Thank you for taking this on. It is utterly despicable, both in theory and practice. It is important, however, to laser-focus on the elephant in the room, namely that the people who could possibly try to right these terrible injustices HAVE TOO MUCH TO LOSE, and the racist wokesters know this very well! It is an extremely rare person who will risk a lifetime of incredible effort to finish medical training to enter practice, and see it all evaporate to feed the the petty whims of the narcissistic/borderline cowards who are driving this narrative.
This is extremely serious: the turning away from excellence in admissions to health programs, the almost panicky drive to admit often underqualified members of protected groups to residency programs to avoid charges of "racism", the primacy of identity over clinical excellence, etc all these are creating a new "Dark Age" in medicine, where the grossest incompetence and quackery are celebrated. Patients are beginning to rightly fear interacting with a medical system that is actively abandoning any pretense of treating ALL patients with compassion and skill.
As a retired health care provider, I abhor this focus on identity over all else. Unfortunately the “institutionalization” of medical practice has led most health care workers, including the physicians, to having their financial survival depend on not being fired. The golden days of kindly Dr. Welby practicing in his one-person solo office are long gone. This dependency on the institution is especially powerful in academia. What a vicious cycle.
Exactly. That is what so abhorrent to me are the affluent white wokesters that advocate something that will have no effect on them. If it’s guns, they live in gated communities and often have private security. If it’s education, their kids don’t go to public school. If it’s defunding the police, see first point. In health care as you point out they will have their own concierge doctors. Just like affluent people from Canada come to the US and pay out of pocket for surgery vs the socialized system at home. And on it goes. It’s all a sort “that would be good for you” mentality. They care little in reality for the very people they profess to care about. But instead it’s a narcissistic virtue signaling that allows them to remain a member in good standing on the cocktail circuit. I haven’t seen any prominent people from the woke squad say a word about or shed a tear for black children caught in the crossfire in Chicago and most other major American cities.
Yes. Defunding the police is a great idea if you are safe, and it doesn't need to be in a gated community. People who are relatively privileged nearly all live, work and play in safe spaces.
And no, they won't admit that the net result of defunding police is just more black deaths. Doesn't fit the narrative.
I know it'd be a huge risk for physicians to speak up against these trends, but perhaps they could take see inspiration from courageous journalists like Katie and Bari themselves. Those journalists bravely pursued stories that questioned prevailing narratives, and even though writing those pieces led to their departures from their outlets, they've achieved great success with their independent ventures. Similarly, maybe doctors who proclaim that they treat all patients equally regardless of immutable characteristics would have a line of new patients waiting to see them if they set up shop independently. Unfortunately, doctors teaching med students and/or residents would probably lose their teaching access if they questioned woke orthodoxy too loudly.
But are things that far gone that a doctor could realistically lose their license for disagreeing with woke orthodoxy and setting up a private practice? What are the guidelines for taking a physician's license away?
You only have to look as far as the ideological flap over hydroxychloroquine. Doctors were threatened with losing their license for prescribing a lifesaving drug.
If this craziness ever comes to fruition, the healthcare system will be even more fractured than it is. I don't know what it would look like or how it would be created, but people across the race and political spectrums don't want to live like this so we would eventually end up with parallel woke and non-woke healthcare systems. Law/regulations/reimbursements cause providers to be tied to large healthcare systems/institutions, so it would require new hospitals, new med schools, new nursing schools, possibly even new health insurance companies...on and on and on.
You nailed it. And I read a great article a few weeks ago on Quillette about how people having higher status to protect subconsciously edit their own thinking so as not to see the wrongthink and feel the obligation to confront it and thus risk their status or position.
Thank God I live in Montana where doctors feel no pressure to be anything but good doctors, for now. I'm an RN. My husband is a physician. We lived in CA for 26 years. We both saw the quality of care declining. Some healthcare providers were far more interested in the color of one's skin than in providing compassionate appropriate treatment, and, frankly, I worked with a shocking number of poorly trained new physicians... Had zero to minimal diagnostic skills. I had to make lists of symptoms, systems, and differential diagnoses for them to check. Was called a racist for caring about my patients of all colors and socioeconomic status. Don't kid yourself. We are headed down a dark dark road and it's no good for anyone.
That’s very discouraging. And your flight to Montana is part of a continued separation happening in our country between red and blue states. Clearly during pandemic a red led state would be more open, and blue state shut down. Free minded people have moved to the Montanas, Dakotas, Florida and of course the Republic of Texas. If you think about the “laboratory of the states” there is a healthy competition playing out. And soon it will be very interesting to look at the demographic data. By the way the flight of people from say the Northeast or a Chicago has been made easier by the shift to remote work due to lockdowns. The leftist governments are not able to see how their policies are setting their cities and states further and further behind. Just as they cannot see woke school systems and police departments harm the minorities they supposedly champion.
The freedom loving, skilled and able will continue to leave the cities and states that are run by woke leadership for greener pasture.
In all honesty we didn't flee so much as simply move. Our one married child was pregnant with our first grandchild, now we have two beautiful babies here. However, my husband and I are both from the Midwest and CA, despite the amazing Pacific Ocean, never felt like home. I desperately wanted out and he easily found work here. All sorts of terrible brainless policy decisions have basically transformed CA into a two-tiered state- the cloistered ultra wealthy and the desperately poor, with a smattering of struggling middle class. Not to mention the fact that the entire state has become a garbage dump. Our son lives in Sacramento- prices are sky high as people are fleeing the Bay Area by the thousands, heading to Sacramento and the Foothills for a more normal life. Which is what you get in Montana- a wonderfully normal life! We now have two of our three children here. Will be interesting to see if our son follows, but he has a good job and cannot work remotely. BTW, Californians moving here are causing huge real estate price hikes here as well. I can't blame them because we did the same in 2017. I can only pray they don't bring their suicidal politics with them. If this last election is any indication, they are not. Republicans won every significant office and control the State Legislature. I agree with you, people are self-selecting, self-segregating into Red and Blue. I can live with that.
