balances. But all it takes is one Google search to compare the differences in acceptance rates between Asians and African Americans for each GPA/MCAT combination. That's one of the issues I (and many people) have with affirmative action, is that it treats every single racial group as a monolith. No racial or ethnic group is a monolith. Med schools do this because it is easier for them and it allows for their virtue signaling and cosmetic diversity.

 

[jhekrubcw]

Regarding my hypothetical, you didn't actually give an answer. If it truly is about patient comfort and preference, then explain why my hypothetical white patient would likely be met with scorn.

Surveys proving that black people are more open and compliant with black doctors do not prove that we need less white doctors, and in fact, this initial concept suggests that the few studies indicating marginally better outcomes from same race doctors is likely not a result of anything in the physicians' medical decision making or sincerity.

It instead proves we need initiatives to help the public understand that white doctors are not less caring towards their patients due to race and we need to work on diminishing race based bias on BOTH ends.

I'm not disputing the studies at all, but it seems you are trying to pretend the only possible conclusion that can be drawn from the findings is the one you prefer, and that's simply not true.

The surveys are not meant to prove that we need less white doctors. It's just trying to show how URM feel more comfortable with doctors that look like them, which is fair since there is a history of them being treated badly in healthcare situations due to race. Even though medical schools are trying to increase URM becoming doctors, its not like they are taking over the majority of the class. ORM make up over 50% of classes. And how would the white patient be met with scorn?

 

[USN2MD]

An article that might add to this discussion. Also look at the included journal article by Dr Henderson. Think SES will be empathized more. Also diversity isn’t just economics and race, someone at Davis mentioned that they want to start being a leader for students with disabilities too.

Also there are 180+ med schools, no admission process is the same everywhere and I’d say some schools won’t change anything because they all ready don’t consider race in admissions.

How one medical school became remarkably diverse — without considering race in admissions

The UC-Davis medical school's class of 1972 was mostly white and male. The class of 2026 is among the most diverse in the nation — without race-based admissions.

www.statnews.com

 

[Just D.O. it]

An article that might add to this discussion. Also look at the included journal article by Dr Henderson. Think SES will be empathized more. Also diversity isn’t just economics and race, someone at Davis mentioned that they want to start being a leader for students with disabilities too.

Also there are 180+ med schools, no admission process is the same everywhere and I’d say some schools won’t change anything because they all ready don’t consider race in admissions.

How one medical school became remarkably diverse — without considering race in admissions

The UC-Davis medical school's class of 1972 was mostly white and male. The class of 2026 is among the most diverse in the nation — without race-based admissions.

www.statnews.com

Like how California schools have. Affirmative Action is actually banned for Californian public universities, but as long as a plaintiff can't prove an explicit racial quota they are still able to use proxies like income and regional background (like where in the state the applicant grew up/which high school they went to) to get the racial breakdown they want in their entering classes.

Kind of misleading phrasing to suggest they don't consider race. The precedent has shown that the law in question only bans a provable and explicit quota based specifically on race.

 

[deleted1135735]

An article that might add to this discussion. Also look at the included journal article by Dr Henderson. Think SES will be empathized more. Also diversity isn’t just economics and race, someone at Davis mentioned that they want to start being a leader for students with disabilities too.

Also there are 180+ med schools, no admission process is the same everywhere and I’d say some schools won’t change anything because they all ready don’t consider race in admissions.

How one medical school became remarkably diverse — without considering race in admissions

The UC-Davis medical school's class of 1972 was mostly white and male. The class of 2026 is among the most diverse in the nation — without race-based admissions.

www.statnews.com

I love the UC Davis model! Their school is both Socioeconomically and racially diverse. It seems that nearly every student who goes there (URM or not) has extensive experiences related to specific areas of rural medicine/serving in the Central Valley, which is great.

 

[USN2MD]

Kind of misleading phrasing to suggest they don't consider race. The precedent has shown that the law in question only bans a provable and explicit quota based specifically on race.

You’re right. I think if you dug in to the process for every school you’d find bias for and against every demographic. If not an explicit bias then a culture that discourages enrollment of certain individuals. Some schools consistently have ratios of 2:1 female to male year over year, some schools are in the single digit percentages wise of minorities or based on those that are considered disadvantaged.

