When I visit a doctor (which, in the interest of full disclosure, is not often), there are a few simple things that I expect:
I expect the physician to be a competent diagnostician – or to be aware of his or her own limitations and willing to refer me to the appropriate specialist.
I expect a thorough explanation of any tests he or she believes I might need or want.
I expect a clean and sanitary examination room, and medical assistants and nurses who are trained in the necessary skills.
I expect everyone in my doctor’s office to protect my private information and only use that which they need to diagnose and treat me and my family.
In addition, it would be nice if the physician has a pleasant demeanor and the office has a friendly atmosphere. It would be nice if the scheduling was done so as to minimize overlap and excessive time in the waiting room. In other words, it would be nice if a trip to the doctor’s office did not require the sum total of my daily allotments of free time, patience, and tolerance for incompetence. After the implementation of Obamacare, I’m not even going to mention how nice it would be if it didn’t also break the bank.
Here’s what I don’t need:
I don’t need a doctor who is worried about the optics of treating a white patient before a black patient, regardless of who was scheduled to be seen first.
I don’t need a doctor who is afraid that he will be sued if he fails to take into account the income inequality among his patients.
I don’t need a doctor who thinks that one patient is more deserving of care than another for any reason other than “he happens to be sicker at this very moment.”
I spent five years working as an x-ray and CT tech in a military hospital and troop clinic at Fort Leonard Wood, MO. While there, I encountered a receptionist who believed that I should rearrange my patients based on rank rather than arrival time or illness. At the time, my waiting room included a Drill Sergeant with a possibly sprained ankle and a trainee who was being checked for pneumonia and could only walk with the assistance of his IV pole.
I tried to explain the concept of triage, but to no avail. And then I simply ignored him and took the sickest patient first.
You can imagine my surprise when I read that the MCAT – the test given to students interested in attending medical school – was going to include a section of questions covering social justice issues in 2015. That section will be made up of questions that address topics such as social stratification, access to resources, cultural differences, white privilege, income inequality, and sociocultural factors that influence the way we think about others.
What does any of that have to do with a prospective physicians aptitude to learn medicine?
In my opinion, a focus on such issues would only encourage doctors to treat patients by rank rather than by arrival time or severity of illness. Minority outranks white. Female outranks male. People who traditionally have less access to income get the best treatments first. It’s applying medicine as a means of redistribution – but of healthcare rather than wealth.
My good friend Christopher Blomgren (former Army medic and Team Rubicon member) said it best:
I have worked in the medical field in inner city America, rural America, oversees in war zones, oversees in refugee camps and post-disaster in a variety of communities. Never once did a provider or a patient care what color anyone was, what their socio-economic background was or what someone's income was. Sick people wanted to be treated, the providers wanted to provide care. If, at anytime race, wealth or anything comes into play in giving someone medical care, that person should find a new profession. If, at any time, race, wealth or anything of that line comes into play from someone receiving medical care, well, they aren't all that sick now, are they?