Written by Diana Blum, MD

WHY IT REMAINS IMPORTANT

Lately, I find myself wondering, “how it is that physicians are increasingly condemning open debate, even when nuance can make the difference between life and death decisions?” Or…” how is it that we find ourselves justifying correlations for causations, and in doing so, subjugating the importance of the scientific method?”

I have been pondering questions like these over the past year as I watched the pandemic unfold and affect my family, friends, and patients. Finding myself caring for folks on all sides of the political spectrum, I felt compelled to understand how the “science” was being discussed. I couldn’t help but notice that, across the whole range of mass media, there was an obvious politicization of narratives. Disappointingly, even physicians, “experts, towed the party lines, depending on which network they appeared.

We are sadly living through a rise in “othering,” which is bringing out our primitive reflexes and distracting us from our shared humanity — the common ground we need to stand together, move forward, and heal. I hope to discuss these important but sensitive topics here with my Hippocratic oath-abiding colleagues, and I am grateful for your willingness to consider my perspective with an open mind.

Among the pandemic-era themes gaining traction within the medical community is a renewed emphasis on “social determinants” of health, and how these factors ultimately impact diseases. Let me be clear: I don’t disagree with my fellow physicians who are advocating that these variables should be considered as highly relevant factors in any analysis of well-being outcomes. It’s reasonable to extrapolate that, by increasing our understanding of these issues, we can adjust how we practice medicine in ways that better address the needs of our patients.

However, in our zeal to deliver equity in medical outcomes, we owe it to the very populations we are trying to help to NOT fall into the trap of mistaking correlations for causations. It shouldn’t be anathema for us to simultaneously recognize the need to address disparate outcomes across patient populations, while also considering – as we were all trained to do – other relevant factors, including a patient’s genetics or personal responsibility, that affect a patient’s health.

One of the reasons I joined FAIR in Medicine was to help address the growing erosion of ethical standards in medical education and delivery of medical care. Physicians are held to a higher standard than most other healthcare professionals because we are trained with a deep grounding in biomedical science and understanding of disease pathophysiology. Without these educational underpinnings, we can’t expect other healthcare “providers” to reliably formulate proper differential diagnoses, workups, and treatment plans. Bending medical education to follow prevalent cultural movements will further escalate the growing trend of deadly unintended consequences we are already witnessing. Meanwhile, instead of addressing root causes of our failing healthcare system — including profit motives in healthcare, 3rd party waste, and clinician shortages — our medical institutions seem to be more focused on emphasizing language manipulation, which will fail to achieve meaningful change in health outcome gaps.

I propose we embrace our roots as scientists and healers and honor the oath we took by speaking up for excellence in education while elevating objectivity and transparency in scientific research. I have faith that we can do this without compromising the empathy and compassion all our patients deserve.

References
https://www.fairforall.org/fair-in-medicine/
https://www.patientsatrisk.com/
https://www.ama-assn.org/system/files/ama-aamc-equity-guide.pdf