The role of doctor, Medicine and Social Justice--the most effective way?

[wu12345]

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Hi all,

Please excuse me if I am posting redundantly, but I couldn't seem to find a similar post despite searching.

I apologize in advance for the length of my post.

My post revolves around the question: "What uniquely defines a doctor as an agent of social change and what unique advantages does being a doctor create?

Personally, I am extremely interested in issues of social and environmental justice and I originally began believing I could simultaneously use my role as not merely doctor but as an agent of social change, an activist, and, even, a policy-maker. I know doctors have a lot of privilege and status within both medical and, broader, social institutions, providing them with a lot of opportunity to challenge and act for equality, whether it be by addressing inequitable healthcare access policy, promoting linguistic access and cultural competency, or even including issues of environment as a critical area the medical institution should engage. Reading about figures like Jack Geiger, Paul Farmer, and Jim Kim gave me a lot of lofty thoughts about what doctors could do, especially because I really wanted to make a difference or I wouldn't feel fulfilled.

However, I'm becoming more and more disillusioned. Although I still think that doctors, as part of the medical establishment, have a unique position to begin change from the inside out, I'm wondering if the time (extra time in residency) /stress (pre-med courses are cutthroat and impersonal) /money/educational (I have to take a lot of science classes like o-chem and biochem I don't find critically engaging, and which prevent me from exploring academic interests more freely) trade-offs are worth pursuing this route.

I'm beginning to think about different routes: What about law school? Because I'm interested in health, what if I also strove for an MPH, or an advanced planning degree. Could I affect change through law or even policy? What about getting a PhD, researching disparities and how to engage them? What about an MBA and creating real business solutions? What about obtaining these degrees, yet still working with grassroots organizations or local governance? I'm wondering if any of these would be better off in terms of cost/benefits and potential societal impacts.

I apologize for the length of my post, so, please let me circle back to my original question: What unique advantages do you see being a doctor has in terms of social justice and creating change?

I would really look forward from hearing from any of you!
Thank you!

 

[Isoprop]

the medical profession afaik isn't concerned with social change or social justice. that doesn't meant hat doctors can't take on this role, but the profession centers around the patient. a doctor's loyalty is not to society but to the people. that may seem like a subtle difference but it really isn't. a society doesn't need a doctors; a loss in life does not constitute a large loss at all. but to the person, a loss of his or her life means everything.

so, the profession isn't uncapable or inadequate of bringing about social change, but the purpose of medicine lies on changes on a smaller scale. but, i would argue, not any less important.

i'm not really saying that a life in medicine isn't aligned with your goals. it just means that you shouldn't expect medical training to prepare you in this way.

 

[brianmartin]

Medicine is not a way to gain power and prestige so you can effect social change. It just is not. You'll spend so much time learning to practice medicine that you won't be able to. Later in life, however, you may have the time to work on some of these things. For example, the guy who does cataracts surgeries in 3rd world nations for free. There are many things you can do, it's just that you won't be doing them until you are much older, with lots of money socked away and more free time.

 

[LizzyM]

Many medical students and physicians at all stages of training and practice are advocates for their patients as a group (population). Some advocate through visits to their legislators; they are heard there because they have been held in high regard in society.

On the other hand, if studying the basic sciences and applied sciences that make up the academic study of medicine, and the care of individual patients is not how you'd like to spend the bulk of your time, perhaps a different route to advocacy is a better fit.

Law, economics & management, and public health (particularly a PhD in epidemiology), or a combination of these might be a better fit with your interests. Legislators and think tanks generally can't afford physicians on their payrolls but they use young thinkers who go on to graduate studies and academic careers where they exert influence through research and publication (on questions of policy -- not bench research) while training and directing the next generation of think tank worker bees.

 

[8744]

Hi all,

Please excuse me if I am posting redundantly, but I couldn't seem to find a similar post despite searching.

I apologize in advance for the length of my post.

My post revolves around the question: "What uniquely defines a doctor as an agent of social change and what unique advantages does being a doctor create?

Personally, I am extremely interested in issues of social and environmental justice and I originally began believing I could simultaneously use my role as not merely doctor but as an agent of social change, an activist, and, even, a policy-maker. I know doctors have a lot of privilege and status within both medical and, broader, social institutions, providing them with a lot of opportunity to challenge and act for equality, whether it be by addressing inequitable healthcare access policy, promoting linguistic access and cultural competency, or even including issues of environment as a critical area the medical institution should engage. Reading about figures like Jack Geiger, Paul Farmer, and Jim Kim gave me a lot of lofty thoughts about what doctors could do, especially because I really wanted to make a difference or I wouldn't feel fulfilled.

However, I'm becoming more and more disillusioned. Although I still think that doctors, as part of the medical establishment, have a unique position to begin change from the inside out, I'm wondering if the time (extra time in residency) /stress (pre-med courses are cutthroat and impersonal) /money/educational (I have to take a lot of science classes like o-chem and biochem I don't find critically engaging, and which prevent me from exploring academic interests more freely) trade-offs are worth pursuing this route.