A few months ago, in what feels like years ago, The Lancet published a "study" or "report" that *personally laid* hundreds of thousands of deaths from COVID at the feet of Donald J. Trump.
Personally - they claim he was *personally* responsible for hundreds of thousands of COVID deaths. This, from one of the most formerly reputable journals in the world. This "study" was right next to other studies of, say, the cell signaling effects of a foreign body in yada yada yada. I.e. we're supposed to accept it with the same impartiality and gravity.
Last year, the New England Journal of Medicine, in total contravention and violation of its rights as a 501c3 non-profit, which should have been very publicly stripped of them, publicly advocated to vote Donald Trump out of office (of note - its Editorial Board are, to a man and woman, Democratic donors). Among their many baseless claims was that he was responsible for vaccine hesitancy. Mind you, this was published in about October - well before we were so certain of the massive vaccine uptake rates that we've seen, where the United States is one of the global leaders in vaccinations.. In other words, complete and utter hogwash.
These institutions, medical journals, scientific journals like Nature, etc - they're all irreparably damaged. Much like the FBI, the intelligence agencies in general, now the woke US military, our educational systems, the media, etc., etc. Or as the sagely David Burge put it:
1. Identify a respected institution.
2. kill it.
3. gut it.
4. wear its carcass as a skin suit, while demanding respect
Well said. Trump had to go for the same reason as the doctors who are described in this piece, he rejected the left ideology. To say for example that Trump was racist is just silly. Anyone with five minutes on YouTube or Google can go back and look at his life. I think he was more Libertarian than Republican, he had no ill will for race, gender etc, he simply distrusted government and the intrenched ideologies of the left. He was the first real challenger from the right towards the status quo. So he had to go. Democrats, Media, Defense and security establishment the pro war foreign entanglements crowd had to line up against him for fear their comfortable existence was at risk.
This article solely focuses on race but there is, at least, one other important issue and that is transgender ideology and its effect on children and young adults. Therapists and medical personal are increasingly required to provide "gender affirming" care which may result in use of irreversible hormones and/or surgery for minors or young adults that may not have long-standing gender dysphoria as the term was commonly understood. We should provide open, loving and supportive medical and psychological care but not ideological care that leads in only one direction. We should not suppress inquiry and research about the exponential increase in surgeries on young women, permanent effects of treatment and later regrets.
I would love to see Bari and Abigail have a serious discussion about the skyrocketing number of teenage girls who claim they're trapped in the wrong body and are prescribed male sex hormones and top surgery.
This is a huge problem. It isn't just a problem with children and young adults. What about a doctor being medically responsible and asking an individual who identifies as a male about "his" menstrual cycle - something that is medically relevant and could help diagnose an ectopic pregnancy for example-while knowing that there will be an ethics complaint because of not accepting the transgender identity.
LOL -- Haven't you gotten the message that men (called the "birthing person") can now have babies, too. They deliver them through the "front hole" and then do "chest feeding."
The lawsuits are starting to be filed and may well be the only thing to reverse this horrendous practice. I have a friend whose 14 yo biological daughter identifies as male. My friend can't find a psychologist to peel the layers of this onion; only affirms. Maybe in his subconscious he thinks that his biological mother (open adoption situation), who has since married and had three sons, would not have chosen adoption for him if he had been born male. We'll never really know unless and until she/he discovers it or grown away from this belief. Meanwhile adoptive mom/dad have firmly said no to hormone blockers or surgeries until 14 yo is of adult age.
God bless those parents! I am disgusted by the push to teenage girls who have questions is to start them on gender change treatment/procedures. And while I don’t think doctors, teachers, counselors should be pushing these girls, all it takes is an involved parent to intercede. As I think about it we don’t see too many questions about “where are the parents” when these awful things are happening to children.
And it is a daily grind to push back from every direction. My friend honestly believes (like so many profiled recently on 60 Minutes) that this is a phase, hence absolutely no hormone blockers or surgeries until she/he is 18. As I heard once on a podcast, transgender individuals need a lifetime of surgeries while gays and lesbians (obviously) do not. It's no wonder there's no pushback -- $$$!
Yes it is mostly about money for these witch doctors aided by useful wokeists. Again where are the parents? It’s not alright for schools and medical professionals to be encouraging these girls. But that could be overcome by engaged parenting.
Bari/Katie: Thank you for taking this on. I am a tenured professor at a good medical school and have been for a very long time. One angle that is not getting the attention it deserves is the absolute removal of virtually ALL measurement other than "wholistic claptrap" from both medical school admissions and residency selection. Classes are all now "pass/fail" with it being almost impossible to fail. Boards are now the same. The deliberate goal is to make sure that the better doctors (yes some people rock out in medical school and some just squeak through) cannot be differentiated from those that any patient should fear. Admissions are in many cases first about the race and "personal journey" of the student and seldom about whether they could succeed in being a good physician knowing the rigors involved to get there. Pointing out that this person might not have the mental acuity/desire to work to succeed will generally get one tossed from the admissions committee as "racist". I have watched substantial numbers of well-qualified applicants rejected in favor of those who are the "correct this week" demographic but who lack the mental and decision making skills of those rejected -- to the greater detriment of patients of all colors and descriptions for decades to come. The committee just announces that their "wholistic evaluation" says they will miraculously get smart in medical school...
Similarly, organizations like Alpha Omega Alpha that were built to recognize academic excellence in medicine have now been reduced to "wholistic-based" vote-ins, deprecating 100% of the value of this once envied organization for which people worked hard to seek admission. (For those not in medicine, Alpha Omega Alpha was an honorary society for medical students/schools, similar to Phi Beta Kappa for the arts and Sigma Xi for scientific research.) It has now become a joke or chapters are being shut down for being "racist" because, apparently, hard work, industry, and success are white cultural icons and should be dismissed. This sounds bizarre but pretending that intelligence/industry/commitment are not pivotal requirements of being a physician is equally bizarre and is becoming the norm.
