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How the Asians Became White:

I've discussed this phenomenon — of Asians not only being classified together with whites for various race preference programs (and calls for such programs), but of actually being called white — in the past. Razib Khan at Gene Expression points to this San Francisco Chronicle story that exhibits something quite like this:

A new study on physicians in California shows a glaring gap between the number of doctors of color compared with the state's ethnically diverse population, especially among African Americans and Latinos.

At the same time, the state has a disproportionate number of Asian and white doctors, according to the UCSF study, which focuses on doctor ethnicity and language fluency.

It found that out of nearly 62,000 practicing doctors in California, only 5 percent are Latino even though Latinos comprise a third of the state's total population. Only 3 percent of doctors in California are black, compared with 7 percent of the state's overall black population. While Latinos and African Americans make up about 40 percent of the state's residents, fewer than 10 percent of California's doctors are black or Latino.

So I guess that Asians aren't "of color" any more — they're colorless like me. At least it's better than their being "lily white," in the words of the late California Chief Justice Rose Bird.

Or maybe I'm missing something subtle here. After all, there is a glaring gap between the number of doctors of color and the state's ethnically diverse population, even among Asians — it's just that the gap there is the other way. Well, I guess that explains it. Or is it that they're indeed counting all nonwhites, and are just pointing to the "glaring gap" between the 52% nonwhite population and 39% nonwhite doctor share? That doesn't strike me as much of a glaring gap, and it's hard to reconcile with the distinction between the "doctors of color" in the first paragraph and the "Asian and white" in the second; it's odd that the categories in the first paragraph and the "At the same time" paragraph would deliberately overlap. (Plus note that the total nonwhite 52-39 gap appears in paragraph 9, while the "glaring gap" language is in paragraph 1 and the Hispanic-plus-black 40-10 gap is in paragraph 3.)

Oh, and check this out: "Yet within the Asian-doctor category, there is a troubling shortage of Samoan, Cambodian and Hmong doctors, the report found, decrying the overall pool of doctors statewide as inadequate." I guess I didn't realize that Samoans really need Samoan doctors, and Cambodians Cambodian doctors — but if they do, then why not worry about whether there's a disproportionately low number of, say, Serb immigrant doctors, or, if you prefer, doctors of Serb extraction? Why are all whites matched with all white doctors, but Asian ethnic groups seen as needing special help from members of that particular ethnic group?

Finally, the study and the story reason that "minority physicians are far more likely to practice primary care medicine and work with poor or uninsured patients in rural areas, inner cities or other communities with a chronic shortage of physicians." But that's a bit odd — I take it many physicians of all races prefer to make lots of money from rich patients, and quite a few physicians of all races work either full- or part-time with poor patients.

If you want to make sure patients in rural areas and inner cities are served, I would think that the logical answer is to give doctors of all ethnic groups a financial incentive to work there (perhaps as a condition of some scholarship or loan forgiveness program). The answer shouldn't be, it seems to me, finding more doctors of this or that racial group — even if that means relaxing the entry standards for that group, which on average will in some measure work against the interests of the patients that the doctors are likely to treat — and then hoping that they'll serve their own rather than serving the rest of us.

The study itself is available here.

Deoxy (mail):

"Yet within the Asian-doctor category, there is a troubling shortage of Samoan, Cambodian and Hmong doctors..."


In every area you can imagine (and every area you can't), the whites are, in some way, oppressing the non-whites. That is one of the primary rules of political correctness.
4.14.2008 3:41pm
mf24:
Good thing all whites are interchangeable. I can't imagine how my daughters would find doctors with the correct blend of Sicilian-French-Austrian-Polish-Ukrainian ancestry if they had to.
4.14.2008 3:43pm
MlR (mail):
Asians ===> The new Jews.

Too successful to count as true "minorities." It's their own fault, if they weren't so successful at succeeding in racist American, they wouldn't need to suffer from such correctives.

Equality of results, not opportunity. Anything that allows the Commissars to manipulate other people's lives.
4.14.2008 3:49pm
no name:
Asian is just a subset of "caucAsian."
4.14.2008 3:58pm
Temp Guest (mail):
And it's my impression -- someone correct me with "hard data" if I'm wrong -- that in California for an extended period Chinese were even more discriminated against than Mexican-Americans or African-Americans.
4.14.2008 3:59pm
DJR:
I wonder whether they include Indians in the asian/white category? I think 4 of the last five doctors I've seen reently were Indian.
4.14.2008 4:02pm
Richard Aubrey (mail):
Being successful by your own efforts makes you an honorary white.
You think the liberals really want to go there?
Maybe they should rethink this.
4.14.2008 4:05pm
astrangerwithcandy (mail):
so does this mean that during Jim Crow the San Francisco Chronicle thinks "White Only" implicitly included asians?

an inquiring lover of history wants to know!
4.14.2008 4:14pm
Kevin P. (mail):
I have changed my profile on match.com from Asian to White after reading this. After all, the San Francisco Chronicle, the newspaper of that gingerbread city says so!

Just kidding - I have no profile on match.com, but if I did ...
4.14.2008 4:17pm
ClosetLibertarian (mail):
A friend of a friend of a friend says SF General has unofficial quotas for the number of gay doctors. Just noting that every profession must represent the "community" on every level to be PC. Race, sex, age, sexual preference, degree of facial hair, what's next? Well we can always fall back on medical competence as a tie breaker.
4.14.2008 4:17pm
Houston Lawyer:
I caught that "We're the new Jews" line on "My Name is Earle" last week, but took it to mean Indians (from India). Most elite institutions now effectively limit the number of Asians that they admit. So the Asian quota has replaced the Jewish quota of yesteryear.

But I'm just sitting here bitterly clinging to my complaint from years ago that we shouldn't be judged based on our race.
4.14.2008 4:19pm
Bill Poser (mail) (www):
While I agree that some of the concern about the ethnicity of doctors is just political correctness gone wild, the perceived need for doctors of some ethnic groups does have a rational basis, namely that they are much more likely to speak the language and understand the customs of their ethnic group. With ethnic groups that are relatively assimilated and speak English, this is not an issue, but with some groups, especially recently arrived groups, it is. For example, older Hmong frequently do not speak English and find many aspects of American life, especially urban American life, bewildering. the number of non-Hmong who speak Hmong is infinitesimal. For such people, being able to see a Hmong doctor is great benefit.
4.14.2008 4:22pm
mathgeek (mail):
DJR: Indians ARE white (most of them, at any rate). I didn't even realize that was in question. If we took Asian literally, then (most) Turks would be Asian, as well as middle easterners and quite a few russians.

And for that matter, hispanic would include the spanish, but exclude portugese speaking brazilians.
4.14.2008 4:26pm
Jim Anderson (www):
The most charitable interpretation I can find would be that language barriers exist, and that cultural practices can vary widely between ethnic communities, so a Hmong doctor, for example, might better understand the needs of a Hmong patient on those two levels. (This very situation is described in The Spirit Catches You and You Fall Down; the title refers to the way the Hmong parents interpret their daughter's epileptic seizures.) At any rate, a competent doctor in our multicultural landscape needs to be aware of the very different role s/he plays when dealing with different groups.
4.14.2008 4:27pm
Sean O'Hara (mail) (www):
Damn Whitey! Always trying to subvert successful minorities into his own race to make himself appear more successful. First the Irish, then the Jews, now Asians. Non-whites need to reclaim our ethnic identities.
4.14.2008 4:32pm
Cornellian (mail):
I'm sure this is in some way connected to the fact that white guys tend to regard asian women as hot.
4.14.2008 4:32pm
DJR:
math geek: How exactly does white include Indian (from India just to be sure we're talking about the same thing)? My Indian friends invariably refer to themselves as "brown" if this question comes up.
4.14.2008 4:33pm
DJR:
Oh, and they also consider themselves Asian (when that question comes up).
4.14.2008 4:33pm
Displaced Midwesterner (mail):
It's really more a matter of culture than race per se. Most Asians (though generally not, for instance, Cambodians, who are singled out in the report, or often Vietnamese, etc.) are, depending on the way you want to look at it, either better assimilated or more "acceptable" to mainstream America. Probably the most telling statistic on this are inter-racial marriage statistics. Exactly what to make of it is pretty complicated, but there is a genuine sense among many people in America that Asians are more, pick your word: white or acceptable or mainstream or assimilated.
4.14.2008 4:35pm
A.C.:
"White" is an artificial category in any case. There are still a few old people around who think it doesn't include Greeks, and there are some young people who think it does include Pakistanis. There was even a time when it didn't really include the Irish, who are physically about as white as you can get. I expect the category to break down entirely with time, as more and more people with non-European ancestry succeed in America. We're passing out of a fairly odd moment in history, when all the European immigrant groups were pretty well assimilated and none of the non-European groups were.

We'll still need a name for those people who are fully assimilated into US society and who don't suffer from any systematic prejudices or disadvantages. It just won't be linked to ancestry or appearance.
4.14.2008 4:39pm
rarango (mail):
OK--let me get this straight. The only people of color are negoes, Samoans, Hmong, and people of Hispanic origin? Do I have that right? Every one else is white? (I apologize if my use of the older term for blacks/african-americans offends anyone--I thought it might help on the chromatic scale differentiator.)
4.14.2008 5:08pm
wuzzagrunt (mail):
We'll still need a name for those people who are fully assimilated into US society and who don't suffer from any systematic prejudices or disadvantages. It just won't be linked to ancestry or appearance.

We could just call them Americans. Nah, that would never do.
4.14.2008 5:15pm
Rich B. (mail):

But that's a bit odd — I take it many physicians of all races prefer to make lots of money from rich patients, and quite a few physicians of all races work either full- or part-time with poor patients.


Is this just intentional obtuseness?

Cambodians and Hmong who do not speak English are not better off with an Asian doctor who speaks only English and Chinese.

The best way to get doctors into poor and immigrant communities is to have doctors who came from those neighborhoods. Certainly not perfect correlation -- some Hmong M.D.s will certainly choose Cedar-Sinai -- but if the evidence shows that the best way to get more doctors into the Hmong community is to get more Hmong doctors, why is that so horribly offensive compared to the roundabout of "give doctors of all ethnic groups a financial incentive." And I guess also give them an incentive to learn the language, and stay for more than a year, etc.

For some people, you require less incentive when it means you can work at "home."
4.14.2008 5:19pm
donaldk2 (mail):
It has always been my impression that medical schools aim to produce the very best and brightest of candidates for the profession, regardless of race creed or color.

As a sometime patient, I thank God for it.
4.14.2008 5:36pm
New World Dan (www):
I'm fine with Asians being white. I once interviewed for a job, was told, "You're the guy we want and we need someone to start right away. Just one problem. The posting doesn't close until Friday. As long as no qualified minorities apply before then, you've got the job." The good news for me was that Asians didn't count as minoritites. I got the job.
4.14.2008 5:47pm
David M. Nieporent (www):
Most elite institutions now effectively limit the number of Asians that they admit. So the Asian quota has replaced the Jewish quota of yesteryear.
No, it has supplemented it. To say that it has "replaced" it would mean that the former quota no longer exists.
4.14.2008 5:50pm
David M. Nieporent (www):
While I agree that some of the concern about the ethnicity of doctors is just political correctness gone wild, the perceived need for doctors of some ethnic groups does have a rational basis, namely that they are much more likely to speak the language and understand the customs of their ethnic group.
Then that would seem to argue for selecting doctors based on foreign language ability, not skin color.
4.14.2008 5:51pm
David M. Nieporent (www):
but if the evidence shows that the best way to get more doctors into the Hmong community is to get more Hmong doctors, why is that so horribly offensive compared to the roundabout of "give doctors of all ethnic groups a financial incentive."
If the evidence shows that blacks are more likely to be criminals than whites, does that mean we should treat blacks differently as a group than whites?
4.14.2008 5:54pm
Loren (mail):
So is 'Latino' now a racial category, instead of an ethnic group? It seems strange to refer to "blacks and Latinos" or "whites and Latinos," since an individual can be a black Latino or a white Latino.
4.14.2008 6:01pm
MDJD2B (mail):

If we took Asian literally, then (most) Turks would be Asian, as well as middle easterners and quite a few russians.