 

[Faha]

If SCOTUS rules against affirmative action I do not believe it will affect IF a URM is admitted to a medical school but rather WHERE they are admitted. It is the top 40 schools that could potentially have fewer URM students due to the SCOTUS ruling and subsequent lawsuits against those schools.
For example, U Chicago has a 10th percentile of 514 for the MCAT. There may currently be URM candidates admitted with MCAT scores in the 511 to 513 range. If U Chicago is forced by the SCOTUS ruling or litigation to admit fewer URM candidates then those previously admitted with scores in the range of 511 to 513 will still be admitted to a medical school but they may be attending Rush, Loyola or Rosalind Franklin instead. where the MCAT medians are in the 511 to 513 range. Mid and lower tier schools that admit a significant number of students below their 10th percentile will admit fewer of those applicants and those students will be admitted to DO schools.
Recent data from DO schools show that only 3% of DO students are African American (14% of population) and 7.5% Hispanic (19% of the population). These low percentages are not evidence that DO schools are discriminating against URM applicants. Rather, MD schools seek diversity and there is shortage of URM applicants relative to their share of the population.
Currently, only 9% of MD students are African American and only 11% Hispanic. Those percentages would drop because applicants with MCAT scores below 504 or GPAs less than 3.3 would have a greater difficulty obtaining an acceptance to a MD school. They would have no problem receiving an acceptance to a DO school with those stats. The main burden for URM applicants that would be attending a DO school instead of a MD school would be financial, since DO schools have less financial aid for students and higher tuition compared to a state public MD school.

 

[chilly_md]

This is a reminder to stay on topic for this thread, which was to discuss how admissions may change and how soon this change would occur.

Faha's post is a good example of answering this.

 

[USN2MD]

I love the UC Davis model! Their school is both Socioeconomically and racially diverse. It seems that nearly every student who goes there (URM or not) has extensive experiences related to specific areas of rural medicine/serving in the Central Valley, which is great.

Davis gets a good amount from the Bay Area. UCD is the school for NorCal region, not just the Central Valley. I think the Central Valley gets shafted but that’s a more complex political problem. Fresno until couple years ago was the largest city without a medical school. It’s just such a wide expanse space that has competing interests both within and amongst other regions.

 

[Friheten]

I'm sorry but this feels like a terribly terribly bad faith to me. If a low education white individual came into the ER and said "I ain't want no colored doctor", are you honestly telling me most staff would be respectful and considerate of his wishes?

Its one thing to offer opportunity to kids who have overcome adversity all their lives and are probably just as good as the others on a level playing field, but I think an implication of "white doctors are bad for black patients" is a supremely evil belief system to have and it isn't healthy for medicine or society in general.

I think the difference is this statement is likely rooted in prejudiced/racist beliefs, which is particularly problematic given the historical issues that medicine has faced and contributed to in regards to race.

However, I do not believe the opposite is acceptable either. The idea of solely prioritizing patient comfort or racial concordance based on a utilitarian approach makes us uneasy because it contradicts an unspoken principle of fairness. The question is how you balance fairness to society vs. fairness to the individual. @ChordaEpiphany brought up this point previously which I'll summarize here: fairness to the individual means ensuring that every person has an equal opportunity to succeed based on their own merits, regardless of their background or circumstances. It involves promoting a consistent set of rules and values that allow individuals to pursue their goals, work hard, and be rewarded accordingly. On the other hand, fairness to society means prioritizing the collective good over individual aspirations, recognizing that certain sacrifices may need to be made for the greater benefit of everyone. This may involve policies and initiatives that address systemic issues and inequalities in society, even if some individuals may be negatively affected. To solely focus on patient comfort, among other problematic implications, completely ignores fairness to individuals and is overly one-sided, which is probably why we may feel uncomfortable with it.

