What is Happening to the Medical Profession?

What is Happening to the Medical Profession? By Sally Satel.

Health professionals argued early in the COVID pandemic that, if hospitals were forced to ration ventilators, they should ration based partly on minority status rather than exclusively by standard criteria, such as clinical need or prognosis. They urged vaccine priority for black Americans to compensate for “historical injustice.” …

A 54-page document from the American Medical Association called Advancing Health Equity: A Guide to Language, Narrative, and Concepts … condemns several “dominant narratives” in medicine. One is the “narrative of individualism,” and its misbegotten corollary, the notion that health is a personal responsibility. … The dominant narratives, says the AMA, “create harm, undermining public health and the advancement of health equity; they must be named, disrupted, and corrected.” …

We should replace the statement, “Low-income people have the highest level of coronary artery disease,” with “People underpaid and forced into poverty as a result of banking policies, real estate developers gentrifying neighborhoods, and corporations weakening the power of labor movements, among others, have the highest level of coronary artery disease.”

Katie Herzog wrote of “doctors who’ve been reported to their departments for criticizing residents for being late. (It was seen by their trainees as an act of racism) … I’ve heard from doctors who’ve stopped giving trainees honest feedback for fear of retaliation. I’ve spoken to those who have seen clinicians and residents refuse to treat patients based on their race or their perceived conservative politics.” …

Last year, Norman Wang, a cardiologist at the University of Pittsburgh School of Medicine who expressed skepticism about mandatory affirmative action after conducting a careful review of the data was stripped by his department of his directorship of the electrophysiology fellowship and barred from having contact with medical students, residents, or fellows because his views were “inherently unsafe.” His peer-reviewed paper, ‘Diversity, Inclusion, and Equity: Evolution of Race and Ethnicity Considerations for the Cardiology Workforce in the United States of America from 1969 to 2019,’ which appeared in March 2020 in the Journal of the American Heart Association (JAHA) was retracted by the journal without Wang’s consent. The American Heart Association, which publishes JAHA, tweeted that his article “does NOT represent AHA values.” The cardiologist has sued both the university and the American Health Association. …

Especially vexing … is the reflexive attribution of group differences to systemic racism. “It’s axiomatic at this point,” said a colleague who had participated in a group discussion of stress and rising suicide in black youth. The tacit rule was that only fear of police aggression and subjection to racial discrimination were allowable explanations, not the psychological torture of bullying by classmates or the quotidian terror of neighborhood gun violence. …

How name-calling works on the gullible:

On January 8th, 2021, I had my own encounter with intolerance in academic medicine. Via Zoom, I gave a Grand Rounds lecture to the Yale Department of Psychiatry, where I had been a resident for four years and an assistant professor for five. …

One month later, I received an e-mail from the chairman of the department, a fine man and brilliant researcher whom I have known since we were interns together in the 1980s. He admitted that he had not anticipated “the extent of the hurt and offense that folks would take” to my presence. He appended an anonymous complaint that he had received from an unspecified number of “Concerned Yale Psychiatry Residents.”

The residents told the chairman that my talk, coming only two days after the January 6th attack on the Capitol, “was further traumatizing to us.” They wrote that, “the language Dr. Satel used in her presentation was dehumanizing, demeaning, and classist toward individuals living in rural Ohio and for rural populations in general … We find her canon to be beyond a ‘difference of opinion’ worth debate.” My earlier writing on health disparities was deemed a “racist canon.” They expressed “shock and disappointment” at the chairman’s failure to “take a public stand against” me and questioned his commitment to the department’s anti-racist agenda. “Will you continue to invite Grand Rounds Speakers with racist and classist mindsets, like Dr. Satel?” the residents asked. Although they requested that the chairman “revoke” my lectureship at Yale, he did not do so.

What they teach nowadays is regressive:

The two accrediting bodies for American medical schools now say that … “individualism and meritocracy” are “malignant narratives” that “create harm,” that using race as a proxy for genetics “leads directly to racial health inequities,” and that medical vulnerability is the “result of socially created processes” rather than biology. …

The guidance won’t just influence the way doctors talk, these practitioners said, but also what they know and how they treat patients. It could even make them unwilling to screen racial minorities for serious conditions—including many types of cancer—that they are more likely to inherit, on the mistaken belief that genes play no role in racial health disparities. …

A professor at one Ivy League medical school agreed, telling the Free Beacon that the curriculum has gotten easier over time because administrators want to avoid failing less qualified admittees. “In order to get them through, the standards for everyone have been lowered,” the professor said. …

According to a 2018 study by Johns Hopkins medical school, medical error is the third leading cause of death in the United States.

The demonization of whites and whiteness continues apace. It’s systematic discrimination, I tell you, when incompetents aren’t given as many good jobs as their numbers deserve — and there’s historic injustice to be corrected as well.