I'm beginning to think about different routes: What about law school? Because I'm interested in health, what if I also strove for an MPH, or an advanced planning degree. Could I affect change through law or even policy? What about getting a PhD, researching disparities and how to engage them? What about an MBA and creating real business solutions? What about obtaining these degrees, yet still working with grassroots organizations or local governance? I'm wondering if any of these would be better off in terms of cost/benefits and potential societal impacts.

I apologize for the length of my post, so, please let me circle back to my original question: What unique advantages do you see being a doctor has in terms of social justice and creating change?

I would really look forward from hearing from any of you!
Thank you!

You know, your job as a doctor is to address the medical problems of your patients. The rest is a hobby, something you do on your own time. Why don't you graduate medical school, do a residency, and then take care of your patients? Trust me, I'm a rapacious, cut-throat, capitalist tool but I probably help more people in a meaningful way than any hundred social activists picked at random (combined). You can do the same. The rest of it is just fluff to make yourself feel better.

 

[8744]

Hi all,

Please excuse me if I am posting redundantly, but I couldn't seem to find a similar post despite searching.

I apologize in advance for the length of my post.

My post revolves around the question: "What uniquely defines a doctor as an agent of social change and what unique advantages does being a doctor create?

Personally, I am extremely interested in issues of social and environmental justice and I originally began believing I could simultaneously use my role as not merely doctor but as an agent of social change, an activist, and, even, a policy-maker. I know doctors have a lot of privilege and status within both medical and, broader, social institutions, providing them with a lot of opportunity to challenge and act for equality, whether it be by addressing inequitable healthcare access policy, promoting linguistic access and cultural competency, or even including issues of environment as a critical area the medical institution should engage. Reading about figures like Jack Geiger, Paul Farmer, and Jim Kim gave me a lot of lofty thoughts about what doctors could do, especially because I really wanted to make a difference or I wouldn't feel fulfilled.

However, I'm becoming more and more disillusioned. Although I still think that doctors, as part of the medical establishment, have a unique position to begin change from the inside out, I'm wondering if the time (extra time in residency) /stress (pre-med courses are cutthroat and impersonal) /money/educational (I have to take a lot of science classes like o-chem and biochem I don't find critically engaging, and which prevent me from exploring academic interests more freely) trade-offs are worth pursuing this route.

I'm beginning to think about different routes: What about law school? Because I'm interested in health, what if I also strove for an MPH, or an advanced planning degree. Could I affect change through law or even policy? What about getting a PhD, researching disparities and how to engage them? What about an MBA and creating real business solutions? What about obtaining these degrees, yet still working with grassroots organizations or local governance? I'm wondering if any of these would be better off in terms of cost/benefits and potential societal impacts.

I apologize for the length of my post, so, please let me circle back to my original question: What unique advantages do you see being a doctor has in terms of social justice and creating change?

I would really look forward from hearing from any of you!
Thank you!

Social justice is a meaningless phrase, by the way.

 

[sunny1]

You should take a few classes on public policy; you seem to have a sincere wish to better understand how change is effected on a large scale.

In verrrry broad terms and in my opinion, you'll find there are those that do the research to show there are disparities. Then there are the people or organizations who care about it and finally have some numbers to back them up. They either band together with other organizations to make some noise about it and try to fix the problem themselves if they have the ability through programming and outreach. Typically they will also go directly to the policymakers and try to convince them to do something about it too. Then politics runs all over it and...yeah. Sometimes things get done and sometimes not.

As a doctor, you have the power to help individuals immediately vs. the longer, uncertain road of implementing new and effective policies. Both are important fights. They're not necessarily mutually exclusive.

Doctors in position of power to create change in the government, or at least those who have the ability to start a national dialogue about it, often have to deal with politics upfront and may be gagged by someone else's ideology or they will have to deal with it as a repercussion. Think Surgeon General. But there are also doctors who try to raise or respond to evolving standards of care within the medical profession like the AMA, etc.

 

[hawk126]

Hi all...

I apologize for the length of my post, so, please let me circle back to my original question: What unique advantages do you see being a doctor has in terms of social justice and creating change?

I would really look forward from hearing from any of you!
Thank you!

Personally, I think you're barking up the wrong tree. As others have commented, your primary concern as a physician should be the well being of your patients on an individual basis. However, I'm not a physician yet, so what do I know?

If you're really interested in affecting social change, you should become a Hollywood movie star.

 

[nskittles57]

I felt like I should add my opinion to this post because you are dealing with the same struggles I dealt with three years ago during my Sophomore year of undergrad...

I wasn't sure if medicine was the best way for me to help others in the capacity I wanted to...I have the strong desire to help others individually as well as in a larger capacity. I eventually decided (as some of the other posters have mentioned) that medicine was the best route for me because I am able, on a day to day basis, help people...bottom line.

I am not going to say that I wasn't frustrated by watching some of my other "socially conscious" friends study abroad in developing countries, go to awesome conferences, and become more deeply involved in service/justice work at school...when I didn't have the time because I needed to study for Ochem, biochem, genetics, etc.

