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PaperclipPerfector  7mo ago (text post)   25710 thread views

Culture War Roundup for the week of May 20, 2024

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It's irrelevant because no one actually cares about their doctor's academic credentials. Maybe fail rates are higher at UCLA but UCLA is hard to get into to begin with, so I imagine the coursework is harder than at a place like NEOMED. And there are already schools of osteopathy that seem to attract people who couldn't get into MD programs. I'd be willing to bet that if I were to take a random poll few people would be able to tell me where their doctor even went to med school let alone how highly that school is regarded or what their grades were. Like almost everything else, once you get your first job your education is pretty much irrelevant.

You'd be surprised how much academic pedigree "matters," plenty of people don't care but you'll find soccer moms, educated people, the neurotic and all kinds of others very insistent on a "good doctor from a good school with good reviews on google," despite how often many of those disconnect from reality. For us it can matter because certain of jobs (like being a program director) may be essentially closed off to you without training at a "good" institution. Now, again this isn't necessarily reality based but it matters to a lot of people.

What you might find more interesting is that programs don't really work like undergrad or other fields. The preclinical half of med school is essentially the same country wide, in a large part because students have settled on a half dozen ultra high quality learning resources and ignore whatever the hell their school is trying to do. Pass rates for the exams (which can be using standardized exams but don't need to be) and boards (standardized) are higher at higher tier schools because the students are better. Therefore fail rates jumping is a huge huge black mark.

The other half of medical school is clinicals which uses standardized exams and evaluations from preceptors to determine your grade. The evaluations can get more program dependent and may actually have deflation, but this is also where variation in educational quality comes in since most schools pre-clinicals are basically the same* these days.

This is a gross simplification but for the purposes of this discussion should do.

Therefore fail rates jumping is a huge huge black mark.

So to speak

It's irrelevant because no one actually cares about their doctor's academic credentials.

That's the old way of thinking under how things used to be. They are no longer that way, and how people think about it will change.

no one actually cares about their doctor's academic credentials

Maybe not for their general practitioner or dermatologist or whatever. But if you get cancer or need brain surgery or something, then people care about the credentials of their oncologist or surgeon.

I'm not elite enough in any respect to really merit an elite doctor. I go to the doctors' office nearest my house. My doctor is a nice Indian lady. Maybe she's good, maybe she's not, who knows.

My doctor is an African immigrant. Which as HBD enjoyers have informed me means he is probably an unusually high IQ individual.

Subjectively he seems competent enough to me. And by importing an African some American medical program got to juice their diversity stats. Win, win.

I encourage this attitude, it's extremely hard to know if your doctor is good or not because the things that are available for a patient to know are generally customer service things that are often extremely uncoupled from actual medical knowledge and practice ability. Very common for people with good customer service skills to be bad doctors.

I would wager that all things equal the more acerbic personality will have higher skills (otherwise how to compete?)

It does, it's very common for patients to ask for things they don't need or for things that may be bad for them (classic examples are controlled substances and antibiotics). People don't like being told things like "just wait out the infection, it is viral" or "well I know you are in pain, but actually the narcotics are bad for you." People who just prescribe like crazy get better reviews.

Inpatient things can be a bit more different, but those encounters don't generally result in reviews.

And that's not counting things like psychiatry where a good psychiatrist is always going to get angry reviews from certain classes of patients.

People don't like being told things like...

The classic example that comes to mind here is "Have you tried eating healthier, getting more exercise, and losing weight?"

"Your diabetes is so advanced your limbs are falling off." "Stop fat shaming me."

You are taking that cartoon out of context. It isn't saying that the patrient's arm fell off because of diabetes. It's showing the patient complaining about one thing, and the doctor telling him routine boilerplate about losing weight that has nothing whatsoever to do with the patient's problem. The patient is not ignoring the doctor's advice about weight, the doctor is ignoring the patient's complaint by mentioning weight.

Note that the cartoon nowhere says "diabetes" or "fat shaming".

Yes. And the real life version of that cartoon is Barry Deutsch telling his doctor about health problems caused by his enormous fatness and then not liking his doctor correctly blaming his weight.

More comments

"I came for my Vicodin for my joint pain, not to be fat-shamed, you sexist pig!"

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