I check with my classmates regularly to make sure that at least one of us will be around to treat the others before we expire. Otherwise, those graduating now will just, I expect, speed us along on that journey toward expiration, however well intentioned they might be. I have never seen good intentions diagnose or cure a patient yet.
I am dropping the AMA membership I have held for decades because it has become an embarrassment; I note that many of my peers are doing so as well. I also note that many of the physicians that read this substack would love to become a member of the group described herein. Maybe if enough of us are there, we might make a difference.
Your account of what is happening in medicine is terrifying. Medical students who are committing their lives to helping others should want honest feedback so that they can improve. If that feedback amounts to, "Maybe you shouldn't be a doctor because you don't demonstrate the skills/knowledge to provide safe care," then med students should want to know that so that they don't kill someone in their care. Not everyone has the ability to be a doctor and there is nothing wrong with that. Medical errors already cause too many injuries and deaths in our country so I can't imagine what those numbers will look like when these med students graduate. Or maybe at that point, we just won't bother tracking those kinds of outcomes. Maybe you and other like-minded providers could work with Chris Rufo (he exposes CRT-based approaches in various organizations/industries) or the Foundation Against Intolerance and Racism (FAIR) to expose this. As the article points out and many others have commented on, doing something like this is easier said than done when talking about your career.
So I wonder what stake the malpractice insurers have in this since they will be the ones holding the bag when the malpractice lawsuits fly like never before!
I fear that because the malpractice standard is the then-current community standard of care, it may not be a malpractice issue once the more competent doctors fall into the minority.
Meritocracy is being attacked - as racism. I’m just glad that I’m retired and don’t have to deal with this nonsense in the workplace. Like John Galt in Ayn Rand’s novel, Atlas Shrugged, I have withdrawn my brain and capital from a society that has lost its way. Liberalism is under attack from the far left, and unless and until liberals and conservatives alike join in the fight against this scourge, they will be eaten alive. Remember, this is all about power, nothing else.
But, they are joining the fight. On this and other boards across the web - liberals and conservatives and everyone in between are speaking frankly and maturely to each other (for the most part). I believe that there is a huge cohort of Americans who will stand up to this madness but they are hard to see because the media doesn't cover them and many are not speaking out yet. As things worsen, more will step up.
I see this whole thing as children playing with paper dolls (in a way) - willing the world to be the way they wish it regardless of reality - and to hell with whoever gets ruined in the process. With standards slipping, outcomes will deteriorate over time and it will become obvious that tossing empirical measures doesn't work.
I want to right the wrongs of the past as much as anyone. I truly do. I want the ideals of this country to be conferred on all. I believe in upholding the dignity of all human beings. But not this way. Not by throwing the baby out with the bathwater.
Posting on social media boards is a good start. But they also need to engage within society in a way that counters the far left narrative, as well as vote against these people at election time. The House of Representatives today has too many Members who bow to the demands of the far left and that’s dangerous.
I think structural changes are needed to permit a third party to win elections. A centrist party comprising reasonable people from both "sides" would be better than the present situation.
Well said. I’m jealous because I intend to do the same. I keep thinking where in the world is the equivalent of the new world created at the end of Atlas Shrug. I too want to let the fools have it while I escape. I love this country but sadly I am not sure I want to be in it anymore.
All of Katie's work is excellent, and this one is too. But, it falls into the same bucket as most coverage of this topic, which is basically gesticulating at the problem and saying, "can you believe this shit?"
Needless to say, many people would read this and not see a problem with what is being described. So, what we need are well written rebuttals of the ideology, or proposals for what sane people can do to help push back. More and more exposition about what is happening doesn't do much good at this point - we can see what is happening, but now what?
The story of Dr. Norman Wang in Herzog’s article provides one answer to the question,”now what?" After publishing a reasonable and well-researched critique of the failures of diversity initiatives and affirmative action in cardiology as compared to applying meritocratic standards, Dr. Wang was betrayed by his editor, his professional organization, and his boss, became the victim of an activist smear campaign and was eventually fired from his position at the U. of Pittsburgh Medical Center because his classroom was now “inherently unsafe” due to his views.
Here’s what Dr. Wang didn’t do. He didn’t apologize in an attempt to appease his boss or the mob. It wouldn’t have helped anyway, and he would have ended up hating himself for the rest of his life. Instead, Dr. Wang is suing the American Heart Association and the U. of Pittsburgh for defamation and violating his First Amendment rights. He has a very good case.
Never apologize. Let them fire you, or walk away if you’ve been placed in an untenable position. And if your First Amendment rights have been violated, hire a good attorney or, if appropriate, contact FIRE (The Foundation for Individual Rights in Education). If you can stomach the conflict and the spotlight, take your story public. It won't change the world right away, but brave people who refuse to be cancelled and who don't cower inspire the rest of us and can make a big difference. Bret Weinstein. Paul Rossi. Jodi Shaw. Christopher Rufo (who collects whistleblower evidence and exposes corporations). Bari Weiss. Katie Herzog!
True enough. But, judges still have to uphold the law and the Constitution regardless of their personal beliefs. I know that they can bend interpretations but I am hopeful that some people will win coerced speech or defamation lawsuits setting all-important precedents. We'll see how it goes.
It is hard knowing how the problem can be addressed. One way might be to write a comment or email to people and institutions who you see are caving to woke pressure. In this article that might include the AMA, JAHA and JAMA. You can email your health care insurance and tell them you don't support woke activism in their company. I sometimes write academics (Universities, etc.) when an article addresses woke misbehavior in their institution.