And Jews. (Originated in Western Asia about 200 miles south of Turkey)<
4.14.2008 6:04pm
MDJD2B (mail):
Why does anyone think that a Hmong doctor would be more likely to practice ahmong people of their own ethnicity?
4.14.2008 6:05pm
BU2L:
I never understood why racial makeup of a given geographical area must dictate the percentage of that race in a given profession.

After all, I don't see anyone mentioning that the New York Giants don't have % of Asian players, proportional to the population of the New York/New Jersey. Perhaps we also need more financial support to develop more Asian football players.
4.14.2008 6:07pm
autolykos:


The best way to get doctors into poor and immigrant communities is to have doctors who came from those neighborhoods. Certainly not perfect correlation -- some Hmong M.D.s will certainly choose Cedar-Sinai -- but if the evidence shows that the best way to get more doctors into the Hmong community is to get more Hmong doctors, why is that so horribly offensive compared to the roundabout of "give doctors of all ethnic groups a financial incentive." And I guess also give them an incentive to learn the language, and stay for more than a year, etc.


What's your basis for your assertion that your way is the "best way"? Professor Volokh's proposed solution is narrowly tailored to achieve the desired result (by giving people an economic incentive to serve underserved communities). It's certainly possible that some level of racial preferences might achieve the result, but I have no idea what your basis is for declaring that path the "best way".
4.14.2008 6:08pm
KWC2000 (mail):
I don't think the study is saying you need more minorities to serve the miniority populations. I think it is just saying that the profession is underrepresented.

The reason Samoan, Hmong, and Cambodian people are specifically discussed is because they are large populations of those ethnicities in California. They don't want the reader to get the impression that all Asians are widely represented. There are not large groups of Serbs or Sicilian-French-Austrian-Polish-Ukrainians such that their wide absence in the field of medicine is particularly remarkable.
4.14.2008 6:13pm
wooga:
How about zip code classifications? The best way to get doctors into the poor and immigrant zip codes is to have doctors who came from those neighborhoods. Certainly not perfect correlation --

[/sarc]. I momentarily forgot that 'diversity' is only based on how someone looks, not their mind/background/experiences. Gotcha.
4.14.2008 6:16pm
Jonathan D (mail):
I think if someone were to check the statistics here, they would find that race matters, coming and going. My experience has been that black doctors, and this is probably true for Mexican-Americans, too, are more likely to choose careers in public health, or in general practice in their own (usually poorer) communities. If so, it seems medical schools wanting to improve overall health should favor them. And I certainly have found people both black and Hispanic who preferred to deal with professionals of their own culture.
Jonathan
4.14.2008 6:19pm
BGates:
Indians ARE white (most of them, at any rate). I didn't even realize that was in question.
You could have saved Gandhi a lot of trouble if you'd told him, or South Africa.

The only people of color are negroes, Samoans, Hmong, and people of Hispanic origin? Do I have that right?
No. If they become Republicans, they're stripped of color (see Comedy Central's portrayal of the Secretary of State in "Lil' Bush").

I certainly have found people both black and Hispanic who preferred to deal with professionals of their own culture.
That would be deplorable racism if they were white. Is it deplorable racism if they are Republicans and don't really count as black or Hispanic? An interesting question.
4.14.2008 6:32pm
Ken Arromdee:
I'm fine with Asians being white. I once interviewed for a job, was told, "You're the guy we want and we need someone to start right away. Just one problem. The posting doesn't close until Friday. As long as no qualified minorities apply before then, you've got the job." The good news for me was that Asians didn't count as minoritites. I got the job.

I don't get it. Based on those facts, if you had been considered a minority he would have said "you're a qualified minority, so we don't need to wait until Friday, I can tell you you have the job right now". Wouldn't that have been better news?
4.14.2008 6:39pm
ejo:
perhaps asians need to have their reverends start preaching hate from the pulpit to gain any credibility on racial issues. otherwise, they are just "whitey".
4.14.2008 6:40pm
shawn-non-anonymous:
ClosetLibertarian:
"A friend of a friend of a friend says SF General has unofficial quotas for the number of gay doctors. Just noting that every profession must represent the "community" on every level to be PC. Race, sex, age, sexual preference, degree of facial hair, what's next?"

Part of an effective health regimen is being able to communicate with your doctor without fear. I have seen doctors through our wonderful HMO system that I regret having been honest with. Higher education is not a guarantee of tolerance or understanding.

Gay men, women, blacks, and the poor all have different health issues that may benefit from a doctor familiar with those issues, often as a member of that same community. San Fransisco has one of the largest gay communities in the US and probably has a higher need or at least desire for gay doctors. Perhaps the "unofficial quotas" have more to do with marketing to profitable customers than a desire to be "PC". If a women's hospital seeks out female doctors over male doctors is that "PC"?
4.14.2008 6:43pm
Crunchy Frog:

So is 'Latino' now a racial category, instead of an ethnic group? It seems strange to refer to "blacks and Latinos" or "whites and Latinos," since an individual can be a black Latino or a white Latino.

That horse is dead. You can quit beating it now.

I don't know any Latinos that self-identify as either White or Black - it's always "Brown", if anything.

Along the same lines, try calling your average immigrant from the Dominican Republic (most of which are considerably darker than Halle Berry) "Black". You're likely to get a fist in your face for the trouble.
4.14.2008 6:44pm
Clayton E. Cramer (mail) (www):

And it's my impression -- someone correct me with "hard data" if I'm wrong -- that in California for an extended period Chinese were even more discriminated against than Mexican-Americans or African-Americans.
The 1879 Constitution of California included Article XIX, simply titled "Chinese" which among its provisions:

Corporations not to employ Chinese.

SEC. 2. No corporation now existing or hereafter formed
under the laws of this State shall, after the adoption of this Constitution, employ, directly or indirectly, in any capacity, any Chinese or Mongolian. The Legislature shall pass such laws as may be necessary to enforce this provision.

Employment of Chinese in public work.

SEC. 3. No Chinese shall be employed on any state, county,
municipal, or other public work, except in punishment for
crime.

Immigration of foreigners ineligible to citizenship discouraged.

SEC. 4. The presence of foreigners ineligible to become citizens of the United States is declared to be dangerous to the well-being of the State, and the Legislature shall discourage their immigration by all the means within its power. Asiatic coolieism is a form of human slavery, and is forever prohibited in this State, and all contracts for coolie labor shall be void.

All companies or corporations, whether formed in this country or any foreign country, for the importation of such labor, shall be subject to such penalties as the Legislature may prescribe.

The Legislature shall delegate all necessary power to the incorporated cities and towns of this State for the removal of Chinese without the limits of such cities and towns, or for their location within prescribed portions of those limits, and it shall also provide the necessary legislation to prohibit the introduction into this State of Chinese after the adoption of this Constitution.

This section shall be enforced by appropriate legislation.
At least in the 19th century, being black or Hispanic was probably less serious a problem than being Chinese. At least, no one felt a need to write such provisions in the state constitution like these.
4.14.2008 6:49pm
Carolina:
The logic underlying these complaints is truly appalling: that people need doctors of their own ethnic group or sub-group.

Can you imagine the howls of protest and the rending of garments that would occur if someone said medical schools need to make sure they have enough white students so that white patients can have white doctors? Anyone who said such a thing seriously would be run out of town on a rail.

Yet the exact same logic is on display here, and hardly commented on except on a blog.
4.14.2008 6:51pm
dcuser (mail):
The answer to much of Eugene's sneering can be found in the report itself:

1) EV: "I guess I didn't realize that Samoans really need Samoan doctors, and Cambodians Cambodian doctors "

Report: While doctors of all ethnicities speak Spanish, fluency in Asian languages is largely limited to members of the correlating ethnicity. (pp. v, 19.).

Not too surprising -- how many non-Hmong doctors do you know who speak Hmong? Adding on to that the fact that some immigrant populations have real culture-divides from western medicine, one could make a pretty strong case that having Hmong healthcare providers might be very useful.

2) EV: ("I take it many physicians of all races prefer to make lots of money from rich patients, and quite a few physicians of all races work either full- or part-time with poor patients"

Report: Underrepresented minorities are roughly 20% to 30% more likely to work in medically underserved areas or high-minority areas. (p., 16).

Again, not necessarily surprising. People frequently do feel a responsibility to serve their own communities. It may well be that you could also increase service to underserved/minority communities by adding more government funding -- but I don't know that Eugene is necessarily running to the polls voting for higher taxes.

That's not to say that the Report is right, or that race-based evaluation of the physician population ultimately makes sense. But you should at least acknowledge the Report's empirical facts.
4.14.2008 6:57pm
Richard Nieporent (mail):
Yet within the Asian-doctor category, there is a troubling shortage of Samoan, Cambodian and Hmong doctors, the report found, decrying the overall pool of doctors statewide as inadequate."

Troubling to whom? It is certainly not troubling to the patients who want their doctors to have the highest qualifications. I don't believe that a doctor that speaks the foreign language of the patient but is not capable of diagnosing the patient's disease will be of much benefit to that patient. If there really is a language problem then hire people from the community to act as interpreters.

Finally, the study and the story reason that "minority physicians are far more likely to practice primary care medicine and work with poor or uninsured patients in rural areas, inner cities or other communities with a chronic shortage of physicians."

What the study is asking for is that less qualified doctors be sent to ethnic communities. The result will be that these people will effectively get substandard treatment. In other words, political correctness will harm the very people whom the Left claims to want to help. So what else is new?
4.14.2008 6:58pm
Smokey:
All this hair splitting over a particular group's race and/or culture demonstrates the total bankruptcy of the racial preferences scheme.

If I were African-American, I'd be very resentful of other races -- and particularly of other lily white, caucasian 'cultures,' like Spanish speaking white folks -- horning in on the gravy train that was begun to help out blacks specifically.

Now, plenty of Spanish speaking caucasians believe they have the right to dig their hands deep into the pockets of the 'other white' taxpayers.
4.14.2008 7:03pm
astrangerwithcandy (mail):
"Hello, patient X. I am Dr. XYZ, and this is my translator, Mr. ABC."

seems much easier than social engineering to assuage liberal guilt.
4.14.2008 7:06pm
kimsch (mail) (www):

BU2L:
I never understood why racial makeup of a given geographical area must dictate the percentage of that race in a given profession.




Ditto. Why is it that PC expectations are that the racial/ethnic make-up of any particular profession or group should mirror the racial/ethnic make-up of the general population? People have different interests, skills, talents, etc. And as BU2L mentioned above, does the Giants' roster reflect the general make-up of the geographic area? I can say no right away because the Giants don't have any girls and there are certainly plenty in the NY/NJ area.
4.14.2008 7:17pm
Carolina:

The answer to much of Eugene's sneering can be found in the report itself:

1) EV: "I guess I didn't realize that Samoans really need Samoan doctors, and Cambodians Cambodian doctors "

Report: While doctors of all ethnicities speak Spanish, fluency in Asian languages is largely limited to members of the correlating ethnicity. (pp. v, 19.).


Strange, then, that the report makes so much hay about the lack of "latino" doctors when "doctors of all ethnicities speak Spanish." I'm just shootin' in the dark here, but maybe there is another agenda at work beyond language fluency. . .
4.14.2008 7:19pm
sbron:
Does this mean that White Hmong patients should only be treated by White Hmong doctors, and Blue Hmong by Blue Hmong doctors? (White and Blue Hmong speak different dialects -- the color refers to style of dress.)

Can't the libertarian types appreciate how this story illustrates the madness of our current system of mass immigration without assimilation and without attention to skills/education of entrants?
4.14.2008 7:24pm
Derrick (mail):
The logic underlying these complaints is truly appalling: that people need doctors of their own ethnic group or sub-group.