I definitely felt limited in my class schedule. I decided to major in Anthropology because I could make almost each course focus on the different cultural aspects of healthcare around the world. I was not able to take a lot of other classes I was interested in because all of my electives were pre-med courses I needed to take to help get into medical school (which has happened!).

All in all...just as some of the other posters have said...medical school and residency will train you to become a physician, not a social activist. There are programs in social medicine that are becoming more familiar in med schools/residencies, you can become a member or physicians for human rights and other organizations, but you are going to have to devote your time and energy to medical school first and then other activities on the side as a "hobby" of sorts.

Doctors can definitely be an agent for social change, it just takes a little more effort on the doctors part because they are not trained in that way...Good luck!

 

[Phoenix.]

All in all...just as some of the other posters have said...medical school and residency will train you to become a physician, not a social activist. There are programs in social medicine that are becoming more familiar in med schools/residencies, you can become a member or physicians for human rights and other organizations, but you are going to have to devote your time and energy to medical school first and then other activities on the side as a "hobby" of sorts.

Doctors can definitely be an agent for social change, it just takes a little more effort on the doctors part because they are not trained in that way...Good luck!

There are certainly some medical schools that offer additional classes/programs/directed research in areas you might be interested in. For example, GW has a health care policy and global health track. Check out this link to see the types of seminars this entails at GW's med school. They also facilitate internships abroad and/or with legislators:

http://www.studentopps.com/

I'm sure there are other schools out there that offer this type of exposure too....

 

[wu12345]

I really appreciate the posts so far and I feel they have really illuminated the different politics people are coming from...

 

[FishDish]

I don't know, I disagree somewhat and think that as a doctor you can definately contribute to social change and improving communities if that is where your interests are. I work at a free clinic as a volunteer coordinator. While there are a large number of people that volunteer with us, it is really the presence of doctors that makes the cricitical difference - no matter how enthusiastic and dedicated other types of volunteers are they ultimately cannot improve the well-being of our patients the way doctors can. Having medical training puts you in a very unique position.

What I find particularly attractive about medicine is that by providing someone with healthcare you are enabling them to address the other challenges of his or her life. If someone is sick they are unable to work, becoming an economic burden on their families, as well as requiring care from family members who already have too many obligations. While it is not a singular solution, I do believe healthcare has a significant role to play for impovershed and oppressed communities, and I think that doctors are more enabled to address issues of social justice than many other professionals.

 

[LizzyM]

Here's an interesting biography if you want to think about affecting policy as a physician.... I recall an interview in Glamour Magazine (or something similar) around the time of her appointment and she said that she could do more for more people in policy than she could in treating kidney patients one by one.

http://www.surgeongeneral.gov/library/history/bionovello.htm

 

[Luxian]

Wow! People are really down on social justice here! I disagree with most of the responses, but perhaps because I'm coming from a different angle.

Social justice successes have never been achieved by people who were paid to do them. It's ALWAYs done on the side, and it's done because it's important. Doctors can do SJ just as much as anyone, and they ARE in a position of power when it comes to health. I have an MPH, and I've found it very limiting. All the leaders of public health I can think of have an MD. That said, you may also find you can accomplish as much with a public policy degree or (especially) an economics PhD. An MBA wouldn't hurt either. All of these subjects focus on how to get large groups of people to get things done.

So now it's a matter of preference. Do you want a part of your job to be caring for individuals? Or would you be just as happy in an office, knowing that your work benefited someone somewhere down the line? I've done the latter for 5 years now and I'm finally turning myself around because it's just not enough for me.

 

[ryandote]

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[ryandote]

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[ryandote]

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[Drogba]

http://www.hms.harvard.edu/dsm/
http://dahsm.medschool.ucsf.edu/
http://www.pih.org/home.html

There are many incredibly intelligent and motivated people who see an intersection between the two despite what the above posters mention. By definition it is a longer and harder path combining the two because you are no longer "just a doctor" carrying out whatever institutional role has been decided for you by the various beauracracies that affect the daily practice of a US physician. The idea that they are mutually exclusive however, especially in some practice environments borders on ludicrous.

You've read about Farmer, why not read some of the books he has written himself and observe what intersection he sees. You can also read about MD epidemiologists if you are more quantitative and other medical anthropologists and see what work they are doing and if it appeals to you. There are many that do not seek to divorce society from the patient and whose careers have been dedicated to understanding the connection while treating individuals. They just don't spend time espousing their perspective on SDN. Hence, I would recommend you look elsewhere for advice on the matter.

 

[wu12345]

I really appreciate this lively discussion and I feel that individuals are providing many useful insights! I'm really excited we could have this discussion.

I really do not want this topic to be about debating the merits of social justice, although a few posters have, but I feel compelled to say that perhaps these differing viewpoints stem from different ideas and frameworks about what social justice might mean. I don't believe one view is necessarily more valid in all levels than another.