Anti-woke people tend to be intelligent and literate. Imagine if each time we read a piece such as this we each wrote a (civil-and-thus-effective) comment to relevant institutions.
When you see articles about the increasing numbers of retiring physicians over the past two years, think of this article. The pandemic was an incitement but this article details many of the underlying causes.
Thank you again, Bari! And Katie, I just want to let you know that I remember reading your article in the Stranger regarding detransitioning, and being very, very grateful for your journalistic integrity and empathetic, truthful, reporting of the issue. I know you took a huge risk in getting that story published and you experienced a lot of backlash for it. From one Seattle-area writer to another (and a formerly gender dysphoric female to boot) thank you for continuing to pursue the truth. It means the world to me that there are folks like you and Bari willing to risk it all for the pursuit of truth. Thank you 💙
I read this with tears in my eyes, I have two boys both under the age of two. Both white and born with a rare but treatable congenital heart defect called Tetrology of Fallot. My older boy already had successful corrective heart surgery when he was 4 months old and my 4-month-old goes in for open-heart surgery at the end of this month. Suffice to say my nerves are a bit raw. They will need follow-up care and potentially more surgery throughout their lives. It breaks my heart to think about my boys on that operating table where the margins are so thin, where a bad outcome is an impossible one to come to terms with.
There isn't a space for this thinking in that field, there can't be, it's too important to too many people. I've met with parents of all backgrounds whose children are born with congenital heart defects and I assure you they care not who is treating their kid, only that it's the best possible care available.
Appreciate the kind words @nancy2001. It's challenging to wrap my head around all of this as the world has changed seemingly so quickly all while I've been focused on the health of my family. One thing I was confident in was the system of care they were being introduced to. The outcome and life expectancy of people born with TOF has improved incredibly, on the backs of great research and component Drs. The facility where the procedure is performed has nearly a 99% survival rate for this procedure, which is incredible given its complexity and length.
My burden is emotional, the overwhelming bulk of the burden falls on the boys, they are the ones that have Drs appointments frequently getting poked and prodded, they are the ones whose hearts are stopped, put on bypass, and brought back to life. The visual when you see them for the first time is something I thought I blocked out, but with my second son's upcoming surgery is burned in my mind. They are so tiny, so helpless and so dependent on this "Christmas tree" of machines over their bed feeding lines and tubes all over their body. The incredible part is that initial horror, if all goes well passes fast.
My last son's surgery was on the morning of the 23rd of December, we were home the 27th, seemingly unbelievable given the sight of him post-op....
All of these words to say, we need the best of the best, there needs to be continued competition and it should be a war of ideas in the pursuit of truth.
With a 99% survival rate for that surgery at your hospital, it sounds like your young sons are receiving the best of the very best care. That's very encouraging, and you should take comfort from that.
Suppose parallel medical systems developed in which medical schools operated on anti-racist principles produced medical professionals who served patients based on anti-racist values, while medical schools operating on merit principles produced medical professionals who served patients based on scientific principles.
Which patients would end up with the better medical outcomes?
The better medical outcomes will be offered up as proof of racism in the works thus requiring more extensive deconstructions and anti- racist interventions. See what the woke are doing to rational discourse?
It seems there is a new generation of doctors - and most likely, nurses and other caregivers -who are incapable of understanding both that 1) racial disparities in healthcare exist and must be addressed, and 2) making a point-of-service healthcare decision for a patient based on skin color is vile, immoral, unethical, and will ultimately lead to a place none of us should want to go. It falls to the institutions and teaching physicians responsible for their training to root out this hubris, enforcing respect and humility with dedication to quality research and patient care. Young enthusiastic doctors who want skin in the game, who want to create more equitable medical institutions, should be seeking work in underserved communities, not denying treatment to patients in their practices they perceive as privileged or morally lacking. Senior doctors who deplore this "woke" way of thinking should act as stewards of their institutions and educators of the next generation, not stand aside and watch them crumble.
This article could be a conversation starter between you and well-chosen colleagues. Having and sharing an idea or an article is a way of opening an intellectual door. “Look what I just read...it shocked me. I’m not sure what to make of it...how does it strike you?” You might be surprised to discover how many like-minded colleagues you have. You’re not calling for an insurrection. When we’re afraid to talk about things, particularly things that directly affect our livelihoods and our fundamental values, we’re screwed.
One of the concerns mentioned in the article, though not touched on directly in the comments, is the reluctance of teaching physicians to criticize a student intern solely because of the individual's ethnicity or sex. That does not speak well for the ultimate competence of that student and those who fall under his care. Better to learn from those that know, than learn from your mistakes for which the patient suffers or dies.
Thank you for taking this on. It is utterly despicable, both in theory and practice. It is important, however, to laser-focus on the elephant in the room, namely that the people who could possibly try to right these terrible injustices HAVE TOO MUCH TO LOSE, and the racist wokesters know this very well! It is an extremely rare person who will risk a lifetime of incredible effort to finish medical training to enter practice, and see it all evaporate to feed the the petty whims of the narcissistic/borderline cowards who are driving this narrative.
This is extremely serious: the turning away from excellence in admissions to health programs, the almost panicky drive to admit often underqualified members of protected groups to residency programs to avoid charges of "racism", the primacy of identity over clinical excellence, etc all these are creating a new "Dark Age" in medicine, where the grossest incompetence and quackery are celebrated. Patients are beginning to rightly fear interacting with a medical system that is actively abandoning any pretense of treating ALL patients with compassion and skill.
As a retired health care provider, I abhor this focus on identity over all else. Unfortunately the “institutionalization” of medical practice has led most health care workers, including the physicians, to having their financial survival depend on not being fired. The golden days of kindly Dr. Welby practicing in his one-person solo office are long gone. This dependency on the institution is especially powerful in academia. What a vicious cycle.