The logic isn't as irrational as you might think. The fact is that from breast cancer and prostate cancer to other types of diseases, all manner of studies have shown that African-Americans and Hispanics are much more likely to be under-treated and under-diagnosed by health care professionals. From a 2002 JAMA study:

n a published report on a cohort of Medicare enrollees, breast cancer screenings, eye examinations in diabetic patients, beta-blocker use after myocardial infarction, and follow-ups after myocardial infarction all were less frequent in African Americans.[3] African Americans have fewer cardiac bypasses and are less likely to receive therapeutic tissue plasminogen activator during stroke, despite the fact that they are at 35% greater risk for stroke. Dr. Rahn Bailey, in his review, highlighted that African Americans are less likely to be placed on renal transplant lists, receive highly active antiretroviral therapy for HIV, and receive hemoglobin A1C tracking for diabetes but are more likely to have their limbs amputated.[2] In mental health treatment, African Americans are more likely to have their conditions misdiagnosed and receive less than state-of-the-art treatment.[4


Obviously this doesn't speak to considering Asian-Americans white or denigrating doctor's of all races who do their job, but to discount the fact that bias does exist between races and that bias filters even into healthcare is to ignore the obvious. I'm not advocating race-based allocations of doctors but if race does factor into the quality of care, attempting to increase the quantity of doctor's in under-served areas who won't have these biases isn't exactly illogical.
4.14.2008 7:28pm
Ryan Waxx (mail):

ut to discount the fact that bias does exist between races and that bias filters even into healthcare is to ignore the obvious. I'm not advocating race-based allocations of doctors but if race does factor into the quality of care

Wouldn't that require you to, oh I don't know, show that race factors into the quality of care, or something?

How 'bout proving a premise before drawing solutions from it? For all you know, white docs might do better.
4.14.2008 7:42pm
taney71:
I read this post and thought that once blacks do as well or better than whites than they will be called "white" ... wasn't the rapid changing of races using some machine a Doctor Seuss book? Not sure how that applies here, but I guess they could consider me black since I am an underachieving white person.
4.14.2008 8:01pm
Ryan Waxx (mail):
"wasn't the rapid changing of races using some machine a Doctor Seuss book?"

Yeah, the "Sneetches" story. For some, the parable is too hard to grasp or learn from.

For the black who does well, see "Oreo".
4.14.2008 8:06pm
Zed:
My race is "human." My human ancestors were treated pretty poorly, so I qualify for any affirmative action benefits or reparations?
4.14.2008 8:50pm
rarango (mail):
Crunch Frog: you are very much data challenged. In fact the census bureau (factfinder.census.gov) reflect racial categories within "hispanic/latino" But you can go to the cite and see for yourself.
4.14.2008 8:52pm
Elliot123 (mail):
Is a black neurosurgeon actually white? If all black neurosurgeons are white, is it then fair to say there are no black neirosurgeons because this is a racist coutry?
4.14.2008 9:13pm
Uthaw:
Gay men, women, blacks, and the poor all have different health issues that may benefit from a doctor familiar with those issues, often as a member of that same community. San Fransisco has one of the largest gay communities in the US and probably has a higher need or at least desire for gay doctors.

Yeah, straight doctors never see cases of sexually transmitted disease, and would be completely baffled when confronting them in a gay patient for the first time. [rolls eyes]
4.14.2008 9:32pm
Elmer:
I can't understand what the fuss is about. Many people feel that physician ethnicity and culture should match that of the population. Different ethnic groups vary widely in the percentage that finish high school. If you believe that things like med school admission are causally related to graduation rates, you'd have to improve K-12 performance of the underrepresented groups to solve the problem. Do you know how to accomplish that? Can you overcome the stakeholders who like things as they are? Far better to ignore causality, perform studies that show some disparity, then recommend, as this article does, that we "invest" in minority education and place the rest of the burden on medical schools to solve the problem. This will not change the physician population, but it makes people feel that they have done their share. We will be pouring more money down the K-12 rathole anyway, so we'll just pretend that we have taken the author's advice. The physician is admonished to do no harm; this study does the same.
4.14.2008 9:40pm
Bama 1L:
I'm sure this is in some way connected to the fact that white guys tend to regard asian women as hot.

Wow, WGWAG finally made it to VC. Can Frat Stud and Gallion be far behind?
4.14.2008 9:40pm
KWC2000 (mail):
Crunch Frog: You are dead wrong on this. Maybe when you think of "latino" you only think of Mexicans because of your location. Lots of Latinos refer to themselves as "white" or "black." Spanish-descended Cubans consider themselves white, and African-descended latinos from the Dominican Republic, Colombia, Puerto Rico, and elsewhere consider themselves black. Indeed, the famous latina singer Celia Cruz identifies herself this way in a song: Rie, Llora, esta negrita no pasa de moda (Laugh, Cry, this black girl never goes out of style).
4.14.2008 9:40pm
CDR D (mail):
I am a helicopter.... and I'm damned proud of it.

(Little blade goes "Guinea, Guinea, Guinea..."

Big one goes "Wop, Wop, Wop...")
4.14.2008 9:43pm
KWC2000 (mail):
The people who don't get the problem don't get it because they haven't experienced the feeling of turning your health over to someone who you have been raised to distrust. Wrongfully or rightfully, it feels a lot safer to go to a doctor who understands your language and culture, than not.

As for gay people, it is hard to go to the doctor office of an old straight man when you don't know if he is a blatant homophobe. The doctors also often assume heterosexuality, which makes it uncomfortable because you have to "come out" to them. It is hard to discuss details of sexually private activity, and it is much more difficult to do that to someone whose personal opinions you are not sure of.

That all said, cultural sensitivity is probably the key, not necessarily just more minority doctors. Though, more minority doctors is good for other reasons, already discussed.
4.14.2008 9:46pm
KWC2000 (mail):
One final thing. I think people are missing one key thing. In SF, Asians aren't "minorities" in a strict sense. So, maybe the authors misspoke when they implied that the Asians were "people of color," what they probably meant was that they are not a minority, especially not one underrepresented in the medical field in SF.

When you understand that "white" is just a proxy for "group in power," you will understand that it's not strictly about race at all.

The irony of all these white people complaining about "race" is that white people are the ones that made race the point of separation in the first place. People want their rights and all of the sudden white people are all up in arms shouting "let's me colorblind." No one believes you. We've already seen how trustworthy white america is.
4.14.2008 9:54pm
will giggins:
Being successful by your own efforts makes you an honorary white.


True. Japanese people were granted the classification of "honorary white" by the ancien regime in South Africa. Going strictly by the book, they were "coloured."

It has always been my impression that medical schools aim to produce the very best and brightest of candidates for the profession, regardless of race creed or color.

True with regard to those whose admissions are on a restricted basis: Jews and Asians. False with regard to officially recognized "minorities." Note that this situation applies to other professions: law, medicine, science, and so forth, particularly at the so-called "elite" educational institutions.
4.14.2008 10:11pm
Dilan Esper (mail) (www):
Troubling to whom? It is certainly not troubling to the patients who want their doctors to have the highest qualifications. I don't believe that a doctor that speaks the foreign language of the patient but is not capable of diagnosing the patient's disease will be of much benefit to that patient. If there really is a language problem then hire people from the community to act as interpreters.

This is pretty reductive. Patients often need doctors whom they trust, to give often embarrassing and confidential information about their health. Interpreters can interfere with the doctor-patient relationship, especially given that patients are sometimes ashamed and embarrassed about language problems.

Further, interpreters may not be able to translate complex information about medical conditions, or translate it completely and accurately.

I am often the last person to accept "racial diversity" arguments. But it seems to me perfectly plausible that you might want to have enough doctors who can discuss things directly in the vernacular immigrant patients. Saying that these doctors aren't as "qualified" as other doctors misses the point that fluency in the language might be just as much a "qualification" as medical training in a given situation.
4.14.2008 10:24pm
Ricardo (mail):
The people who don't get the problem don't get it because they haven't experienced the feeling of turning your health over to someone who you have been raised to distrust. Wrongfully or rightfully, it feels a lot safer to go to a doctor who understands your language and culture, than not.


Does this apply to WASPs who have been raised to distrust Jews? Why or why not?


The irony of all these white people complaining about "race" is that white people are the ones that made race the point of separation in the first place


When I travel in different (non-white) countries, I am always struck at how blunt people are in their dislike and blatant stereotyping of those who belong to different national or ethnic groups. "White" people did not invent racial separation by any stretch of the imagination.

If you think collective guilt and communitarian resentment are wonderful policies that the U.S. should adapt, go on believing that. Some of us who have seen what these lead to in other countries (whether we are "white" or not) would honestly not like the U.S. to turn into another Yugoslavia.
4.14.2008 10:42pm
Michelle Dulak Thomson (mail):
KWC2000,

In SF, Asians aren't "minorities" in a strict sense. So, maybe the authors misspoke when they implied that the Asians were "people of color," what they probably meant was that they are not a minority, especially not one underrepresented in the medical field in SF.

What do you mean by "in a strict sense"? The population of San Francisco is roughly 30% "Asian." That is a minority by any "strict sense" I've ever heard of.

If you mean that Asians are overrepresented in SF relative to their fraction of the CA population, well, sure; they're similarly overrepresented in CA relative to their fraction of the US population. I don't see why that makes them not a "minority," though.
4.14.2008 10:53pm
Richard Aubrey (mail):
I may have mentioned this before when a similar subject was under discussion:
While splitting firewood, I was smacked in the head by the wedge. I got a pretty bloody compression cut.
At the emergency room, while the Indian doc was poking and poking around, I asked him what he was doing.
I will not attempt the accent, but the point is, he was looking for the wedge.
I'd caught the butt end of something larger than a sledgehammer head.
He had no clue.
So, yes, I was temporaril disadvantaged by being treated by a doc who came from a place where there had been no wood large enough to need splitting in a thousand years, or a caste which considered even the contemplation of manual labor a sin.
Would have been better off with somebody from Duluth.

Is a shrink from another culture effective? Are the fundamentals so fundamental that he could cut through cultural dressing?
I doubt it.
4.14.2008 11:27pm
Clayton E. Cramer (mail) (www):
KWC2000 writes:

The irony of all these white people complaining about "race" is that white people are the ones that made race the point of separation in the first place. People want their rights and all of the sudden white people are all up in arms shouting "let's me colorblind." No one believes you. We've already seen how trustworthy white america is.
Wow. I have bad news for you: I never made "race the point of separation." I am not old enough to have done so. By the time I was an adult, racial discrimination in employment, housing, voting, etc., was unlawful. It had been so for a number of years.

If "white america" had been this untrustworthy, who passed the Civil Rights Act and the Voting Rights Act? Who ruled that racial segregation of schools was unlawful? Was there some black majority on the Court and in Congress that I missed?

Your racism is revolting.
4.14.2008 11:33pm
Clayton E. Cramer (mail) (www):
KWC2000 writes:

As for gay people, it is hard to go to the doctor office of an old straight man when you don't know if he is a blatant homophobe. The doctors also often assume heterosexuality, which makes it uncomfortable because you have to "come out" to them. It is hard to discuss details of sexually private activity, and it is much more difficult to do that to someone whose personal opinions you are not sure of.
The last time that I had a doctor doing a prostrate gland examination (which is not exactly what I would call a comfortable situation), it was an openly lesbian physician. Maybe I'm just a bit more openminded than all these "gay people" that you think can't handle talking to a straight doctor.
4.14.2008 11:35pm
Jim Miller (mail) (www):
It can be even more complicated. In Washington state, before I-200 outlawed racial preferences, Asians did not get an advantage in admission to public universities -- but they did get an advantage in contracts with the state and many local governments. So the same person could be "white" when they applied to the UW, but Asian when they signed a contract with Washington state.

And Indian tribes can have rules with quite strange effects. I once knew a couple with three sons. Two of the sons belonged to the Indian tribe that their father (who was, as I recall one fourth Indian) belonged to, but the third did not. Why not? Because the tribe changed its rules in between the births of the second and third sons. By the way, the father was a college librarian, and the mother was musician so the two older boys were not underprivileged.

(For the record, I am almost certain that the University of Washington, which fought against I-200, is still using racial preferences. But they are being sneakier about it.)
4.14.2008 11:42pm
CHTYorkville (mail):
Back in the pre-Mandela days in Soth Africa, the authorities had the problem of how to slot racially vistiting Japanese business and even a few tourists f rom Nippon. The solution was to classify them as "honorary" Caucasians, permitting them to stay in "white" hotels, eat in "white" restaurants, etc. Since the Ward Connelly amendment was added by the people of California to their State constitution, many Golden State liberals have come to find, for polemical purposes anyway, the South African model appealing.
4.14.2008 11:51pm
Jim Rhoads (mail):
Let's assume that this report's recommendations are adopted. Does that mean that standards for admission to practice will then be modified to assure all those who have been admitted to study medicine will automatically qualify to be MDs in California? Elsewhere?