I definitely see the validity in which other individuals are coming from, frustrations and concerns about victimization, a "welfare state," individual responsibility. These are legitimate. I would agree that such, indeed, can negatively impact society.

But, please allow me some space to share as well. Our definitions of social justice are not mutually exclusive, but can intersect in important ways.

As a person of color, i would not say that social justice is meaningless and it certainly doesn't mean welfare and victimization; in fact, it's quite empowering. It's about voice. It's about self-reflection. It's about recognizing and engaging social structures and institutions, critically based on an oppressive history, politics, and hegemonic culture. Its about recognizing and engaging this history, which has and continues to negatively impact and inform the oppressions of the present. It's about hope and change. It's about the politics of the personal and the everyday. This might sound idealist to some, but I simply wish to mention it here. Ultimately, however, social justice isn't an end in itself. It's also, quite importantly, a process. The devil is in the details-- how policy is thought out, created, and implemented and, even, who controls the policy-making process?

Sorry to get off track.
Just a question. What unique roles do doctors have as individuals who recognize the intersection between social justice and medicine, compared to others (like lawyers, policy-makers, etc)? Is it simply a personal matter of choice?

Thank you!!!

 

[caffeineaholic]

Here's a link to what I think is an interesting comparision of medicine & public health from Harvard's School of Public Health:
http://www.hsph.harvard.edu/about/public-health-medicine/

There are distinct differences between them. I think that interest in both can definitely be fostered in someone, although I think it's difficult to work within both simultaneously. I think medicine holds broad opportunities for physicians throughout their careers if they chose to take them although sometimes at other costs, i.e. may not be as financially lucrative as private practice.

 

[Jolie South]

Here's a link to what I think is an interesting comparision of medicine & public health from Harvard's School of Public Health:
http://www.hsph.harvard.edu/about/public-health-medicine/

There are distinct differences between them. I think that interest in both can definitely be fostered in someone, although I think it's difficult to work within both simultaneously. I think medicine holds broad opportunities for physicians throughout their careers if they chose to take them although sometimes at other costs, i.e. may not be as financially lucrative as private practice.

I think that this is the main issue at hand.

Having worked in public health, I can say that there are areas where I didn't feel comfortable with just my Master's. I think it does take an MD in certain circumstances and with certain issues.

 

[Drogba]

Here's a link to what I think is an interesting comparision of medicine & public health from Harvard's School of Public Health:
http://www.hsph.harvard.edu/about/public-health-medicine/

There are distinct differences between them. I think that interest in both can definitely be fostered in someone, although I think it's difficult to work within both simultaneously. I think medicine holds broad opportunities for physicians throughout their careers if they chose to take them although sometimes at other costs, i.e. may not be as financially lucrative as private practice.

I think it's pretty obvious that this is not the path that someone chooses if their primary concern is their finances or providing for others in an economic sense. That being said, you don't have to choose poverty, especially if you can secure an academic post 🙂.

 

[Jolie South]

I think it's pretty obvious that this is not the path that someone chooses if their primary concern is their finances or providing for others in an economic sense. That being said, you don't have to choose poverty, especially if you can secure an academic post 🙂.

Absolutely, but a person has to pay back their loans at some point. Taking that sort of post wouldn't really facilitate that.

I would imagine social justice type work is something that one does later in their career for this very reason. That's not to say it couldn't encompass the career from the get go.

 

[Drogba]

Absolutely, but a person has to pay back their loans at some point. Taking that sort of post wouldn't really facilitate that.

I would imagine social justice type work is something that one does later in their career for this very reason. That's not to say it couldn't encompass the career from the get go.

You could pay back your loans probably if you are willing to sacrifice quite a bit. Or... you could try and get into an MD/PhD program and not have to pay for med school or graduate training and then try and get an academic post. This way you only "sacrifice" time. That is how I am considering limiting my financial liabilities. It really depends on how much of yourself you want to dedicate to others at the expense of personal/family time.

 

[Jolie South]

You could pay back your loans probably if you are willing to sacrifice quite a bit. Or... you could try and get into an MD/PhD program and not have to pay for med school or graduate training and then try and get an academic post. This way you only "sacrifice" time. That is how I am considering limiting my financial liabilities. It really depends on how much of yourself you want to dedicate to others at the expense of personal/family time.

I agree. I just don't think that seems attractive to most, thus why there aren't many physicians out there doing advocacy work.

I'm glad that there are people like you willing to sacrifice. I just have too much debt and financial responsibility to do that. 🙂

 

[Quadratic]

An "agent of social change"? My God you sound like those pathetic politicians in Washington (and elsewhere). As a doctor, your role would be to take care of people, while hoping the system doesn't screw you over in the process. The moment you step outside that, trying to influence policy, you become a LOBBYIST. And the AMA will shut you down for doing their job.

Medicine and social justice are simply two different fields. You don't need a MD to be the next Jane Addams. Just some balls.