The wealthy will find the concierge docs while the poor will be driven to the woke docs. Classism will soon trump perceived racism in medicine.
Exactly. That is what so abhorrent to me are the affluent white wokesters that advocate something that will have no effect on them. If it’s guns, they live in gated communities and often have private security. If it’s education, their kids don’t go to public school. If it’s defunding the police, see first point. In health care as you point out they will have their own concierge doctors. Just like affluent people from Canada come to the US and pay out of pocket for surgery vs the socialized system at home. And on it goes. It’s all a sort “that would be good for you” mentality. They care little in reality for the very people they profess to care about. But instead it’s a narcissistic virtue signaling that allows them to remain a member in good standing on the cocktail circuit. I haven’t seen any prominent people from the woke squad say a word about or shed a tear for black children caught in the crossfire in Chicago and most other major American cities.
Yes. Defunding the police is a great idea if you are safe, and it doesn't need to be in a gated community. People who are relatively privileged nearly all live, work and play in safe spaces.
And no, they won't admit that the net result of defunding police is just more black deaths. Doesn't fit the narrative.
Well said all around. The last point you made is a litmus test of authenticity for the anti-racists.
The health care system is at real risk. Quality is dropping while computer charting is pristine.
I know it'd be a huge risk for physicians to speak up against these trends, but perhaps they could take see inspiration from courageous journalists like Katie and Bari themselves. Those journalists bravely pursued stories that questioned prevailing narratives, and even though writing those pieces led to their departures from their outlets, they've achieved great success with their independent ventures. Similarly, maybe doctors who proclaim that they treat all patients equally regardless of immutable characteristics would have a line of new patients waiting to see them if they set up shop independently. Unfortunately, doctors teaching med students and/or residents would probably lose their teaching access if they questioned woke orthodoxy too loudly.
Unfortunately, doctors can lose their licenses to practice medicine. They can't just set up an office on substack.
But are things that far gone that a doctor could realistically lose their license for disagreeing with woke orthodoxy and setting up a private practice? What are the guidelines for taking a physician's license away?
You only have to look as far as the ideological flap over hydroxychloroquine. Doctors were threatened with losing their license for prescribing a lifesaving drug.
If this craziness ever comes to fruition, the healthcare system will be even more fractured than it is. I don't know what it would look like or how it would be created, but people across the race and political spectrums don't want to live like this so we would eventually end up with parallel woke and non-woke healthcare systems. Law/regulations/reimbursements cause providers to be tied to large healthcare systems/institutions, so it would require new hospitals, new med schools, new nursing schools, possibly even new health insurance companies...on and on and on.
Separate but equal, its time has come around again.
It may not have actually happened yet, but it's surely in the woke pipeline.
That good people have more to lose than bad people is a problem in many areas, and it needs solving.
You nailed it. And I read a great article a few weeks ago on Quillette about how people having higher status to protect subconsciously edit their own thinking so as not to see the wrongthink and feel the obligation to confront it and thus risk their status or position.
Thank God I live in Montana where doctors feel no pressure to be anything but good doctors, for now. I'm an RN. My husband is a physician. We lived in CA for 26 years. We both saw the quality of care declining. Some healthcare providers were far more interested in the color of one's skin than in providing compassionate appropriate treatment, and, frankly, I worked with a shocking number of poorly trained new physicians... Had zero to minimal diagnostic skills. I had to make lists of symptoms, systems, and differential diagnoses for them to check. Was called a racist for caring about my patients of all colors and socioeconomic status. Don't kid yourself. We are headed down a dark dark road and it's no good for anyone.
That’s very discouraging. And your flight to Montana is part of a continued separation happening in our country between red and blue states. Clearly during pandemic a red led state would be more open, and blue state shut down. Free minded people have moved to the Montanas, Dakotas, Florida and of course the Republic of Texas. If you think about the “laboratory of the states” there is a healthy competition playing out. And soon it will be very interesting to look at the demographic data. By the way the flight of people from say the Northeast or a Chicago has been made easier by the shift to remote work due to lockdowns. The leftist governments are not able to see how their policies are setting their cities and states further and further behind. Just as they cannot see woke school systems and police departments harm the minorities they supposedly champion.
The freedom loving, skilled and able will continue to leave the cities and states that are run by woke leadership for greener pasture.
In all honesty we didn't flee so much as simply move. Our one married child was pregnant with our first grandchild, now we have two beautiful babies here. However, my husband and I are both from the Midwest and CA, despite the amazing Pacific Ocean, never felt like home. I desperately wanted out and he easily found work here. All sorts of terrible brainless policy decisions have basically transformed CA into a two-tiered state- the cloistered ultra wealthy and the desperately poor, with a smattering of struggling middle class. Not to mention the fact that the entire state has become a garbage dump. Our son lives in Sacramento- prices are sky high as people are fleeing the Bay Area by the thousands, heading to Sacramento and the Foothills for a more normal life. Which is what you get in Montana- a wonderfully normal life! We now have two of our three children here. Will be interesting to see if our son follows, but he has a good job and cannot work remotely. BTW, Californians moving here are causing huge real estate price hikes here as well. I can't blame them because we did the same in 2017. I can only pray they don't bring their suicidal politics with them. If this last election is any indication, they are not. Republicans won every significant office and control the State Legislature. I agree with you, people are self-selecting, self-segregating into Red and Blue. I can live with that.
A few months ago, in what feels like years ago, The Lancet published a "study" or "report" that *personally laid* hundreds of thousands of deaths from COVID at the feet of Donald J. Trump.
Personally - they claim he was *personally* responsible for hundreds of thousands of COVID deaths. This, from one of the most formerly reputable journals in the world. This "study" was right next to other studies of, say, the cell signaling effects of a foreign body in yada yada yada. I.e. we're supposed to accept it with the same impartiality and gravity.