As one who has survived life-threatening heart disease for more than 40 years, I hope I never have an "event" in California after such a regime is instituted.
4.14.2008 11:55pm
ed (mail) (www):
Hmmm.

"SEC. 2. No corporation now existing or hereafter formed
under the laws of this State shall, after the adoption of this Constitution, employ, directly or indirectly, in any capacity, any Chinese or Mongolian. The Legislature shall pass such laws as may be necessary to enforce this provision. "

To tell a family secret, my grandmother was Dutch....
4.15.2008 12:00am
Elliot123 (mail):
"When you understand that "white" is just a proxy for "group in power," you will understand that it's not strictly about race at all."

How about Condolezza Rice, Senator Obama, and Colin Powell? Are they white? If so, when did they become white?
4.15.2008 12:12am
SocratesAbroad (mail):

Derrick:
The fact is that from breast cancer and prostate cancer to other types of diseases, all manner of studies have shown that African-Americans and Hispanics are much more likely to be under-treated and under-diagnosed by health care professionals.

That's quite a statement to make, especially without links. But to be kind, I looked for your cite and found it here.
There are three highly suspect aspects of the original article (and not a study, as you suggested) by John Franklin, Asst Prof of Psych at Northwestern.
1) The issue of causality by class/economics - and not race - receives scant attention despite ample evidence in the piece itself:

African Americans have fewer cardiac bypasses and are less likely to receive therapeutic tissue plasminogen activator during stroke...
(Aside: anyone care to guess the cost of a cardiac bypass?)

In mental health treatment, African Americans are more likely to have their conditions misdiagnosed and receive less than state-of-the-art treatment.[4]

[African Americans] are more likely to receive cheaper tricyclics rather than serotonin reuptake inhibitors...

Pamela D. Straker, PhD, highlighted how social institutions such as child protection agencies, foster care agencies, schools, and mental hospitals can fail children by causing institutional neglect and psychological trauma.[21] African American children make up 40% of the child welfare population but represent only 20% of children in the general population.

2) Franklin's unsourced, and thus unsupported, assertions are extremely bold:

As a result, there is a high likelihood that this psychological trauma [racism (that) has both overt and subtle forms and is still present today] may make African Americans more vulnerable to posttraumatic stress disorder and thus result in differential health outcomes.
(Aside: so African Americans are now more susceptible to PTSD?)
Low expectations for African American students often create an institutional bias in our schools.
(Aside: Ignoring the total lack of evidence, the statement also conjures up the chicken vs. egg argument, i.e. poor results vs. low expectations)

3) The author of the article is hardly an objective researcher:
Franklin is also the Assoc Dean Minority and Cultural Affairs and head of the Office of Minority and Cultural Affairs, and the diversity-speak is waist-deep over at the OMCA:

Diversity and Excellence Go Hand in Hand at Feinberg School of Medicine
A diverse class is essential to the quality of education for every student at Feinberg, and to this end the Feinberg School of Medicine works to recruit students from all backgrounds and walks of life. We recognize that diversity in today's society is not mirrored in the physician workforce, and therefore focus our efforts on increasing membership in medicine from underrepresented groups.

In fact, one could argue that Franklin's work is essentially self-perpetuating:
1) find race disparities
2) work in "diversity" position to resolve said disparities
3) when done go back to 1)
------------------------------------------------------------
The original post also hits home personally for me. I lived in Japan for a number of years and have lived here in China for several years as well. I'm fully competent in both languages (supporting my studies at a Chinese uni. via medical translation for Japanese companies). The rub here, though, is that I'm also white.
The original article makes me question the wisdom of returning back to the States - if a job there depends on language fluency, I'm a great candidate, but if it hinges on ethnicity?
4.15.2008 12:15am
wuzzagrunt (mail):
The logic isn't as irrational as you might think. The fact is that from breast cancer and prostate cancer to other types of diseases, all manner of studies have shown that African-Americans and Hispanics are much more likely to be under-treated and under-diagnosed by health care professionals.

...

Obviously this doesn't speak to considering Asian-Americans white or denigrating doctor's of all races who do their job, but to discount the fact that bias does exist between races and that bias filters even into healthcare is to ignore the obvious. I'm not advocating race-based allocations of doctors but if race does factor into the quality of care, attempting to increase the quantity of doctor's in under-served areas who won't have these biases isn't exactly illogical.

Before we go off to the races (pun intended) and create remedies for the substandard care that poorer minorities receive, shouldn't we first determine the source of the problem? Without more data, it seems at least possible that those patients are being harmed by less qualified practitioners who were admitted to med schools on "diversity" quotas. There is also the matter of poor patients seeking treatment at county and municipal hospitals, where (depending on the locale) there have been many scandals about the facilities being run in a thoroughly horrid manner. This, I believe, has much more to do with poor management and political cronyism, than incompetent physicians--though some public health facilities pay physicians shockingly little, and you frequently get what you pay for. I'm just not buying an explanation that points to racist white doctors (of whatever race) who let patients go off to die, because they don't care about people of color.
4.15.2008 12:38am
Brian G (mail) (www):
My daughters' doctor is Indian. No wait, I think he's Bangladeshi...er, wait, he could be Pakistani, or perhaps he's from Sri Lanka....uh, maybe he's from Iran. I don't know, because I never asked Dr. Koil where he is from and nor do I give a damn! My daughter's don't need a white doctor, they need a good one. And they love Dr. Koil, who is a damn good doctor. They trust him and when they see him, believe or not, they are happy and they do what he asks them to do, which anyone with a 4-year old and a 2-year old knows is next to impossible.

The problem, like it or not, is racial attitudes. Asians demand excellence from their children. You can't say the same about African-Americans and Hispanics. I have a friend, Eddie, an African-American guy. We go back nearly 30 years. (I am 36, so you can see how he has basically always has been a part of my life). You should see the difference in the way he acts around me as compared to his friends and family. He graduated a great university and now works as research analyst. For years, all he heard was how he was a "sell out" for "acting white" and hanging with a lot of white guys. Very few people, even his own family, told gave him support. And when he married a white woman...don't even ask.

And, I live in a majority Hispanic state now. We have a Hispanic governor, a majority Hispanic legislature, and nearly ever position of power, from the courts to the top positions in government, are filled with Hispanics. And all you ever hear is about racism against Hispanics and how they are underprivileged minorities.

Asians don't burden themselves with such things, which is why they are successful. They choice to work hard instead of whine hard and blame whitey for everything.

Of course, I am a racist for pointing all of this out. So be it. I prefer to take the advice given at the end of the artice you linked to: "[W]e should be scrupulously honest about what's really going on."
4.15.2008 1:31am
BS Detector:

For example, older Hmong frequently do not speak English and find many aspects of American life, especially urban American life, bewildering. the number of non-Hmong who speak Hmong is infinitesimal. For such people, being able to see a Hmong doctor is great benefit.


Undoubtedly, but I don't see why it's society's or the state's role to act in this fashion to accommodate this group that apparently either don't or can't learn English. I don't know when the US decided it was going to be the accepter of all peoples fleeing from [insert your poison here], but what further duty do "we" have to thereafter changing things to grant these peoples an easier time? Life is unfair. It's about time the diversity at all costs crowd got the message.
4.15.2008 1:48am
Richard Nieporent (mail):
Patients often need doctors whom they trust, to give often embarrassing and confidential information about their health.

Are you trying to say that these immigrants are all racists Dilan Esper? We are talking about doctors here not policemen.

Interpreters can interfere with the doctor-patient relationship, especially given that patients are sometimes ashamed and embarrassed about language problems.

You do know that you are babbling now, don't you? What you said makes no sense at all. Normally if someone can't speak the English, a relative or friend comes with the person to translate. That was the way it was done when all of the immigrants from the past came to this country or do you think all of the white immigrants automatically spoke English.

Further, interpreters may not be able to translate complex information about medical conditions, or translate it completely and accurately.

Do you want to try that again? Are you trying to claim that it is impossible to translate the fact that you have a pain in a particular part of your body? I know it is hard for you to believe, but we are all human. We all have the same physiology. This is not Star Trek where the alien life form has no human analog.


I am often the last person to accept "racial diversity" arguments.

You could have fooled me.
4.15.2008 1:58am
Fano:
I am a white person that was trained as a medical professional in Memphis, Tennessee. I was trained to recognize and understand many cultural approaches to medicine. I now practice elsewhere.

I certainly understand and can deal with the "major minority" approaches to medicine, but I certainly wouldn't feel certain with the nuances of Hmong culture. That said - I assimilated enough spanish to be proficient with my hispanic patients, of which I have many.

I suppose that the points that I would like to make are this: Some patients are more comfortable with a doctor of their ethnic group. I knew some docs who might have not been great on paper - but could communicate. That is worth a lot.
And with practice, an outlander can learn. Maybe not be guaranteed trustable, but if say a white doc has a patient population that is largely Hmong, that doc will learn the cultural mores, and be better at it. Ditto for any ethnic/cultural distinction. The person that worried about heterosexual doctors tut-tuting gay values? Bah, you aren't the first person to come out to the doctor. It's a real concern, I know, but believe me, for most things people say, it isn't the first time we've seen it. Docs may have prejudices just like other people, but we do care about general humanity.
4.15.2008 2:16am
wuzzagrunt (mail):
I've worked around Blacks and Hispanics for most of my adult life. I wish I had a dollar for every time I heard one of my coworkers or employees speak negatively about professionals of their own racial/ethnic group (i.e., "I'm not going to a Black/Hispanic doctor/lawyer, I want a JEW doctor/lawyer!").

I know...purely anecdotal, but probably a more honest statement of preference than an opinion pollster would ever get.
4.15.2008 2:16am
Dilan Esper (mail) (www):
Without more data, it seems at least possible that those patients are being harmed by less qualified practitioners who were admitted to med schools on "diversity" quotas.

Now that's just silly and actually gets to a false argument that too many conservatives believe. Affirmative action, at least in elite higher education, admits people with somewhat lower test scores. That's all it does. They still have to pass their classes. They still have to pass their professional exams.

So the idea that you are getting these incompetent minority doctors and lawyers is completely silly. (There is a better argument, made by Richard Sander, that too many minorities flunk out who would have succeeded at less elite institutions. That is a ponderable problem. But no, the ones who graduate from the top law and medical schools, I assure you, are perfectly competent people.)

Undoubtedly, but I don't see why it's society's or the state's role to act in this fashion to accommodate this group that apparently either don't or can't learn English.

This comment strikes me as evil. Yes, I know, we want people to learn English. But we are talking about FRICKING HEALTH CARE. PEOPLE'S LIVES ARE AT STAKE. And maybe if you would THINK a little bit about what it is like to be an immigrant, you might realize that EVEN ENGLISH SPEAKING IMMIGRANTS MIGHT BE MORE COMFORTABLE AND MORE ABLE TO COMMUNICATE ABOUT THEIR PRIVATE HEALTH CONCERNS TO A DOCTOR WHO SPEAKS THEIR NATIVE LANGUAGE! Really! You need a LOT more "there but for the grace of God go I".

Are you trying to say that these immigrants are all racists Dilan Esper? We are talking about doctors here not policemen.

This one pisses me off too. Guess what, Richard: PEOPLE WHO FEEL COMFORTABLE TALKING ABOUT PRIVATE HEALTH CONCERNS WITH SOMEONE WHO SPEAKS THEIR LANGUAGE ARE NOT RACISTS. Conservatives can be real jerks on the issue of racism, pretending that racism is about powerless immigrants who want to have a discussion in their native language, rather than powerful whites who pointed fire hoses at black demonstrators.

Really, if you think that some immigrant who can't find the words to describe her culturally taboo vaginal discharge to a doctor who only speaks English and knows nothing of her culture is the moral equivalent of Bull Connor or the KKK, you MUST have slept through your history classes.

You do know that you are babbling now, don't you? What you said makes no sense at all. Normally if someone can't speak the English, a relative or friend comes with the person to translate. That was the way it was done when all of the immigrants from the past came to this country or do you think all of the white immigrants automatically spoke English.