As a person of color, i would not say that social justice is meaningless and it certainly doesn't mean welfare and victimization; in fact, it's quite empowering. It's about voice. It's about self-reflection. It's about recognizing and engaging social structures and institutions, critically based on an oppressive history, politics, and hegemonic culture. Its about recognizing and engaging this history, which has and continues to negatively impact and inform the oppressions of the present. It's about hope and change. It's about the politics of the personal and the everyday. This might sound idealist to some, but I simply wish to mention it here. Ultimately, however, social justice isn't an end in itself. It's also, quite importantly, a process. The devil is in the details-- how policy is thought out, created, and implemented and, even, who controls the policy-making process? !

So what exactly are you proposing? Are you hoping that work in social justice will overcome the past? That more benefits to a select group of people will help advance society as a whole? I agree that in most cases, conditions for inner city minorities and people in general are crappy. However social justice tends to mean "what can the government do directly for <insert specific group>" I don't think that's going in the right direction.

And why do I feel like I'm reading something from a Obama speech?

 

[Drogba]

I agree. I just don't think that seems attractive to most, thus why there aren't many physicians out there doing advocacy work.

I'm glad that there are people like you willing to sacrifice. I just have too much debt and financial responsibility to do that. 🙂

There is a lot of time between and now. Not to mention huge admission obstacles to overcome to go a to a program like that. I am also not yet entirely clear what my financial responsibilities will be. It's a complicated decision obviously.

Interestingly, you get this response a lot (I'm glad that there are people like you willing to sacrifice") when people mention they want to go into basic science MD/PhD but when someone mentions wanting to do something socially oriented the most common response is "mind your own business, you hippy."

 

[Drogba]

An "agent of social change"? My God you sound like those pathetic politicians in Washington (and elsewhere). As a doctor, your role would be to take care of people, while hoping the system doesn't screw you over in the process. The moment you step outside that, trying to influence policy, you become a LOBBYIST. And the AMA will shut you down for doing their job.

Medicine and social justice are simply two different fields. You don't need a MD to be the next Jane Addams. Just some balls.



So what exactly are you proposing? Are you hoping that work in social justice will overcome the past? That more benefits to a select group of people will help advance society as a whole? I agree that in most cases, conditions for inner city minorities and people in general are crappy. However social justice tends to mean "what can the government do directly for <insert specific group>" I don't think that's going in the right direction.

And why do I feel like I'm reading something from a Obama speech?

Medicine is one of many tools with which you can address problems of a social origin (such as most health problems). You can't make that categorical statement when the careers of many doctors contradicts it. The more integrated the approach the more likely it is to succeed in my opinion.

 

[Dienekes]

Social justice is a meaningless phrase, by the way.

Thank you.....I was waiting for someone to point out that no one ever deserves any more than what they earn. If you are a lazy ****er and/or dumb bastard, you just plain get less and screwed more often than the guy who is industrious and/or smart. That's justice, not whatever pipe dream some limpwristed hippie ***** came up with between his regularly scheduled bong hits and his monthly meeting of the Save the Whales committee.

 

[Dienekes]

Medicine and social justice are simply two different fields.

Exactly. Beyond the fact that medicine pays (for now) a lot better, the difference is one is a honorable profession and the other you find yourself whining about how much things suck whilst among unwashed masses of people who are delusional and likely haven't bathed in a very long time. I'll leave it to you to figure out which one is which.

You don't need a MD to be the next Jane Addams. Just some balls.

...and a really flawed idea of how things actually work. A full blown delusional state often will be accepted in place of education for positions working for "social justice"

And why do I feel like I'm reading something from a Obama speech?

I don't know....because you like being lied to by someone who can't deliver on his promises?

 

[Quadratic]

Medicine is one of many tools with which you can address problems of a social origin (such as most health problems). You can't make that categorical statement when the careers of many doctors contradicts it. The more integrated the approach the more likely it is to succeed in my opinion.

Yes, but it is not necessary. Al Gore was never an scientist and yet he addresses environmental issues, particularly global warming. Bill Gates didn't get his degree in social work, and yet he has a foundation that helps the impoverished. So this idea that the "logical" approach to making an impact is through being a doctor is shady. Basically what you're saying is that having a "Dr" behind your name makes a person credible. We're in a new age. In 20 years, Ph.Ds, MDs, DOs, etc. will be the norm and no one will care, just like B.A.s are today. Besides, re-read this:

As a person of color, i would not say that social justice is meaningless and it certainly doesn't mean welfare and victimization; in fact, it's quite empowering. It's about voice. It's about self-reflection. It's about recognizing and engaging social structures and institutions, critically based on an oppressive history, politics, and hegemonic culture.

The OP is talking about making a communal difference that doesn't seem to deal with medicine or if it does, it has a very little to do with the overall focus. This is admirable, but I just don't feel that he has to do the MD route to do it.

 

[Drogba]

Thank you.....I was waiting for someone to point out that no one ever deserves any more than what they earn. If you are a lazy ****er and/or dumb bastard, you just plain get less and screwed more often than the guy who is industrious and/or smart. That's justice, not whatever pipe dream some limpwristed hippie ***** came up with between his regularly scheduled bong hits and his monthly meeting of the Save the Whales committee.