Last year, the New England Journal of Medicine, in total contravention and violation of its rights as a 501c3 non-profit, which should have been very publicly stripped of them, publicly advocated to vote Donald Trump out of office (of note - its Editorial Board are, to a man and woman, Democratic donors). Among their many baseless claims was that he was responsible for vaccine hesitancy. Mind you, this was published in about October - well before we were so certain of the massive vaccine uptake rates that we've seen, where the United States is one of the global leaders in vaccinations.. In other words, complete and utter hogwash.
These institutions, medical journals, scientific journals like Nature, etc - they're all irreparably damaged. Much like the FBI, the intelligence agencies in general, now the woke US military, our educational systems, the media, etc., etc. Or as the sagely David Burge put it:
1. Identify a respected institution.
2. kill it.
3. gut it.
4. wear its carcass as a skin suit, while demanding respect
#lefties
The progressives during their “March through the institutions” destroyed them all. Much like Sherman’s March our will is broken
The sad reality is they did the takeover in front of our eyes, but slowly and surely over decades.
Well said. Trump had to go for the same reason as the doctors who are described in this piece, he rejected the left ideology. To say for example that Trump was racist is just silly. Anyone with five minutes on YouTube or Google can go back and look at his life. I think he was more Libertarian than Republican, he had no ill will for race, gender etc, he simply distrusted government and the intrenched ideologies of the left. He was the first real challenger from the right towards the status quo. So he had to go. Democrats, Media, Defense and security establishment the pro war foreign entanglements crowd had to line up against him for fear their comfortable existence was at risk.
This article solely focuses on race but there is, at least, one other important issue and that is transgender ideology and its effect on children and young adults. Therapists and medical personal are increasingly required to provide "gender affirming" care which may result in use of irreversible hormones and/or surgery for minors or young adults that may not have long-standing gender dysphoria as the term was commonly understood. We should provide open, loving and supportive medical and psychological care but not ideological care that leads in only one direction. We should not suppress inquiry and research about the exponential increase in surgeries on young women, permanent effects of treatment and later regrets.
Exactly. And I highly recommend Abigail Shrier's recent book, "Irreversible Damages" on the subject.
https://smile.amazon.com/Irreversible-Damage-Transgender-Seducing-Daughters/dp/1684510317/ref=tmm_hrd_swatch_0?_encoding=UTF8&qid=1622732657&sr=8-1
I would love to see Bari and Abigail have a serious discussion about the skyrocketing number of teenage girls who claim they're trapped in the wrong body and are prescribed male sex hormones and top surgery.
This is a huge problem. It isn't just a problem with children and young adults. What about a doctor being medically responsible and asking an individual who identifies as a male about "his" menstrual cycle - something that is medically relevant and could help diagnose an ectopic pregnancy for example-while knowing that there will be an ethics complaint because of not accepting the transgender identity.
LOL -- Haven't you gotten the message that men (called the "birthing person") can now have babies, too. They deliver them through the "front hole" and then do "chest feeding."
The lawsuits are starting to be filed and may well be the only thing to reverse this horrendous practice. I have a friend whose 14 yo biological daughter identifies as male. My friend can't find a psychologist to peel the layers of this onion; only affirms. Maybe in his subconscious he thinks that his biological mother (open adoption situation), who has since married and had three sons, would not have chosen adoption for him if he had been born male. We'll never really know unless and until she/he discovers it or grown away from this belief. Meanwhile adoptive mom/dad have firmly said no to hormone blockers or surgeries until 14 yo is of adult age.
God bless those parents! I am disgusted by the push to teenage girls who have questions is to start them on gender change treatment/procedures. And while I don’t think doctors, teachers, counselors should be pushing these girls, all it takes is an involved parent to intercede. As I think about it we don’t see too many questions about “where are the parents” when these awful things are happening to children.
And it is a daily grind to push back from every direction. My friend honestly believes (like so many profiled recently on 60 Minutes) that this is a phase, hence absolutely no hormone blockers or surgeries until she/he is 18. As I heard once on a podcast, transgender individuals need a lifetime of surgeries while gays and lesbians (obviously) do not. It's no wonder there's no pushback -- $$$!
Yes it is mostly about money for these witch doctors aided by useful wokeists. Again where are the parents? It’s not alright for schools and medical professionals to be encouraging these girls. But that could be overcome by engaged parenting.
The parents are woke.....until they (literally) wake up one day to their kid's suicide or reversal to original body or both.
How awful. To think their own parents will not protect these kids.
Bari/Katie: Thank you for taking this on. I am a tenured professor at a good medical school and have been for a very long time. One angle that is not getting the attention it deserves is the absolute removal of virtually ALL measurement other than "wholistic claptrap" from both medical school admissions and residency selection. Classes are all now "pass/fail" with it being almost impossible to fail. Boards are now the same. The deliberate goal is to make sure that the better doctors (yes some people rock out in medical school and some just squeak through) cannot be differentiated from those that any patient should fear. Admissions are in many cases first about the race and "personal journey" of the student and seldom about whether they could succeed in being a good physician knowing the rigors involved to get there. Pointing out that this person might not have the mental acuity/desire to work to succeed will generally get one tossed from the admissions committee as "racist". I have watched substantial numbers of well-qualified applicants rejected in favor of those who are the "correct this week" demographic but who lack the mental and decision making skills of those rejected -- to the greater detriment of patients of all colors and descriptions for decades to come. The committee just announces that their "wholistic evaluation" says they will miraculously get smart in medical school...