You might stop for a second and consider that MAYBE what happened is some of those people, because they were embarrassed or couldn't find an adequate interpreter, just didn't get treatment for their health problems? You are REALLY making assumptions here about what went on in the "good old days".

Do you want to try that again? Are you trying to claim that it is impossible to translate the fact that you have a pain in a particular part of your body?

Richard, you seem to know as little about going to the doctor as you do about immigrants. Doctors and patients discuss private embarrassing medical information ("I have a burning sensation in my penis"), complicated diagnoses ("you have abdominal hemoraging"), and complicated treatments ("you need to soak it in warm water treated with this tetracycline powder for 45 minutes each evening, and take this pill three times daily and 1/2 a pill of this one 4 times daily"). And if the patient gets it wrong, he or she may be injured or killed.

How about some SYMPATHY for people who don't have it as well as you do? Would it kill you?

You could have fooled me.

Only because you ASSUME that no liberals have any criticisms about affirmative action and racial diversity programs. But if you don't assume that liberals are evil, if you consider that maybe we've thought through our arguments, you might find that we are a very heterodox lot. In fact, I oppose a heck of a lot of race-based affirmative action. It seems to me that the need to have doctors who speak the language of their patients is a pretty persuasive, narrow reason to do it.

If you believe otherwise, tell me this. If the US government reacted to the shortage of Arabic-speaking linguists who can be enlisted to fight the war on terror by creating a scholarship program for Arabic speakers, would that be unconstitutional? If not, how is that different from a preference for medical students with particular language skills?
4.15.2008 2:25am
Gary Rosen:
Just remember, it's not about race - it's about culture.
4.15.2008 2:42am
wuzzagrunt (mail):
Dilan Esper wrote:
Without more data, it seems at least possible that those patients are being harmed by less qualified practitioners who were admitted to med schools on "diversity" quotas.


Now that's just silly and actually gets to a false argument that too many conservatives believe. Affirmative action, at least in elite higher education, admits people with somewhat lower test scores. That's all it does. They still have to pass their classes. They still have to pass their professional exams.

My one experience with an affirmative action doc confirms my suspicion that every field harbors a certain percentage of incompetents. Yeah, this doctor went to an elite school, was smart enough to pass his courses and his licensing exam, but he was a crappy doctor. He missed a bunch of important things. BTW, he was the beneficiary of the other kind of affirmative action. He was the son of a big time surgeon with a Park Avenue practice.

You have to admit that some doctors are just not very good at what they do...unless you believe that all medical malpractice suits are scams. All doctors don't graduate from elite schools, either.
4.15.2008 3:15am
Cornellian (mail):
The last time that I had a doctor doing a prostrate gland examination (which is not exactly what I would call a comfortable situation), it was an openly lesbian physician. Maybe I'm just a bit more openminded than all these "gay people" that you think can't handle talking to a straight doctor.


The other possibility is that there are a lot more straight guys who bear animosity against gay guys than there are lesbians who bear animosity against straight guys.
4.15.2008 5:21am
truth fairy (mail):
Um, lets get real here. If your going to use the term WHITE East Asians have always been a creamy milky white color while Europeans have always been a pasty transparent reddish white.
4.15.2008 6:06am
tioedong (mail) (www):
Asians became white because, like Jews, they studied hard and succeeded.

If it wasn't for the Indian and Pinoy docs, many of them first or second generation, a lot of small town America would be in trouble. So is it a crime if Dr. Patel sees Mr. Gonzalez, or Dr. Reyes (father born in Pampanga) sees a black patient? Give me a break.
4.15.2008 6:54am
BruceM (mail) (www):
They're not brown, they're not actually "yellow" ... so they must be white by default.
4.15.2008 10:12am
Zed:
As a white person, can I tell my white friends to take our medical business to white doctors? We feel culturally much comfortable with people of our own kind. Thanks.
4.15.2008 10:30am
Extraneus (mail):
This stuff should be illegal in America, pure and simple. Fine for other countries, perhaps, but not for one founded on the principle that "all men are created equal." Sure, you can point to examples which didn't live up to that principle, such as slavery or Jim Crow or the California anti-Chinese laws cited above, but these were clearly wrong as well, and certainly wouldn't be tolerated today. The fact that the U.S. government even classifies people on the basis of race or ethicity is offensive.
4.15.2008 10:42am
Iolo:
Dilan, a little less spittle on the screen, please.

Affirmative action, at least in elite higher education, admits people with somewhat lower test scores. That's all it does. They still have to pass their classes. They still have to pass their professional exams.

Uh huh. And they don't get any extra "help" there, either.

This comment strikes me as evil.

Someone can't differ with you without being "evil"? Hmmm, I'm thinking the Hitler card will be played soon...

Yes, I know, we want people to learn English. But we are talking about FRICKING HEALTH CARE. PEOPLE'S LIVES ARE AT STAKE.

All the more reason for them to learn English! If I moved to a foreign country, I certainly would not expect them to have a cadre of English-speaking doctors on hand just to accommodate my needs. I would gain basic competence in the language of that country, especially if I thought I might need medical care there.

racism is about powerless immigrants who want to have a discussion in their native language, rather than powerful whites who pointed fire hoses at black demonstrators.

Oh good grief, when are we going to get over this? Nearly 70% of the population in this country wasn't even born when the "powerful whites" were using the fire hoses.

Really, if you think that some immigrant who can't find the words to describe her culturally taboo vaginal discharge to a doctor who only speaks English and knows nothing of her culture is the moral equivalent of Bull Connor or the KKK, you MUST have slept through your history classes.

Unfortunately, you seem to think that a doctor who only speaks English and only understands American culture is the moral equivalent of Bull Connor and the KKK. This indicates you paid all too much attention to the Lefty professor who taught your history class.

Only because you ASSUME that no liberals have any criticisms about affirmative action and racial diversity programs.

A good assumption is that the liberal "criticism" about affirmative action and racial diversity programs is that there are not enough of them, they're not pervasive enough, and they aren't backed by sufficiently strong government power.

if you consider that maybe we've thought through our arguments

Your posts certainly don't suggest this is the case.

If the US government reacted to the shortage of Arabic-speaking linguists who can be enlisted to fight the war on terror by creating a scholarship program for Arabic speakers, would that be unconstitutional? If not, how is that different from a preference for medical students with particular language skills?

The US government should react to this "shortage" by training the best possible recruits to speak Arabic, not by importing / recruiting Arabs to work for the US government. Medical schools should also recruit the best possible students on the basis of their future competence to practice medicine, not their "particular language skills".
4.15.2008 10:48am
Richard Nieporent (mail):
Affirmative action, at least in elite higher education, admits people with somewhat lower test scores. That's all it does. They still have to pass their classes. They still have to pass their professional exams.

Do you really believe that all people who pass their exams and get a diploma are equally competent? In other words, you would argue that the B or C student is just as competent as the A student, is that correct Dilan? You know that position is indefensible, so why do you even attempt to make it?

This one pisses me off too. Guess what, Richard: PEOPLE WHO FEEL COMFORTABLE TALKING ABOUT PRIVATE HEALTH CONCERNS WITH SOMEONE WHO SPEAKS THEIR LANGUAGE ARE NOT RACISTS.**

Really? What would you call White people who don't want to use non-White doctors because they don't feel comfortable telling them their "private health concerns"? I do believe the answer would be racists. Of course the reverse is never true because as we know only White people can be racists.

**By the way Dilan you don't have to shout. Your patronizing attitude towards minorities comes through loud and clear. What is it about liberals that they have to ascribe their own racist feelings onto other groups?

Conservatives can be real jerks on the issue of racism, pretending that racism is about powerless immigrants who want to have a discussion in their native language, rather than powerful whites who pointed fire hoses at black demonstrators.

This comment is truly pathetic. Are you really that much of a Leftist that you believe this crap? I thought I would only hear such an argument from a Black Nationalist. I am embarrassed for you that would actually make such an argument.

Richard, you seem to know as little about going to the doctor as you do about immigrants.

You are correct. White people don't have to go to doctors. We are immune to all diseases. In is only these lesser racists who get sick and have to go to the doctor. In fact we developed diseases to kill off these brown people. Your arguments are getting more and more bizarre, Dilan.

Doctors and patients discuss private embarrassing medical information ("I have a burning sensation in my penis"), complicated diagnoses ("you have abdominal hemoraging"), and complicated treatments ("you need to soak it in warm water treated with this tetracycline powder for 45 minutes each evening, and take this pill three times daily and 1/2 a pill of this one 4 times daily"). And if the patient gets it wrong, he or she may be injured or killed.

Is the only reasons people go to a doctor to discuss private "embarrassing" medical information? Why are you focusing on only one part of the body? Are those the only diseases that you know about? This is a stupid straw man that doesn't fool anyone. And how do you know it is embarrassing to them. After all their culture is alien to us.

How about some SYMPATHY for people who don't have it as well as you do? Would it kill you?

What has this got to do with "SYMPATHY". I am not talking about denying people medical service. Rather I am talking about giving them the best medical service possible, not the politically correct medical service where they get a doctor who is barely competent but is of the right ethnic group. What you are arguing is that not even a Vietnamese doctor is capable of treating a Hmong because they are from different ethnic groups. If anyone is causing these immigrants to be harmed it is people of your ilk that will deny them the most competent doctors to satisfy your own racists beliefs.
4.15.2008 10:55am
Bored Poster:
Why is everyone talking about Asians as if they're one monolithic group? Hasn't the recent SF protest proven that there really is NO Asian community, more like a "disunity"?

Even among the Chinese communities, Honkies and Taiwanese dislike Mainlanders. Then Vietnamese and Tibetans have axes to grind with Chinese. Then Chinese and Koreans dislike Japanese. South Asians and East Asians throw shots at each other for being cheap and having weird smelling food. Honestly, the designation for "Asian" on the US census is more based on the fact none of these groups fit anywhere else.
4.15.2008 11:05am
Mikeyes (mail):
But no, the ones who graduate from the top law and medical schools, I assure you, are perfectly competent people.)

All doctors don't graduate from elite schools, either


Unlike law schools, graduates of medical schools (there are about 160 MD and DO schools) don't have to rely on the USNWR ranking of their schools to get a well paying job. In this respect, there are no elite medical schools unless you are just counting the universities they are attached to.

Every medical student takes the same basic courses, passes the same national exams, and is subject to the same matching program for residencies. Graduates of foreign medical schools have to take the same national exams in addition to a very rigid entrance test to practice in the States.

In order to get into a medical school you have to have a high GPA, do very well on the MCAT and have the usual feel-good extras. The difference between the whole of medical school entrants and law school entrants is that the range of aptitude for medical students is quite narrow and the selectivity is much higher compared to law students.

This presents a practical problem for some groups whose members are not going to college in large numbers. As a result, the majority of medical students are white middle/upper class or Asian - the cultural groups that have high participation in upper education.

There are medical schools who try to boost minority participation (Meharry and Howard, for example) and others who cater to specific populations (most state schools) in an attempt to bolster the presence of physicians in underserved areas.

Because being a physician is a secure job, there is still a lot of competition for these slots. According to a Tulane study, only a third of all entering fresmen who profess that they are pre-med even apply to medical school by graduation (this is an older study, a lot more medical students have experience outside of college before they apply) mostly because the grind of pre-med takes its toll. And pre-med is only a taste of the stressors placed on a medical student.

People who imply that anyone with the intellectual capacity can go to medical school have probably not been through medical school. Not everyone has the combination of discipline, self-starting capabilities, and immunity to boredom needed to tolerate the long hours of study and practicum in medical school. And that is just to get the degree.

Becoming a physician is a dedication of at least seven years of your life after college. At my school the average entering medical student is 24 years of age and half of them are women (another minority, perhaps?) All of them bring high academic achievement, high aptitude, and a proven history of being goal driven to school.

As another writer pointed out, this is a cultural issue.

Are some people being overlooked who could get through medical school? Sure, probably half of those who are turned down could be a good physician. Many of them try again and are admitted (most of this information is on the AAMC web site )and some schools have back door policies to let in students who don't meet all the usual standards.