Are those the only options?

 

[Drogba]

Yes, but it is not necessary. Al Gore was never an scientist and yet he addresses environmental issues, particularly global warming. Bill Gates didn't get his degree in social work, and yet he has a foundation that helps the impoverished. So this idea that the "logical" approach to making an impact is through being a doctor is shady. Basically what you're saying is that having a "Dr" behind your name makes a person credible. We're in a new age. In 20 years, Ph.Ds, MDs, DOs, etc. will be the norm and no one will care, just like B.A.s are today. Besides, re-read this:

No one suggested it is THE approach, only one of many alternatives.

The OP is talking about making a communal difference that doesn't seem to deal with medicine or if it does, it has a very little to do with the overall focus. This is admirable, but I just don't feel that he has to do the MD route to do it.

Depends on what you think the goal of medicine is or better yet if you think the goal of medicine depends on the context of problems you find compelling. He certainly does not HAVE to do the MD route, but there is no reason why he shouldn't if there is something he finds particularly attractive about that approach.

 

[Dienekes]

Al Gore was never an scientist and yet he addresses environmental issues, particularly global warming.

Hence the saying "Al Gore did not invent the Internet, but he did make up global warming."

 

[wu12345]

An "agent of social change"? My God you sound like those pathetic politicians in Washington (and elsewhere). As a doctor, your role would be to take care of people, while hoping the system doesn't screw you over in the process. The moment you step outside that, trying to influence policy, you become a LOBBYIST. And the AMA will shut you down for doing their job.

Medicine and social justice are simply two different fields. You don't need a MD to be the next Jane Addams. Just some balls.



So what exactly are you proposing? Are you hoping that work in social justice will overcome the past? That more benefits to a select group of people will help advance society as a whole? I agree that in most cases, conditions for inner city minorities and people in general are crappy. However social justice tends to mean "what can the government do directly for <insert specific group>" I don't think that's going in the right direction.

And why do I feel like I'm reading something from a Obama speech?

I'm sorry if you are so offended by my words. I don't understand why we can't at least be polite and try to have some kind of meaningful discourse.

In response to your question, I believe there are alternative frames through which we can talk about social justice. Words can have many definitions and connotations. There is no reason for us to believe that social justice is simply about a single reactive government act. It can be thought about very proactively. It's can be about democracy, empowering institutions, local participatory citizenship, public and informal conversations, especially for those who have typically been excluded from the process or overshadowed by those comfortable in their social positions. You can define it as simply a single act. Or you can think about it more broadly, as an emergent property that continually results in important paradigm shifts.

 

[Dienekes]

It is cases such as this that cause bitchslapping to be listed as a TOS violation.

 

[wrenwrenwren]

Hi all,

Please excuse me if I am posting redundantly, but I couldn't seem to find a similar post despite searching.

I apologize in advance for the length of my post.

My post revolves around the question: "What uniquely defines a doctor as an agent of social change and what unique advantages does being a doctor create?

Personally, I am extremely interested in issues of social and environmental justice and I originally began believing I could simultaneously use my role as not merely doctor but as an agent of social change, an activist, and, even, a policy-maker. I know doctors have a lot of privilege and status within both medical and, broader, social institutions, providing them with a lot of opportunity to challenge and act for equality, whether it be by addressing inequitable healthcare access policy, promoting linguistic access and cultural competency, or even including issues of environment as a critical area the medical institution should engage. Reading about figures like Jack Geiger, Paul Farmer, and Jim Kim gave me a lot of lofty thoughts about what doctors could do, especially because I really wanted to make a difference or I wouldn't feel fulfilled.

However, I'm becoming more and more disillusioned. Although I still think that doctors, as part of the medical establishment, have a unique position to begin change from the inside out, I'm wondering if the time (extra time in residency) /stress (pre-med courses are cutthroat and impersonal) /money/educational (I have to take a lot of science classes like o-chem and biochem I don't find critically engaging, and which prevent me from exploring academic interests more freely) trade-offs are worth pursuing this route.

I'm beginning to think about different routes: What about law school? Because I'm interested in health, what if I also strove for an MPH, or an advanced planning degree. Could I affect change through law or even policy? What about getting a PhD, researching disparities and how to engage them? What about an MBA and creating real business solutions? What about obtaining these degrees, yet still working with grassroots organizations or local governance? I'm wondering if any of these would be better off in terms of cost/benefits and potential societal impacts.

I apologize for the length of my post, so, please let me circle back to my original question: What unique advantages do you see being a doctor has in terms of social justice and creating change?

I would really look forward from hearing from any of you!
Thank you!