Similarly, organizations like Alpha Omega Alpha that were built to recognize academic excellence in medicine have now been reduced to "wholistic-based" vote-ins, deprecating 100% of the value of this once envied organization for which people worked hard to seek admission. (For those not in medicine, Alpha Omega Alpha was an honorary society for medical students/schools, similar to Phi Beta Kappa for the arts and Sigma Xi for scientific research.) It has now become a joke or chapters are being shut down for being "racist" because, apparently, hard work, industry, and success are white cultural icons and should be dismissed. This sounds bizarre but pretending that intelligence/industry/commitment are not pivotal requirements of being a physician is equally bizarre and is becoming the norm.
I check with my classmates regularly to make sure that at least one of us will be around to treat the others before we expire. Otherwise, those graduating now will just, I expect, speed us along on that journey toward expiration, however well intentioned they might be. I have never seen good intentions diagnose or cure a patient yet.
I am dropping the AMA membership I have held for decades because it has become an embarrassment; I note that many of my peers are doing so as well. I also note that many of the physicians that read this substack would love to become a member of the group described herein. Maybe if enough of us are there, we might make a difference.
Your account of what is happening in medicine is terrifying. Medical students who are committing their lives to helping others should want honest feedback so that they can improve. If that feedback amounts to, "Maybe you shouldn't be a doctor because you don't demonstrate the skills/knowledge to provide safe care," then med students should want to know that so that they don't kill someone in their care. Not everyone has the ability to be a doctor and there is nothing wrong with that. Medical errors already cause too many injuries and deaths in our country so I can't imagine what those numbers will look like when these med students graduate. Or maybe at that point, we just won't bother tracking those kinds of outcomes. Maybe you and other like-minded providers could work with Chris Rufo (he exposes CRT-based approaches in various organizations/industries) or the Foundation Against Intolerance and Racism (FAIR) to expose this. As the article points out and many others have commented on, doing something like this is easier said than done when talking about your career.
You’re making too much sense. The “everyone gets a trophy” generation doesn’t want “feedback”.
So I wonder what stake the malpractice insurers have in this since they will be the ones holding the bag when the malpractice lawsuits fly like never before!
I fear that because the malpractice standard is the then-current community standard of care, it may not be a malpractice issue once the more competent doctors fall into the minority.
yikes
Treating people differently on the basis of immutable characteristics is wrong and evil. Always.
Meritocracy is being attacked - as racism. I’m just glad that I’m retired and don’t have to deal with this nonsense in the workplace. Like John Galt in Ayn Rand’s novel, Atlas Shrugged, I have withdrawn my brain and capital from a society that has lost its way. Liberalism is under attack from the far left, and unless and until liberals and conservatives alike join in the fight against this scourge, they will be eaten alive. Remember, this is all about power, nothing else.
But, they are joining the fight. On this and other boards across the web - liberals and conservatives and everyone in between are speaking frankly and maturely to each other (for the most part). I believe that there is a huge cohort of Americans who will stand up to this madness but they are hard to see because the media doesn't cover them and many are not speaking out yet. As things worsen, more will step up.
I see this whole thing as children playing with paper dolls (in a way) - willing the world to be the way they wish it regardless of reality - and to hell with whoever gets ruined in the process. With standards slipping, outcomes will deteriorate over time and it will become obvious that tossing empirical measures doesn't work.
I want to right the wrongs of the past as much as anyone. I truly do. I want the ideals of this country to be conferred on all. I believe in upholding the dignity of all human beings. But not this way. Not by throwing the baby out with the bathwater.
Posting on social media boards is a good start. But they also need to engage within society in a way that counters the far left narrative, as well as vote against these people at election time. The House of Representatives today has too many Members who bow to the demands of the far left and that’s dangerous.
I think structural changes are needed to permit a third party to win elections. A centrist party comprising reasonable people from both "sides" would be better than the present situation.
Well said. I’m jealous because I intend to do the same. I keep thinking where in the world is the equivalent of the new world created at the end of Atlas Shrug. I too want to let the fools have it while I escape. I love this country but sadly I am not sure I want to be in it anymore.
All of Katie's work is excellent, and this one is too. But, it falls into the same bucket as most coverage of this topic, which is basically gesticulating at the problem and saying, "can you believe this shit?"
Needless to say, many people would read this and not see a problem with what is being described. So, what we need are well written rebuttals of the ideology, or proposals for what sane people can do to help push back. More and more exposition about what is happening doesn't do much good at this point - we can see what is happening, but now what?
The story of Dr. Norman Wang in Herzog’s article provides one answer to the question,”now what?" After publishing a reasonable and well-researched critique of the failures of diversity initiatives and affirmative action in cardiology as compared to applying meritocratic standards, Dr. Wang was betrayed by his editor, his professional organization, and his boss, became the victim of an activist smear campaign and was eventually fired from his position at the U. of Pittsburgh Medical Center because his classroom was now “inherently unsafe” due to his views.
Here’s what Dr. Wang didn’t do. He didn’t apologize in an attempt to appease his boss or the mob. It wouldn’t have helped anyway, and he would have ended up hating himself for the rest of his life. Instead, Dr. Wang is suing the American Heart Association and the U. of Pittsburgh for defamation and violating his First Amendment rights. He has a very good case.
Never apologize. Let them fire you, or walk away if you’ve been placed in an untenable position. And if your First Amendment rights have been violated, hire a good attorney or, if appropriate, contact FIRE (The Foundation for Individual Rights in Education). If you can stomach the conflict and the spotlight, take your story public. It won't change the world right away, but brave people who refuse to be cancelled and who don't cower inspire the rest of us and can make a big difference. Bret Weinstein. Paul Rossi. Jodi Shaw. Christopher Rufo (who collects whistleblower evidence and exposes corporations). Bari Weiss. Katie Herzog!
Glenn Loury. John McWhorter. Matt Taibbi. Dave Rubin. Matt Kibbe.
This is a great answer. Thanks!
Exactly.
FAIR---the whole organization.
Bravely and kindly stand up against it. We have to many cowards in leadership.
Also, lawsuits. Lots of them.
Lots of “woke” judges in place since around 2010 though.