What does this have to do with low numbers of non-Asian minority doctors? Getting into medical school is a numbers game. If you don't have the numbers, you don't get in. I certainly would not have as good a chance these days as I did in the time when physicians were mostly white, mostly male. If the starting pool for certain groups is small to begin with, the chances are that these groups will not have very many members who make the cut, even with special care in selection in an environment with very high standards.

The same could be said about physics graduate school, but you don't hear much about that.
4.15.2008 11:14am
David M. Nieporent (www):
In fact, I oppose a heck of a lot of race-based affirmative action. It seems to me that the need to have doctors who speak the language of their patients is a pretty persuasive, narrow reason to do it.
That would seem to argue for language-based affirmative action, not race-based affirmative action.
If you believe otherwise, tell me this. If the US government reacted to the shortage of Arabic-speaking linguists who can be enlisted to fight the war on terror by creating a scholarship program for Arabic speakers, would that be unconstitutional?
That depends. Would it be limited to Arabs regardless of what language they spoke, or would it be open to all Arabic speakers, regardless of their skin color?
4.15.2008 11:24am
shawn-non-anonymous:
Fano: "The person that worried about heterosexual doctors tut-tuting gay values? Bah, you aren't the first person to come out to the doctor. It's a real concern, I know, but believe me, for most things people say, it isn't the first time we've seen it. Docs may have prejudices just like other people, but we do care about general humanity."

That would be me--a gay person who had to "come out" to a doctor who turned out to be a fundamentalist Christian. I left humiliated. Like Uthaw, the doctor automatically assumed the issue was VD simply because I was gay. (It wasn't.) That was back when I trusted doctors (my mother was an RN) to be professionals first. Now I do research to find doctors that have other gay patients. With the basic HMO-type health insurance most of us get from our employers, this can be difficult. I have seen ambulance personnel balk at entering a gay bar to treat a patient. We've all read about medical personnel refusing treatment to people on religious grounds. When I'm sick or hurt and need to see someone the last thing I want to deal with is the fear that my treatment may suffer because of my caregiver's prejudices.

There is nothing special about doctors that prevents them from behaving as good or as bad as people in other professions. Something as private as medical care requires communication which requires trust. Not all doctors can be trusted by all patients.
4.15.2008 11:26am
Elliot123 (mail):
Perhaps the Blacks, Hmongs, and Mexicans wouldn't face this problem if they encouraged their kids to do well in school and go to medical school? That's what the Asians and Indians do and it works very well.

The success of the Asians and Indians makes it a bit difficult to accept the excuse that minorities can't succeed because of racism. If Blacks, Mexicans, and Hmong had the same test scores as Asians and Indians, they would be in medical school, too.
4.15.2008 12:10pm
Iolo:
Like Uthaw, the doctor automatically assumed the issue was VD simply because I was gay. (It wasn't.)

Just for my own enlightenment, what "health issues" do gay men have that straight men do not other than STDs? If the issue is not an actual or potential STD, why even mention that you are gay?
4.15.2008 12:25pm
Iolo:
That would be me--a gay person who had to "come out" to a doctor who turned out to be a fundamentalist Christian. I left humiliated. Like Uthaw, the doctor automatically assumed the issue was VD simply because I was gay. (It wasn't.) That was back when I trusted doctors (my mother was an RN) to be professionals first.

Oh, and also just curious, did he not treat your medical problem? If he did, how was he "unprofessional"? Indeed, how is it "unprofessional" to ask a gay man about STDs regardless of the reason he comes to the office, inasmuch as gay men are well known to engage in risky behaviors, to have a higher chance of having STDs than straight men, and to have STDs that straight men generally do not have? Seems to me he would be unprofessional not to ask you about your sex life as it relates to your health.
4.15.2008 12:31pm
KWC2000 (mail):
It's so funny to me that white people have such a difficult time accepting what is common knowledge among minority groups.

Clayton:

(1) You aren't more open-minded than the "gay people" I describe, you've never been called a faggot or a homo, had your life threatened by a bigot with a baseball bat, or had laws enacted to restrict your rights. THAT's why when you walk into the doctor's office you are free to be who you are. The lesbian doctor was hardly going to judge you for being straight. Your logic is more disjointed than your website, which by the way advocates boycotting Amazon because they sell a book you don't like. I mean, care you not about freedom of expression?

(2) That whole "those white people are different white people than me, so I'm innocent, minorities stop complaining" line of argumentation is so annoying. First of all, at least most of your parents lived in the hayday of segregation -- they drank out of the not-for-black-people fountains, etc. So don't tell me about how far divorced you are from it all. Second, you live your life everyday benefiting from the white privilege that your ancestors set up for you. Others benefit, too (white immigrants who easily assimilate after a generation or two). It's easy to walk around life preaching about equality when you are protected by a bubble of white, straight privilege.

Elliot123:

(1) I said "group in power." Naming three black people in power hardly constitutes a "group in power."

(2) Racism is a lot easier to fight when you come to this country with higher education. Many South Asian and East Asian people come here with degrees in medicine, engineering, etc. It's an economic thing. And we can't ignore that the economic situation of Blacks and Mexicans is directly derived from their oppression at the hands of a racist society. Hmongs came here as refugees with nothing. It doesn't really seem like a fair comparison does it? (Hmongs are Asian, btw).
4.15.2008 12:46pm
BladeDoc (mail):
The valedictorian of my Med school class (UVa '96) is a Kenyan immigrant. If you want to hear a rant about the idiocy of affirmative action, she3's the one to go to (too polite to actually foam at the mouth, but not far from it). On the other end of the spectrum of competence if you were a defined minority (no Asians need apply) you could come to school 2 months early and take a condensed lecture series on the first year classes, including the tests then retake them with the rest of the class for grades that counted. You also had access to a program that allowed you to spread the first two years of med school over three (for no extra tuition, unlike if you were white/Asian and had to repeat a year) and access to a free tutorial service not open to white students. Furthermore it was almost impossible for a minority student to flunk out of school -- including the student (class of '98 I believe) who was convicted of selling crack cocaine during his first year. So, assuming you were just ignorant Dilan I'd like to inform you that affirmative action for physicians is a hell of a lot more than just lowering the score on the MCAT that they need to get into med school.

Secondly the concept of a "Hmong physician" is somewhat of an oxymoron being that Hmong culture rejects the medical paradigm of disease so in order to actually become a physician the first thing you'd have to do is reject your original cultural upbringing. How many people do you think are going to sign on for that no matter how low you set the bar for entry? It's like expecting to recruit a bunch of Christian Scientist cardiac surgeons or Jehovah's Witness hematologists. Yes, if you could get one they probably would understand the culture a little better -- but you've got a hell of a lot better chance educating the rest of us about the culture than the reverse.
4.15.2008 12:54pm
Iolo:
It's so funny to me that white people have such a difficult time accepting what is common knowledge among minority groups.

"Common knowledge" =/= true, rational, non-racist, or even terribly interesting.

at least most of your parents lived in the hayday of segregation -- they drank out of the not-for-black-people fountains, etc. So don't tell me about how far divorced you are from it all.

Oh, please... now racism is a permanent genetic taint... one drop of racist blood, and you are a racist!
4.15.2008 1:09pm
Jack Denver (mail):
As usual, the elephant in the room is ignored. Not all ethnic groups are equal when it comes to IQ (nor running and jumping ability, height, musical talent, etc, etc. - yet nobody proposes "affirmative action" because whites and Asians are "underrepresented" in the NBA ) To complete an advanced professional degree such as medicine, you generally need to have an IQ in the upper range, say 125 or above. If your ethnic group has a higher than average IQ (Ashkenazi Jews, Chinese) then a disproportionate # will fall in the above 125 "tail" and that group will be "overrepresented" in the learned professions. If a group's average IQ is below 100, then that group will be "underrepresented" because instead of 125 being 1 standard deviation away from the mean (where the normal distribution curve is relatively "fat", 125 will be 2 or more SD's away where the curve is skinny. If you show me the IQ scores of a population at say age 6, I could predict with good accuracy the % that will enter the learned professions such as medicine 20 years later. Show me the test scores of today's first graders and I will tell you the ethnic composition of the med school class of 2028. There is nothing mysterious about this, but liberals have to ignore the obvious and pretend to be "puzzled" as to why certain groups are underrepresented and invent non-existent "racist" explanations based on the situation in Alabama in 1958 (when all evidence is to the contrary - colleges and med schools are literally begging today for qualified black applicants).

Liberals remind me of the mad dictator in Woody Allen's "Bananas". On coming to power, he demands that people change their underwear every half hour and that that "all children under 16 years old are now... 16 years old!". Likewise, liberals would like to proclaim "All persons (of color) with an IQ of less than 125 are now 125." Wishing does not make it so.

Putting aside the question of whether IQ is a heritable characteristic that is at least partly determined at birth (anyone not blinded by ideology realizes that it is, at least in part), the level of government intervention at an early age that it would take to make black culture similar enough to Jewish culture or Hmong parenting similar to Chinese parenting (respect for learning and achievement, emphasis on education, degree of verbal interaction with children, etc. etc.), such that the "nurture" factor would be equalized, is far beyond what could be tolerated in any free society. Looking at this problem at the med school level, when 3/4ths of the black students in Detroit never even finish high school, is looking at this from the wrong end. Even high school is too late. By the time you get to first grade is too late. You'd have to change the whole parenting style of an entire culture from birth even IF it was a pure question of nurture, and it ain't.
4.15.2008 1:14pm
Jack Denver (mail):
"Hmongs came here as refugees with nothing. It doesn't really seem like a fair comparison does it? (Hmongs are Asian, btw)."

But the Vietnamese boat people (many of whom are actually ethnic Chinese) came here at the same time and also as refugees with nothing, and yet they have done significantly better. Is that a "fair" comparison? To the average white "racist", isn't one "gook" like another? If racism was the explanation, then wouldn't the Hmong do as well as the Vietnamese, the Samoans as well as the Chinese? Hmm, maybe there is some explanation rooted in their native cultures - liberal ideology is the REAL racism because it puts the power of explanation solely in the hands of white people - the are the actors that do stuff TO other people, everyone else is just a passive recipient and what they do or don't do has no relevance.

Generally speaking, EVERYONE who immigrates to America, with the recent exception of the Indian professional class, does so because they have "nothing" - if they had "something", they'd stay home. The Irish had nothing, the Italians had nothing, the Jews had nothing. As others have pointed out, the reason why Asians (and the Jews and the Irish and the Italians before them) have become "white" is because they put the lie to the explanation that minority "underrepresentation" is due to white "racism".
4.15.2008 1:33pm
Michelle Dulak Thomson (mail):
KWC2000,

I'm still curious in what "strict sense" Asians are not a "minority" in San Francisco. Can you explain?
4.15.2008 1:34pm
SIG357:
It's almost as if the notion that people are interchangable units is false, isn't it?



"Generally speaking, EVERYONE who immigrates to America, with the recent exception of the Indian professional class, does so because they have "nothing" - if they had "something", they'd stay home."




No, that's not true. All that's neccessary is for them to have less than they would in America, which is a low bar. The Irish who came here, for example, were actually from the middle class. The true "have nothings" did not have the means to even buy passage on a ship, which was a fairly pricy proposition in those days.
4.15.2008 2:34pm
KWC2000 (mail):
Jack Denver:

I don't think you know enough about Hmong or Vietnamese culture to make a comparison. First of all, Vietnamese people (as well as most Southeast Asians) are not doing as well as the Chinese, Koreans, or Japanese. Second, the Vietnamese have only started to emerge now that they have been here for a couple of generations.

The only person seeing that elephant is you, Jack, because it seems you are on drugs. There is no evidence that different races have different levels of IQ. Where are you getting that from? Who takes those tests? Also, they are so infused with cultural bias that they can't actually test intelligence quotient, they test raw aptitude. MENSA is crap! Look at their questions -- they require you to know the English language really well, including even idioms and expressions. How is that testing quotient nad not aptitude?

Michelle Dulak Thomson:

Asians are not underrepresented in the medical field based on their population. That's all I meant.
4.15.2008 2:44pm
CWuestefeld (mail) (www):
@KWC2000:
(1) You aren't more open-minded than the "gay people" I describe, you've never been called a faggot or a homo, had your life threatened by a bigot with a baseball bat, or had laws enacted to restrict your rights.

