Posted on 09/05/2004 4:22:12 PM PDT by freedom44
The medical profession used to be the preserve, give or take an interloper or two, of the white middle class male. Surgeons were supposedly like Sir Lancelot Spratt, as played by James Robertson Justice, and general practitioners like Dr Cameron, as played by Andrew Cruikshank. Indeed, the exclusiveness of the medical preserve was one of the criticisms levelled at the profession as a whole by reformists. Whether white males served the population well or badly was quite beside the point: they were seen to be operating an old boys' network in order to retain their privileges.
Not for very much longer. White males, despite being 43 per cent of the population, comprise only 26 per cent of medical students. Whether you think this is a good, bad or indifferent thing depends on how seriously you take the idea that the ethnic composition of every rank in society ought exactly to coincide with the ethnic composition of society as a whole. Should you or shouldn't you worry about the fact that there are no professional footballers of Indian subcontinental origin, or that there are so few Chinese prisoners in our jails?
Irrespective of whether it matters, what accounts for the forthcoming decline in the numerical, and no doubt intellectual, predominance of white males in the British medical profession?
There are two possible explanations, which are not mutually incompatible. The first is the decline in academic performance, relative to other groups, of young white males. If places in medical schools are allocated strictly according to examination results, then any such decline would be reflected in their numbers in the student body. And it is certainly possible that the young white male subculture in this country is not conducive to concerted academic effort. Studiousness is not, after all, among the principal characteristics of the new laddishness. The children of several (though not by any means all) ethnic minorities, as well as girls, strive harder at school, and therefore succeed better, than the young white males.
There is also the possibility that medicine as a profession is a less attractive career than it once was. Certainly, the number of applications for each place at medical school is falling, which would suggest that such is the case. Clever, diligent white males, who once might have become doctors, prefer to do something else. The relative loss of white males is actually a sign of the decreasing prestige of medicine as a career.
Certainly, this decrease is a trend that successive governments have tried to encourage: and, unlike most government efforts, it seems to have achieved its aim. Governments are afraid of doctors, because they are held in high esteem by the public, and they might at some time seriously oppose the government. If the government cannot improve the health service, it can at least destroy the medical profession, which is the next best thing from its slightly peculiar standpoint.
Patients have therefore been encouraged officially to regard themselves as customers or consumers, rather than as people seeking advice and help from trusted professionals. And more and more, doctors are expected not to think for themselves and do what they think is right, as members of true learned professions should, but to act as part of the conveyor belt delivering central government policy to the population. They are technical clerks.
Not only are the financial rewards of medicine declining compared with other jobs, but the risks for doctors are growing ever greater. The public is litigious; the regulatory bodies are ever more bureaucratically intrusive and demanding; even the Crown Prosecution Service is adding its mite by insisting on prosecuting doctors more frequently than ever before for criminal negligence. Above all, doctors are increasingly beholden to bureaucrats, who are often their intellectual and moral inferiors.
Who wants to go through a lengthy and arduous training (though, further to reduce the prestige of the profession, the Government is trying to reduce the length and thoroughness of British medical education), only to find that he or she is simultaneously disrespected by the patients, the administrators and the Government, and subject to permanently mistrustful regulatory bodies of doubtful integrity? No wonder an ever larger proportion of the doctors in this country wish they had never gone into medicine in the first place, or fail to practise it once they have qualified, treating their medical degrees as people once treated their degrees in philosophy, history or literature as a sign of general intellectual competence rather than as the beginning of a career in the subject. While our doctors drop out, of course, doctors from poor foreign countries drop in. This is our ethical foreign policy.
No doubt those who see the whole of history as a tale of oppression by dead white males, from Plato to Ronald Reagan, will rejoice at or applaud the demise of the socially prominent white male doctor. But even they, when they are ill, will want their doctors to be as good as possible. There is nothing quite like serious illness, after all, for unmasking the frivolity of ideology. And if the social prestige of medicine is destroyed, it is quite likely that its quality will follow shortly afterwards. It is not that white males necessarily make the best doctors, of course; but if we don't want to be doctors, then you are in trouble.
I got the impressiont that the author thinks of himself too much. He thinks that something requires a majority presence of white males in it to be respectable, which isn't true. The real concern here and in the UK is increasing government control.
"The pillar of Afro-American society who took Bakke's rightful place just because he was black? He went on to kill several of his patients, lost his medical license, and is now a long-term 'guest' of the State of California Department of Corrections."
Any link to support this? I'd love to save it in my archives.
very interesting... considered that many people self identify themselves, I wonder how accurate studies are unless they actually use a dna-type test to determine the percentages of genes. It's pretty fascinating if one is a geneticist I suppose.
Isn't this article from England, where they have national health insurance for everyone. If so, imagine all the regulations they must have on doctors, including income.
If so, forget the entire content of the article.
http://www.adversity.net/FRAMES/Editorials/48_PatrickChavis.htm
*** Bakke was murdered. He's not even alive.
Yes I think this is bad too --- the blue-collar work mentality where you clock in and out for 8 hour shifts when being a physician takes a different mentality. A patient in crisis at 3 am needs a doctor who can respond. Also patients are in the hospital for 36 hours straight -- it's good to have that overall perspective of how things run in the hospital at various times --- not their whole career but at the beginning is a good time to learn that.
I think the valid concern the author has is that question he makes that why the field has changed so much that the types it used to attract no longer want this profession. A lot of good doctors say if they had it to do over, they would choose something different because even here in the USA, a doctor cannot order a simple cholesterol test without checking managed care plans and Medicare guidelines to see if they're allowed or else tell the patient that they will be paying for the test. And if a Hillary type plan goes into effect, the patient couldn't have the test even if willing to pay the full cost of it.
But for myself I don't pick doctors by their skin color or ethnic background but I have access to more information --- it's interesting to know who the doctors themselves go to when they or their family members are patients. Not always the white male.
I worry about the health care system today.
I hate to say it --- when it comes to doctors, I'm likely to discriminate on the basis of age --- the new ones coming in don't seem to have what the old ones have. And checking with the HMO on their next course of action isn't the same as the way the old-timers do things -- they're more likely to consult each other.
No, actually, that patient needs a doctor who wants to respond.
That can be taught. It's not inborn.
What do you think of critical care nurses having five 12 hour shifts in a row?
Do you mean 5 12s interrupted by 5 twelve-hour rest periods, or 5 straight 12s (60 hours without a break)?
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