True enough. But, judges still have to uphold the law and the Constitution regardless of their personal beliefs. I know that they can bend interpretations but I am hopeful that some people will win coerced speech or defamation lawsuits setting all-important precedents. We'll see how it goes.
It is hard knowing how the problem can be addressed. One way might be to write a comment or email to people and institutions who you see are caving to woke pressure. In this article that might include the AMA, JAHA and JAMA. You can email your health care insurance and tell them you don't support woke activism in their company. I sometimes write academics (Universities, etc.) when an article addresses woke misbehavior in their institution.
Anti-woke people tend to be intelligent and literate. Imagine if each time we read a piece such as this we each wrote a (civil-and-thus-effective) comment to relevant institutions.
Exposition by groups of people can be powerful. It will require coalitions and reaching across the aisle. Imagine that...
Which is why I question this piece of work. She seems to be serving a perfect volley
When you see articles about the increasing numbers of retiring physicians over the past two years, think of this article. The pandemic was an incitement but this article details many of the underlying causes.
Thank you again, Bari! And Katie, I just want to let you know that I remember reading your article in the Stranger regarding detransitioning, and being very, very grateful for your journalistic integrity and empathetic, truthful, reporting of the issue. I know you took a huge risk in getting that story published and you experienced a lot of backlash for it. From one Seattle-area writer to another (and a formerly gender dysphoric female to boot) thank you for continuing to pursue the truth. It means the world to me that there are folks like you and Bari willing to risk it all for the pursuit of truth. Thank you 💙
I read this with tears in my eyes, I have two boys both under the age of two. Both white and born with a rare but treatable congenital heart defect called Tetrology of Fallot. My older boy already had successful corrective heart surgery when he was 4 months old and my 4-month-old goes in for open-heart surgery at the end of this month. Suffice to say my nerves are a bit raw. They will need follow-up care and potentially more surgery throughout their lives. It breaks my heart to think about my boys on that operating table where the margins are so thin, where a bad outcome is an impossible one to come to terms with.
There isn't a space for this thinking in that field, there can't be, it's too important to too many people. I've met with parents of all backgrounds whose children are born with congenital heart defects and I assure you they care not who is treating their kid, only that it's the best possible care available.
Richie, I hope everything goes well for your son, for both boys.
Appreciate the kind words @nancy2001. It's challenging to wrap my head around all of this as the world has changed seemingly so quickly all while I've been focused on the health of my family. One thing I was confident in was the system of care they were being introduced to. The outcome and life expectancy of people born with TOF has improved incredibly, on the backs of great research and component Drs. The facility where the procedure is performed has nearly a 99% survival rate for this procedure, which is incredible given its complexity and length.
My burden is emotional, the overwhelming bulk of the burden falls on the boys, they are the ones that have Drs appointments frequently getting poked and prodded, they are the ones whose hearts are stopped, put on bypass, and brought back to life. The visual when you see them for the first time is something I thought I blocked out, but with my second son's upcoming surgery is burned in my mind. They are so tiny, so helpless and so dependent on this "Christmas tree" of machines over their bed feeding lines and tubes all over their body. The incredible part is that initial horror, if all goes well passes fast.
My last son's surgery was on the morning of the 23rd of December, we were home the 27th, seemingly unbelievable given the sight of him post-op....
All of these words to say, we need the best of the best, there needs to be continued competition and it should be a war of ideas in the pursuit of truth.
With a 99% survival rate for that surgery at your hospital, it sounds like your young sons are receiving the best of the very best care. That's very encouraging, and you should take comfort from that.
Suppose parallel medical systems developed in which medical schools operated on anti-racist principles produced medical professionals who served patients based on anti-racist values, while medical schools operating on merit principles produced medical professionals who served patients based on scientific principles.
Which patients would end up with the better medical outcomes?
The better medical outcomes will be offered up as proof of racism in the works thus requiring more extensive deconstructions and anti- racist interventions. See what the woke are doing to rational discourse?
It seems there is a new generation of doctors - and most likely, nurses and other caregivers -who are incapable of understanding both that 1) racial disparities in healthcare exist and must be addressed, and 2) making a point-of-service healthcare decision for a patient based on skin color is vile, immoral, unethical, and will ultimately lead to a place none of us should want to go. It falls to the institutions and teaching physicians responsible for their training to root out this hubris, enforcing respect and humility with dedication to quality research and patient care. Young enthusiastic doctors who want skin in the game, who want to create more equitable medical institutions, should be seeking work in underserved communities, not denying treatment to patients in their practices they perceive as privileged or morally lacking. Senior doctors who deplore this "woke" way of thinking should act as stewards of their institutions and educators of the next generation, not stand aside and watch them crumble.
True. Racism is immoral. The answer to racism is not more racism.
This is the Lysenkoism of our time.
I’m a physician and am afraid to forward this article to my colleagues. Cowardice at its finest.
I guess there need to be more support groups like the one described in the article.
I feel and understand your fear.
This is short but worth watching. It certainly made me stop and think hard about my reticence to speak out.
https://www.youtube.com/watch?v=eP_wE0fdlGE
This article could be a conversation starter between you and well-chosen colleagues. Having and sharing an idea or an article is a way of opening an intellectual door. “Look what I just read...it shocked me. I’m not sure what to make of it...how does it strike you?” You might be surprised to discover how many like-minded colleagues you have. You’re not calling for an insurrection. When we’re afraid to talk about things, particularly things that directly affect our livelihoods and our fundamental values, we’re screwed.
Sad.
One of the concerns mentioned in the article, though not touched on directly in the comments, is the reluctance of teaching physicians to criticize a student intern solely because of the individual's ethnicity or sex. That does not speak well for the ultimate competence of that student and those who fall under his care. Better to learn from those that know, than learn from your mistakes for which the patient suffers or dies.