You're wrong. I've had all three of these things done to me. You seem to think that being straight/white is just a bowl of cherries. I've got news for you, there are a lot of bad people in the world, and they come from all societies and orientations.

Moreover, the very topic here is over a potential need for laws that restrict my rights. Isn't that what affirmative action is? To restrict the potential options of members of one group to give preference to another?


(2) That whole "those white people are different white people than me, so I'm innocent, minorities stop complaining" line of argumentation is so annoying. First of all, at least most of your parents lived in the hayday of segregation -- they drank out of the not-for-black-people fountains, etc. So don't tell me about how far divorced you are from it all. Second, you live your life everyday benefiting from the white privilege that your ancestors set up for you.

My ancestors fought in the civil war to free the slaves, they marched for civil rights, etc. They paid a price to achieve what degree of equality we currently enjoy. Why do you demand that they pay more?

(then you restart counting)
(1) I said "group in power."

It might be more accurate to consider "ideology in power". The stranglehold that PC-think has on our society should be self-evident: again, it's the reason for this conversation.
(2) Racism is a lot easier to fight when you come to this country with higher education. Many South Asian and East Asian people come here with degrees in medicine, engineering, etc. It's an economic thing. And we can't ignore that the economic situation of Blacks and Mexicans is directly derived from their oppression at the hands of a racist society. Hmongs came here as refugees with nothing. It doesn't really seem like a fair comparison does it?

That's because it's NOT a fair comparison. You switched arguments in midstream. On one hand you want to consider blacks who have been here for generations, while on the other you want to limit the discussion to (supposedly) wealthy immigrants. Aside from this bait-and-switch, your information is flawed. Focusing on Chinese, e.g., until recently those who came here were not rich, but fleeing famines in which millions starved to death. And has been pointed out previously, the Chinese who were here in the Jim Crow period suffered worse discrimination (particularly in CA and the city of SF) than did blacks.
4.15.2008 2:49pm
MlR (mail):
Why is everyone talking about Asians as if they're one monolithic group? Hasn't the recent SF protest proven that there really is NO Asian community, more like a "disunity"?

That would be reason #3234324 that this policy is racist and demonstrates the extent to which the people running this program are way over their head playing King Solomon.

Can you imagine their attempts to rationalize this nonsense if they couldn't stick people into easily identifiable, but otherwise irrational groups?

This stuff's disgusting.
4.15.2008 3:28pm
NickM (mail) (www):
Foam at the mouth much lately, KWC?

Do you even realize that your arguments are self-contradictory?

Nick
4.15.2008 3:47pm
Michelle Dulak Thomson (mail):
KWC2000,

So "minorities in the strict sense" means "not underrepresented" in a given profession, role, whatever? Well, if you say so — though other people, aware that this is not what most people think of as "the strict sense" of the word "minority," have taken to saying, well, "underrepresented minorities" when that's what they are talking about. You had specified that Asians were not "minorities in the strict sense" in SF, which made me assume you meant something else; surely Asians as a group are "overrepresented" in medicine not merely "in SF" but in CA and indeed in the US as a whole.
4.15.2008 3:48pm
c.gray (mail):

The Irish who came here, for example, were actually from the middle class. The true "have nothings" did not have the means to even buy passage on a ship, which was a fairly pricy proposition in those days.


Off topic, but...


By the 1830s, passage from Liverpool to New York had fallen to 2 Pounds Sterling. A ferry over the Irish Sea to Liverpool was just a shilling or two. For a poor, landless Irish peasant, the total was a lot of money. But it wasn't exactly out of reach...more on the order of 2-4 weeks wages than one's life savings. After the Famine and the Poor laws hit, those landlords who were not going bankrupt often paid the fares for tenants behind on rent to get rid of them, rather than go through the considerably more wrenching and expensive process of eviction.

So the Irish who fled from 1845 on or so were mostly the poor and the not quite poor. The Irish middle class appears to have used the collapse of land values as a chance to buy up holdings from bankrupt absentee landlords on the cheap.
4.15.2008 4:29pm
Dilan Esper (mail) (www):
Uh huh. And they don't get any extra "help" there, either.

Iolo, people have to take state administered, blind exams to get a medical or legal license. There's no way that race can enter into their scoring.

Nor does race enter into the scoring of exams in medical and law schools. If you have any evidence to the contrary, you might call the Department of Justice.

Someone can't differ with you without being "evil"? Hmmm, I'm thinking the Hitler card will be played soon...

What's "evil" is the idea that somebody would argue that the way to incentivize the learning of English is to do something that might kill them, i.e., denying them health care if they can't speak the language.

Immigrant assimilation is important, but it isn't life-or-death. Someone who thinks it is more important for people to learn English than it is to save their lives is grossly immoral.

All the more reason for them to learn English! If I moved to a foreign country, I certainly would not expect them to have a cadre of English-speaking doctors on hand just to accommodate my needs. I would gain basic competence in the language of that country, especially if I thought I might need medical care there.

True enough, but if you had some very esoteric medical condition, you might feel more comfortable and better able to execute your treatment if you had it explained to you in your native language.

Plus, you are missing the point about cultural concerns. We are pretty open about sex and genitals in the western world, but in a lot of places, they aren't, and this can make a big impact.

Oh good grief, when are we going to get over this? Nearly 70% of the population in this country wasn't even born when the "powerful whites" were using the fire hoses.

We aren't going to get over it until people stop calling immigrants who want to discuss private medical conditions in their native language "racists".

Unfortunately, you seem to think that a doctor who only speaks English and only understands American culture is the moral equivalent of Bull Connor and the KKK.

I don't know if you are lying or just being extremely dumb. I said NOTHING about "moral equivalence". I was RESPONDING to an argument that said that immigrants were "racists" if they wanted to talk to someone in their own language about their health problems. I was saying that Bull Connor = racism; wanting to talk to a doctor in your own language does not = racism. There was nothing in there about white doctors.

A good assumption is that the liberal "criticism" about affirmative action and racial diversity programs is that there are not enough of them, they're not pervasive enough, and they aren't backed by sufficiently strong government power.

No, that's an ignorant assumption. In fact, liberals like Richard Kahlenberg and Stephen Carter and William O. Douglas have eviscerated affirmative action over the years. But many conservatives would rather believe their fairy tales rather than learning about the subject.

The US government should react to this "shortage" by training the best possible recruits to speak Arabic, not by importing / recruiting Arabs to work for the US government.

You should pick up a linguistics book and learn about native speakers versus second language acquisition. Doing it that way would cripple us because non-native speakers almost never understand all the nuances and idioms of the language.
4.15.2008 4:30pm
Dilan Esper (mail) (www):
Do you really believe that all people who pass their exams and get a diploma are equally competent? In other words, you would argue that the B or C student is just as competent as the A student, is that correct Dilan?

Richard:

Medical board exams are VERY difficult. We aren't talking about getting a "C" in a high school class. You have to be exceptional to graduate from a top medical school and pass the boards.

Your patronizing attitude towards minorities comes through loud and clear.

Wow! Apparently anyone who defends poor minorities from charges of racism is "patronizing". That's not an argument; that's just an attempt to shut down any criticism of your position.

What has this got to do with "SYMPATHY". I am not talking about denying people medical service. Rather I am talking about giving them the best medical service possible, not the politically correct medical service where they get a doctor who is barely competent but is of the right ethnic group.

In other words, your position is "I'm gonna give them the best medical service available, even if it kills them!".
4.15.2008 4:34pm
Jack Denver (mail):
"There is no evidence that different races have different levels of IQ."

This reveals your imperviousness to evidence. There is a HUGE body of evidence that documents racial differences in IQ. No serious scientist disputes that such differences exist. Whether such differences are genetically determined or could be somehow erased in the future is another question, but that such differences currently exist is utterly beyond dispute.

Read this wikipedia article for a more or less balanced discussion
4.15.2008 4:35pm
Dilan Esper (mail) (www):
That depends. Would it be limited to Arabs regardless of what language they spoke, or would it be open to all Arabic speakers, regardless of their skin color?

All Arabic speakers, but with a preference for native speakers, because native speakers have communicational advantages.
4.15.2008 4:36pm
Mikeyes (mail):
The Irish who came here, for example, were actually from the middle class. The true "have nothings" did not have the means to even buy passage on a ship, which was a fairly pricy proposition in those days.


SIG357, do you have a cite for that statement? I am surprised to hear that millions of post-famine members of the middle class in Ireland managed to leave without causing financial havoc. Ireland remained a net exporter of food and industry throughout the famine. I guess the upper and lower classes managed somehow.

What is your definition of "middle class"?

Of course you might be referring to the later emigrations in which many middle class persons had to leave Ireland in the twentieth century due to the high rate of unemployment.
4.15.2008 4:46pm
Elliot123 (mail):
"(1) I said "group in power." Naming three black people in power hardly constitutes a "group in power."

Sure seems like Rice, Obama, and Powell can be counted as being among the "group in power." Sec of State and US senator are squarely in that group. They still look black to me.

"(2) Racism is a lot easier to fight when you come to this country with higher education. Many South Asian and East Asian people come here with degrees in medicine, engineering, etc. It's an economic thing. And we can't ignore that the economic situation of Blacks and Mexicans is directly derived from their oppression at the hands of a racist society. Hmongs came here as refugees with nothing. It doesn't really seem like a fair comparison does it? (Hmongs are Asian, btw)."

And lots of blacks have just as much money as the Asians who came to this country. There are also many more blacks than Asians. So, how come those Asian minorities do so much better than blacks? How come they do so much better than middle class blacks? I think the reason is they work very hard, and have a culture that supports them in their efforts.

Obama and Bill Cosby have suggested that a cultural value among blacks not to "act white" contributes to an acceptance of poor academic performance. I doubt Asians have such a value.
4.15.2008 5:52pm
SIG357:
SIG357, do you have a cite for that statement?




I don't have a cite for that statement. I take it as self evident that the roughly one million people who died in the famine did NOT have the wherewithal to hop on a boat to America, or elsewhere. But who knows, maybe the Irish are really really stupid.

Ireland remained a net exporter of food and industry throughout the famine.




That is pretty common in famines, which are normally man-made events. The Irish one was an instance of what Hayek called "the wooden insistence ... on certain rough rules of thumb, above all the principle of laissez faire".
4.15.2008 5:56pm
Jordan Keith (mail):
(1) You aren't more open-minded than the "gay people" I describe, you've never been called a faggot or a homo, had your life threatened by a bigot with a baseball bat, or had laws enacted to restrict your rights.


Well I'm white and heterosexual and I've experienced every one of those, genius. Nobody goes through life without being a victim of bigotry (well except for guild-ridden white liberals apparently).
4.15.2008 6:19pm
KWC2000 (mail):
I will respond to just one comment because the rest intentionally misconstrue what I am saying take it out of the context of the dialogue it was a part of.

CWuestefeld: I didn't switch midstream. Tee argument still holds. The blacks you are talking about have been here for generations and have been oppressed for generations. It wasn't until the late 50s early 60s that equality was even recognized as necessary and fair, and the aspirations of the Civil RIghts movement are still far from being accomplished. You can't erase hundreds of years of damage with just a few decades of change.

Also, people are grouping all Chinese immigrants together. The ones that were oppressed are not the wealthy, successful ones. There have been several waves of immigration. It is the recent group that constitutes the wealthy group. The Hakka, Cantonese, and Fukkinese of yore, are being supplemented with Mandarin-speaking Taiwanese immigrants and Cantonese-speaking Hong Kongers who are undoubtedly wealthy and who undoubtedly push their kids to follow their lead.

I don't think most of you even know what you are talking about. You just see "Chinese" and you think that they are all the same. They are not.
4.15.2008 6:33pm
Michelle Dulak Thomson (mail):
KWC2000,

If I have misconstrued you, it was certainly not intentionally; my point was that in the context in which you used it, I didn't see how you could have meant by "minority" what it turns out you did mean.