Doctors absolutely have the opportunity and an obligation to use their position for social good, beyond the good of their immediate patients. Doctors get a very unique and privileged view of peoples lives and thus of society and its ills.
I am very happy to see that someone in this pool of premeds is interested in something beyond getting in to medical school. You are considering the implications of how you choose to live your life and that is awesome.
I would encourage you to do what ever it is you want to do now. Go abroad. Join the Peace Corps. Do an MPH. When you have done whatever it is that is getting you excited today, you will be in a different place in your life from which you can reevaluate whether you think your best contribution can be made through medicine. Don't rush into it. There is always time later and what is important to you will become more clear with time. I hope it'll still be social justice and working toward equality, because god knows we need it.
I'll be starting medical school at 26, after having gotten my degree in anthropology, working a bunch of crappy jobs, and teaching English in the Peace Corps. I had to go back to do the science courses, and it was interesting. If I were starting med school at 30, or 50, and if I were as excited as I am now to begin medical school, that also would not be too late. Good luck.

 

[Quadratic]

I'm sorry if you are so offended by my words. I don't understand why we can't at least be polite and try to have some kind of meaningful discourse.

Not offended. It just sounds like the same redundant crap I've been hearing for my entire life.

In response to your question, I believe there are alternative frames through which we can talk about social justice. Words can have many definitions and connotations. There is no reason for us to believe that social justice is simply about a single reactive government act. It can be thought about very proactively. It's can be about democracy, empowering institutions, local participatory citizenship, public and informal conversations, especially for those who have typically been excluded from the process or overshadowed by those comfortable in their social positions. You can define it as simply a single act. Or you can think about it more broadly, as an emergent property that continually results in important paradigm shifts.

That's great. What does medicine have to do with any of that?

 

[Wind Up Bird]

I don't understand the reactions from people who maintain that social justice-oriented work and medicine are two completely unrelated fields. Just as you can have a social justice-oriented career as a teacher, a community organizer, or an accountant for that matter, you can incorporate advocacy for communities as a doctor - probably more effectively than many other careers since your job is already to help individuals in the community. It's an attitude/outlook on life and not necessarily a part of most job descriptions.

I just wanted to address that issue and I know it doesn't answer answer the OP's questions about impact or effectiveness. The way I think about the OP's question is that I want a career that is enjoyable and challenging, but also a career in which I am helping people and that I can sustain for the long run. I may be able to make "more" of a difference as an organizer or a policy maker (though that is disputable), I don't think I enjoy those things enough to keep it up for more than a few years. It wouldn't be fair to myself to do those things if I don't feel like I belong there. I'm going into medicine because I want to be a DOCTOR. Practicing medicine through a lens of social change isn't secondary - it's simply going to further enhance a career I love through me offering my skills to communities who need doctors most and advocating on their behalf.

 

[hawk126]

An "agent of social change"? My God you sound like those pathetic politicians in Washington (and elsewhere). As a doctor, your role would be to take care of people, while hoping the system doesn't screw you over in the process. The moment you step outside that, trying to influence policy, you become a LOBBYIST. And the AMA will shut you down for doing their job.

Medicine and social justice are simply two different fields. You don't need a MD to be the next Jane Addams. Just some balls.



So what exactly are you proposing? Are you hoping that work in social justice will overcome the past? That more benefits to a select group of people will help advance society as a whole? I agree that in most cases, conditions for inner city minorities and people in general are crappy. However social justice tends to mean "what can the government do directly for <insert specific group>" I don't think that's going in the right direction.

And why do I feel like I'm reading something from a Obama speech?

Ditto. Also feels alot like Elsworth Toohey from The Fountainhead.

 

[Drogba]

For those interested in medicines roll, especially on a global level: Awakening Hippocrates: A Primer on Health, Poverty, And Global Service.

 

[brianmartin]

PS - I'd probably vote for you for president. Especially this year.

...the Panda Bear cadre 🙄

Social justice is a meaningless phrase, by the way.

please explain.

 

[LibationBearer]

I think some people here might be underestimating the role that social factors play in the health of populations. For instance, if you look at the death rates from the major infectious diseases that once causes mortality, these numbers began to drastically fall decades before the advent of the relevant vaccines, mainly due to the germ theory of disease. Social activists and government organizations were responsible for disseminating important sanitation and hygiene information to those who didn't have accesses to informational resources (it has been well-documented that the deaths from infectious diseases fell first in doctors and teachers, i.e. people who had access to the information)

Today, it isn't big medicine that is going to make our population healthier, it is social changes in risk factors. We live in the era of chronic disease. Changing people's diets (generally the lower income individuals tend to eat more of a high-fat western diet), eliminating smoking (also more prevalent among the poor), etc. are the things that we have to do to prevent such diseases. The fact is that there are disparities that exists between the health of the "rich" and "poor" due to the latter's lack of access and sometimes toxic environment (learned helplessness, etc.). Addressing these inherent disparities is a key role of physicians in our generation, and it is a form of social justice. Teaching people to help themselves is really what social justice is about, not just cutting a welfare check.

 

[Dr Lyss]

Thank you.....I was waiting for someone to point out that no one ever deserves any more than what they earn. If you are a lazy ****er and/or dumb bastard, you just plain get less and screwed more often than the guy who is industrious and/or smart. That's justice, not whatever pipe dream some limpwristed hippie ***** came up with between his regularly scheduled bong hits and his monthly meeting of the Save the Whales committee.