As an interesting aside, what is the premise behind promoting race concordance between a URM doctor and patient? It's culture--cultural similarities and shared experiences that foster better rapport and perhaps clinical outcomes. In this sense, we have inconsistent views when it comes to culture. At times, culture is considered a fundamental aspect of our identity, influencing our choices and experiences. Given this, it seems logical to assume that cultures that prioritize education would be "overrepresented" in fields like medicine. However, this cultural argument is often met with resistance which is contradictory because the success of ORMs can arguably be attributed to cultural factors. Of course these cultures didn't emerge in isolation but are often shaped by systemic racism and historical realities, such as the sentiment among certain groups that full acceptance was unattainable, no matter how well they performed.

EDIT: Just saw @chilly_md's post above so I'll refrain from further replies. It's difficult to avoid discussing race/URMs/ORMs given that this case revolves around these issues but it's fair if OP does not want to discuss these issues in their thread.

 

[deleted1135735]

I think the difference is this statement is likely rooted in prejudiced/racist beliefs, which is particularly problematic given the historical issues that medicine has faced and contributed to in regards to race.

However, I do not believe the opposite is acceptable either. The idea of solely prioritizing patient comfort or racial concordance based on a utilitarian approach makes us uneasy because it contradicts an unspoken principle of fairness. The question is how you balance fairness to society vs. fairness to the individual. @ChordaEpiphany brought up this point previously which I'll summarize here: fairness to the individual means ensuring that every person has an equal opportunity to succeed based on their own merits, regardless of their background or circumstances. It involves promoting a consistent set of rules and values that allow individuals to pursue their goals, work hard, and be rewarded accordingly. On the other hand, fairness to society means prioritizing the collective good over individual aspirations, recognizing that certain sacrifices may need to be made for the greater benefit of everyone. This may involve policies and initiatives that address systemic issues and inequalities in society, even if some individuals may be negatively affected. To solely focus on patient comfort, among other problematic implications, completely ignores fairness to individuals and is overly one-sided, which is probably why we may feel uncomfortable with it.

As an interesting aside, what is the premise behind promoting race concordance between a URM doctor and patient? It's culture--cultural similarities and shared experiences that foster better rapport and perhaps clinical outcomes. In this sense, we have inconsistent views when it comes to culture. At times, culture is considered a fundamental aspect of our identity, influencing our choices and experiences. Given this, it seems logical to assume that cultures that prioritize education would be "overrepresented" in fields like medicine. However, this cultural argument is often met with resistance which is contradictory because the success of ORMs can arguably be attributed to cultural factors. Of course these cultures didn't emerge in isolation but are often shaped by systemic racism and historical realities, such as the sentiment among certain groups that full acceptance was unattainable, no matter how well they performed.

EDIT: Just saw @chilly_md's post above so I'll refrain from further replies. It's difficult to avoid discussing race/URMs/ORMs given that this case revolves around these issues but it's fair if OP does not want to discuss these issues in their thread.

I like how you brought up the "fairness to the system" over "fairness to individuals". There needs to be a balance of this in medical school admissions, and right now I see the system as anything but fair to individuals. For example, it is really disheartening to see ORM's from California with a 3.8 GPA and a 516 on their 3rd application cycle. It is discrimination no matter how you slice or dice it, but the difference is is that many of these people in power are okay with certain types of discrimination, as long as it benefits some other group. I am not trying to make a URM versus ORM argument here, but basically the Harvard vs SFFA case shows racial discrimination in action, but it's just a matter of whether people are okay with that. Some people seem to be okay with it, which I cannot understand.

Also, just a thought that has been on my mind for quite some time now. The SFFA case is alleging discrimination against Asian Americans, but there is not one Asian US Supreme Court Justice who is reviewing the case. Our country has never, ever had an Asian Supreme Court justice in our 200+ year history. When Joe Biden had to nominate a judge, he said that he was going to only pick from Black women. Why didn't he include Asian women in this? Where is the outrage about there being a lack of Asian representation on the court when deciding a case alleging Asian American discrimination??

I think this is a classic example of how Asians are so frequently left out of the "diversity" conversation. I never see Americans advocating for Asians, and I feel this is horrible. I feel that many privileged white liberals view Asian Americans as inconvenient to their narrative and political agendas, which is why Asians are frequently left out of the whole "diversity" debate.

 

[gyngyn]

Some things never change.