But as to there being different waves of Chinese immigration, I don't see anyone either denying or minimalizing that — unless, perhaps, it be those who (like the SF Chron in the linked article, or like every race-based affirmative action program I've ever heard of) treat "Chinese" as a single group. And a presumptively "privileged" one at that.
4.15.2008 7:37pm
Richard Nieporent (mail):
Medical board exams are VERY difficult. We aren't talking about getting a "C" in a high school class. You have to be exceptional to graduate from a top medical school and pass the boards.

Dilan, repeating the same erroneous argument over and over again does not change the fact that you are wrong. Are you really willing to contend that all doctors who pass the medical boards are equal in ability? I don't think so. Unless the grade is set at 95 then there is a big difference in knowledge between a doctor who barely passes the board exam and one who aces the board exam. In any case, at this point in time it would be impossible to get enough competent let along excellent Hmong doctors, so some Hmongs will in fact have to be treated by a non Hmong doctor.

In other words, your position is "I'm gonna give them the best medical service available, even if it kills them!".

You are correct. I am evil. I insist on these immigrants being treated by excellent doctors. How can I be so cruel? Yes it's so much better to use a barely competent Hmong doctor (assuming you could even find one) than to provide them with a doctor who excelled as a medical student. I am afraid your position is untenable and you know it.

The worse thing about your argument is that you deliberately ignore the fact that Hmongs are members of the human race. They have the same physiology as Whites and other Asians. They are not some non-human species that can only be treated by their own kind. Basically what you are proposing is that we segregate society along tribal lines so that only member of the same ethnic group are allowed to treat other member of that group. That, Dilan is pure racism, and it is indefensible.
4.15.2008 7:54pm
steveH:
KWC2000;

I don't think you know enough about Hmong or Vietnamese culture to make a comparison. First of all, Vietnamese people (as well as most Southeast Asians) are not doing as well as the Chinese, Koreans, or Japanese.


It's overwhelmingly likely that this is because they haven't been here long enough; they're the latest major wave of asians to arrive.

You saw the same progression with Chinese and Japanese; the first generation tended to be basic/unskilled laborers, their children began to move into owning their own businesses, as grocers, for example, and *their* children then started going for higher education, entering law, medicine, and so on.


Second, the Vietnamese have only started to emerge now that they have been here for a couple of generations.


Just like the earlier waves from Asia, not to mention immigrant groups from Ireland, Germany, Italy, Russia, etc etc etc.

The Vietnamese look to be right on track here.
4.15.2008 9:04pm
Elliot123 (mail):
It will be interesting to track the progress of the descendents of the Vietnamese boat people.
4.15.2008 9:10pm
Mikeyes (mail):
SIG357, do you have a cite for that statement?

I don't have a cite for that statement. I take it as self evident that the roughly one million people who died in the famine did NOT have the wherewithal to hop on a boat to America, or elsewhere. But who knows, maybe the Irish are really really stupid.


Thanks for clearing that question up.
4.15.2008 10:32pm
Uthaw:

The US government should react to this "shortage" by training the best possible recruits to speak Arabic, not by importing / recruiting Arabs to work for the US government.

You should pick up a linguistics book and learn about native speakers versus second language acquisition. Doing it that way would cripple us because non-native speakers almost never understand all the nuances and idioms of the language.


Gee, I wonder how the NSA managed to fight the Cold War for 40+ years using American-trained Russian speakers rather than Russian immigrants? Why, even having relatives in Russia could disqualify a Russian speaker from employment. Think of all the nuances and idioms they missed and somehow still got the job done!
4.15.2008 10:57pm
Iolo:
What's "evil" is the idea that somebody would argue that the way to incentivize the learning of English is to do something that might kill them, i.e., denying them health care if they can't speak the language.

They're not being "denied health care", and this contention is preposterous. What would actually deny health care - to everybody, not just immigrants - would be some sort of affirmative action to ensure that we have the "right" number of doctors who speak every sort of obscure dialect that immigrants might possibly speak.

Immigrant assimilation is important, but it isn't life-or-death. Someone who thinks it is more important for people to learn English than it is to save their lives is grossly immoral.

The decision does - and should - lie with the immigrant in question. Each immigrant must decide for himself whether or not he wants to learn English, knowing that not doing so puts his life at risk in a number of ways. The state has no obligation whatsoever to accommodate those who refuse to do so.

True enough, but if you had some very esoteric medical condition, you might feel more comfortable and better able to execute your treatment if you had it explained to you in your native language.

My desire to see an English-speaking doctor would not create any sort of moral or legal obligation on the part of the country I was visiting to accommodate that desire.

If I had such an esoteric condition, and cared whether I lived or died, I would stay in my native country to ensure that I could talk to a doctor in my native language! I wouldn't take my complicated problem to Outer Derkaderkastan and then demand - as a matter of "moral right" - to see an English-speaking doctor!

Plus, you are missing the point about cultural concerns. We are pretty open about sex and genitals in the western world, but in a lot of places, they aren't, and this can make a big impact.

I understand your point perfectly, but I don't believe such "cultural concerns" have any practical or moral relevance here. People who come here from other cultures should conform to the cultural norms here. We have no obligation at all to conform to their cultural norms or accommodate them in any way.

We aren't going to get over it until people stop calling immigrants who want to discuss private medical conditions in their native language "racists".

There is no better word for someone who thinks only Hmong doctors can properly treat Hmongs - and indeed, demands a Hmong-speaking doctor as a matter of moral right - but "racist".

I was saying that Bull Connor = racism; wanting to talk to a doctor in your own language does not = racism.

Wrong. If I went to some foreign country and demanded to see a white, English-speaking doctor - only such a doctor could possibly treat me! - what else would you call that but racism?

There was nothing in there about white doctors.

It is clear that you think that doctors who speak only English and only understand American culture are just big dumb racist clodhoppers who are too insensitive to treat "culturally taboo vaginal discharge" and other such delicate ailments. As others have said, foreign immigrants are not an alien species - they are physiologically identical to every other resident of this country - and as a result can be effectively treated by any competently trained doctor.
4.16.2008 10:52am
c.gray (mail):

I take it as self evident that the roughly one million people who died in the famine did NOT have the wherewithal to hop on a boat to America, or elsewhere. But who knows, maybe the Irish are really really stupid.


They didn't have to go to all the way to America to find work &food. England was a few days walk and couple shillings away. Authorities in Liverpool and London complained bitterly about Irish migrants all through the famine years.

The reality is that pre-modern, illiterate peasants are very, very, VERY reluctant to exchange their homeland for permanent exile in a foreign land. Some simply will not do it, under any circumstances. Far from being "stupid", The Irish have actually proven to be among those most willing to move out when times got tough.
4.16.2008 3:09pm
Dilan Esper (mail) (www):
Yes it's so much better to use a barely competent Hmong doctor (assuming you could even find one) than to provide them with a doctor who excelled as a medical student. I am afraid your position is untenable and you know it.

You are stacking the deck. The real issue is whether it is better to use a quite competent Hmong doctor who may have had lower MCAT scores and undergraduate grades, but may nonetheless be just as good as the white doctor.

You are assuming that every beneficiary of affirmative action is unqualified. I'd like to see you say that to the faces of the extremely smart black lawyers I went to law school with.
4.16.2008 3:13pm
Dilan Esper (mail) (www):
Gee, I wonder how the NSA managed to fight the Cold War for 40+ years using American-trained Russian speakers rather than Russian immigrants? Why, even having relatives in Russia could disqualify a Russian speaker from employment. Think of all the nuances and idioms they missed and somehow still got the job done!

Uthaw, if you think that we didn't use any native Russian speakers in the cold war, you are quite mistaken.

If what you believe were really true, then one would have to assume that all of our spies in Moscow were Americans not of Russian ancestry.
4.16.2008 3:14pm
Dilan Esper (mail) (www):
It is clear that you think that doctors who speak only English and only understand American culture are just big dumb racist clodhoppers who are too insensitive to treat "culturally taboo vaginal discharge" and other such delicate ailments.

You have a standing invitation to come to Los Angeles. I will take you to some clinics that treat immigrants. You can talk to some of them, and meet them, and find out how they feel.

Really, you seem very insulated. Why else would you make fun of cultural differences the way you do? You want this issue to be black-and-white, but there are more things on heaven and earth than are dreamt of in your philosophy.

You know, Ebeneezer Scrooge had a lot of fixed ideas about the way people who were different than he was lived. Look what happened to him.
4.16.2008 3:17pm
googaw:
Cambodians and Hmong who do not speak English

Why are they staying in the U.S. if they do not speak English? That's like a computer trying to get on the Internet without speaking Internet Protocol.
4.16.2008 3:24pm
Elliot123 (mail):
"You are assuming that every beneficiary of affirmative action is unqualified."

If they weren't considered intellectually deficient, they wouldn't need affirmative action.
4.16.2008 5:33pm
Uthaw:
If what you believe were really true, then one would have to assume that all of our spies in Moscow were Americans not of Russian ancestry.

All of our intelligence officers in Moscow most certainly were Americans not of Russian ancestry. The Russian spies with whom they interacted were, of course, Russians. Somehow we achieved a number of notable intelligence triumphs using Americans trained to speak Russian to spy on Russians in Russia.

Thanks for making my point for me!
4.16.2008 6:30pm
Richard Aubrey (mail):
You will recall that Dilan, in the lengthy threads on women in combat specialties, suggested that the increased casualties were worth it because the equality of women was a higher value.

Lives are less important to Dilan than the results of arcane beancounting.

Just so we have in in the proper context.

Of course he's only secondarily concerned about life and death of the immigrants. Of course the reduction in the quality of medical care resulting from the efforts to find or manufacture physicians from one ethnic group or another is important. But not as important as the numbers.
4.17.2008 12:13am
Dilan Esper (mail) (www):
If they weren't considered intellectually deficient, they wouldn't need affirmative action.

Again, I would invite you to say it to the face of my black law school classmates. Many of whom have gone on to be extremely successful lawyers.

I don't know about the educational background of the people making these sorts of comments. But I doubt that anyone who went to a top 25 institution, even the conservatives, would ever say something so uninformed.
4.17.2008 2:18am
Dilan Esper (mail) (www):
You will recall that Dilan, in the lengthy threads on women in combat specialties, suggested that the increased casualties were worth it because the equality of women was a higher value.

Lives are less important to Dilan than the results of arcane beancounting.

Just so we have in in the proper context.

Of course he's only secondarily concerned about life and death of the immigrants. Of course the reduction in the quality of medical care resulting from the efforts to find or manufacture physicians from one ethnic group or another is important. But not as important as the numbers.


Richard, you are missing a crucial distinction. Outlawing women from serving in combat is SEX DISCRIMINATION. It has nothing to do with "numbers" or quotas. It is simply a LEGAL BAR on women doing something.

Yes, I take the Supreme Court's holding that governmental sex discrimination requires an "exceedingly persuasive justification" seriously.

I do not, however, view this issue in the same way. Here we are talking about affirmative action. Except on a specific showing of past discrimination, affirmative action is never required and is barely permitted. So no, if you could really prove that lots of people were going to die because these people were terrible doctors, I would not support this sort of diversity program. In fact, I wouldn't even support it if the evidence were equivocal, because I don't think affirmative action programs are generally a good idea.

But having dealt with many people of other cultures over the years, I can tell you that you are being insensitive to the factors that will really result in good medical treatment being delivered. And therefore, in this limited circumstance, I could support an affirmative action program based on native language skills.
4.17.2008 2:22am
Richard Aubrey (mail):
Dilan. You would support the unnecessary deaths of soldiers to make up your favored bean counting ratio.
That you would quibble at the deaths of minorities because we had to beat the bushes to find barely qualified candidates and drag them through law school is impossible to conceive.
BTW. The guy who got Bakke's slot was a butcher. I mean, not a meat cutter, but a horrendously dangerous physician.
Fact remains: If they actually qualified, they wouldn't need AA.
But it's easier to blame the rest of us for racism or to call for AA--secure in the knowledge that the costs will be paid by The Other (soldiers in the earlier case, unfortunate ethnics in this case) whom you will never meet--than to lift a finger to increase the readiness of various ethnic groups to compete equally.
That's work. That's sweaty. That's dangerous. That requires telling people their way of life is counterproductive.
4.17.2008 12:25pm
Richard Aubrey (mail):
woops. That's "drag them through med school".
4.17.2008 1:17pm