Wow that's ignorant. So if you are interested in medicine do you believe that people should only get your services if they earn it? If they can't afford it too bad, feel free to die. I hope you never fall off your horse, friend, because in your mind no one would be there to help you get up. Social injustice exists because of *****ic, selfish mindsets like that.

 

[Drogba]

I think some people here might be underestimating the role that social factors play in the health of populations. For instance, if you look at the death rates from the major infectious diseases that once causes mortality, these numbers began to drastically fall decades before the advent of the relevant vaccines, mainly due to the germ theory of disease. Social activists and government organizations were responsible for disseminating important sanitation and hygiene information to those who didn't have accesses to informational resources (it has been well-documented that the deaths from infectious diseases fell first in doctors and teachers, i.e. people who had access to the information)

Today, it isn't big medicine that is going to make our population healthier, it is social changes in risk factors. We live in the era of chronic disease. Changing people's diets (generally the lower income individuals tend to eat more of a high-fat western diet), eliminating smoking (also more prevalent among the poor), etc. are the things that we have to do to prevent such diseases. The fact is that there are disparities that exists between the health of the "rich" and "poor" due to the latter's lack of access and sometimes toxic environment (learned helplessness, etc.). Addressing these inherent disparities is a key role of physicians in our generation, and it is a form of social justice. Teaching people to help themselves is really what social justice is about, not just cutting a welfare check.

It's not exactly that simple. There are multiple theories as to why ID was declining before therapies were available. The role of public health health is not that clearly understood, and some offer the explanation that improved living standards (and increased resistance) were the significant factor in decreased ID mortality. I'm sure you've seen this chart from McKeown:

TB was on the decline even before the bacillus was identified and even before germ theory took hold of the scientific community. The one thing that is sure though is that biomedicine had little to do with the epidemiological transition. That doesn't mean that medical technology hasn't had a more significant effect since then. Prevention and treatment should go hand in hand.

 

[ryandote]

.

 

[Doublecortin]

You know, your job as a doctor is to address the medical problems of your patients. The rest is a hobby, something you do on your own time. Why don't you graduate medical school, do a residency, and then take care of your patients? Trust me, I'm a rapacious, cut-throat, capitalist tool but I probably help more people in a meaningful way than any hundred social activists picked at random (combined). You can do the same. The rest of it is just fluff to make yourself feel better.

well said

 

[Dienekes]

For those interested in medicines roll, especially on a global level: Awakening Hippocrates: A Primer on Health, Poverty, And Global Service.

Thanks Drogba! You know I'm always looking for something to keep around in case I run out of toilet paper. 😉

 

[Doublecortin]

I was hoping for a little inflammatory commentary on the word choice of "social justice." Something like:

”Social Justice,” like “natural,” “holistic,” “organic,” and “diversity” is a meaningless term used as cover for whatever ridiculous agenda cannot be advanced by an honest use of language. The importance of language indeed.

Entertaining article here.


PS - I'd probably vote for you for president. Especially this year.

wow! At least someone's got it on here. WAy to go pandabear and ryandote 👍.

Social justice=rubbish👎

 

[Dienekes]

Wow that's ignorant. So if you are interested in medicine do you believe that people should only get your services if they earn it? If they can't afford it too bad, feel free to die. I hope you never fall off your horse, friend, because in your mind no one would be there to help you get up. Social injustice exists because of *****ic, selfish mindsets like that.

Correction, it exists because it is simply the natural order of things. You can not create a system where everyone is treated completely equally. Actually, I should rephrase that- you can not create a system where everyone will believe that they are being treated equally, especially when they are told they can't have something. Simply put, there will never be a sustainable system where the stupid, the lazy and the other burdens upon society will be treated on the same par as the intelligent, the diligent and the other beneficial people. It will destroy itself in a relatively short span of time.

No system is without corruption and if you remove at least the basic tenet of greed from most systems they begin to operate less efficiently. People need to be given incentive to work harder. Which do you prefer? The carrot or the stick? It is not as though I am suggesting that we take the uninsured out and line them up and summarily execute them all in a HMO redux of Babi Yar. I am suggesting that you need to pull your head out of the clouds and face the cold harsh reality that is, well, reality.

It's "*****ic, short-sighted" idealistic bull**** such as is espoused by the dim bulbs that use such liberal BS as "social justice" that makes me believe even more fervently that every premed should be required to have at least a minor in economics. It would certainly cut down on the number of you all who think that "social justice", "socialized medicine" or whatever other cracked out fallacy you might find assuages your guilt as someone who is going to (if your ilk don't seriously mess things up) make a comfortable living. I would guess more than a few of you are guilty white liberals who wanted for nothing during your childhoods. Well, as a white conservative who grew up dirt poor, if you don't like my pointing out the flaws in your "theories" (using the loosest possible definition of the word) you can kiss a certain part of my anatomy. The line forms to the left.