Don’t you want a doctor who cares about all of you?
A rather backwards and whiny WSJ OpEd titled “Take Two Aspirin and Call Me By My Pronouns” has sparked an explosive backlash from the larger medical community, and with good reason.
Physician Stanley Goldfarb, retired dean of the University of Pennsylvania School of Medicine, laments all the class time being wasted teaching such medically irrelevant topics such as firearms injuries and deaths, healthcare disparities based on race/ gender/ sexual orientation, food insecurity-related health outcomes, climate change impacts on humans, et cetera. All that silly extracurricular stuff “that relates to health care only tangentially”, as he puts it.
Seriously? Hello, ever heard of the obesity epidemic, Adverse Childhood Experiences health outcomes, Social Determinants of Health research, any mass shooting, AIDS, Flint Michigan? How about the fact that US life expectancy is declining, while infant mortality is increasing (especially for African American babies, or maybe this doc doesn’t think they matter).
Nope, he doesn’t appear to be aware of any of that, or care. He wishes med student education could go back to the the good ole’ days, like when the students were all white men.
The OpEd baffled me, and many others. One of the best rebuttals to his sad pap was written by Emergency physician Zachary Meisel and Public Health researcher Carolyn Cannuscio and published in the Philadelphia Inquirer: “Social Justice Is The Foundation of Healthcare– and Medical Education“.
They publicly correct ole’ Stan: “Social and health policies have always determined who gets sick and who gets care, and where, and how. Understanding the social drivers of health and illness is not peripheral or tangential to health. It is key to diagnosing and meeting a patient’s fundamental needs, and to restoring health.“
And they point out: “It is well established, for example, that bias in medicine has led to underdiagnosis of heart attacks in women, to undertreatment of depression in black patients, and to difficulty scheduling primary care appointments for low-income patients covered by Medicaid.“
Ole’ Stan apparently isn’t keeping up with the robust evidence proving that social inputs such as childhood trauma, food insecurity, education, poverty, domestic violence, institutionalized racism and more have actual hard and bad health outcomes. This is science, and med students need to know and understand the science driving the health outcomes they will encounter.
Ole’ Stan’s piece infers that doctors shouldn’t trouble themselves about healthcare disparities, and rather should focus on being comfortable with the status quo. No need to worry about all of you, meaning every person, or all of you, meaning the whole person. In his world view, medicine is 100% technical, 0% personal.
Perhaps most sadly, the editorial board at the WSJ corroborated Ole’ Stan’s opinion with their piece “Corrupting Medical Education”, a double-down that reminded me of a certain orange president’s insistent babble with a black sharpie pen.
My conclusion: Old White Wealth is feeling threatened. Not sure they need to feel afraid, but I am sure we need to take action. We meaning physician educators, ensuring that medical students know and understand the facts.
As Dr. Cannuscio Tweeted out: “We want science-informed policies. We want justice-oriented health professionals. We want evidence-based medicine. And choosing science without justice will not produce a healthier world.”
After all, we have an imperative to create doctors who care about all of you, and can provide great care for all of you.