Group therapy: New book ponders the damage political correctness can do to medicine

Observations. By Bonnie Booth, amednews staff. Feb. 19, 2001.

OBSERVATIONS

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Every so often a book is published that threatens to severely undermine the public's faith in the medical establishment and/or those who practice the healing profession.

Most recently, Blind Eye: The Terrifying Story of a Doctor Who Got Away With Murder comes to mind. The book, by James B. Stewart, tells the story of Michael Swango, MD, who is widely believed to have killed several patients in his care.

Despite a criminal conviction in Illinois, he was able to obtain positions in hospitals in South Dakota and New York. Stewart blames the medical establishment for Dr. Swango's ability to lie his way into these positions and ones at other hospitals.

The book's hardcover edition was released around the time then U.S. Rep. Thomas Bliley (R, Va.) was introducing legislation to open the National Practitioner Data Bank. Stewart popped up on newspaper editorial pages supporting the opening of the data bank, although it is highly unlikely such a move would have made a difference in the Swango case.

Now comes another assault on the medical establishment in the form of P.C. M.D.: How Political Correctness is Corrupting Medicine -- a new book by psychiatrist Sally Satel, MD. Dr. Satel's premise is that the tenets of political correctness, including victimology, multiculturalism, and the rejection of fixed truths and individual autonomy, are causing serious damage to patient care and medical standards.

These are serious accusations, and the book is more often than not well-argued. But it is highly unlikely that it will enjoy the widespread audience of Stewart's Blind Eye or pose as much of a threat to the standing of the medical profession. Stewart's book is what we like to call a "great read" -- it has drama, it has suspense, it has people being murdered. On top of all that, it's a true story.

It's not that Dr. Satel's book isn't interesting -- it is. If you buy into her premise, then you understand that its ramifications reach deep into the health care system and could affect patients. The ramifications are as far reaching, if not more so, than those in Stewart's book. After all, there are very few Michael Swangos out there.

But Dr. Satel's book is likely to be debated more by you and your colleagues than by you and your patients or you and your friends who don't practice medicine.

Here's why: Dr. Satel is willing to say things that some (perhaps more and more) physicians think, but are unwilling to say because they know it wouldn't be politically correct.

For instance, it's not politically correct to say that:

Nurses have latched on to alternative and unproven therapies such as therapeutic touch because of a "fiery resentment of the medical establishment, the so-called male medical elite."
"The legitimate concerns and can-do spirit of the 1970s' women's health movement have given way to a campaign [that is] largely fueled by misplaced aggrievement and misinformation.
"The charge of physician bias against minority patients is often made reflexively, overlooking the myriad complicated reasons for differences in care.
"Professionals betray the public trust when they use their status as health experts to continue the work they began as political activists in the 1960s."

Definitely not P.C. Those statements are likely to make the politically correct individual that dwells in many of us a bit uncomfortable. In fact, reading the book made me incredibly uncomfortable at times.

I was particularly uneasy when Dr. Satel discussed the status of minorities in medical school. In the Professional Issues section of AMNews, we dedicate some space to stories about medical education and have covered the issue of minorities in medical schools and a wide range of plans to boost their enrollment.

While the medical establishment may not agree on much, they seem to agree that medical schools need more minority students. We dutifully report that. But Dr. Satel raises uncomfortable questions about competency and qualifications that we don't often address in our stories because our sources are wont to bring them up. And frankly, when she brings them up, I'm slightly offended by the political incorrectness of her questions.

Yet as much as my P.C. sensibilities were, at times, offended by what Dr. Satel had to say, there were other times when I was right there with her. Granted, the more outrageous her examples, the more vivid her point. But I cannot help but share one of them with you. It, too, pertains to medical education, only here she's exploring the status of women.

In a chapter entitled "Sisterhood and Medicine," Dr. Satel takes on the belief that medicine is still basically a patriarchal system. She quotes Christiane Northrup, MD, author of Women's Bodies, Women's Wisdom: Creating Physical and Emotional Health and Healing and an expert in women's health, talking about how she herself began to recover from "patriarchal influences."

Dr. Northrup refers to a reading she had with an internationally known medical intuitive. "She told me that my body registered a rape between the ages of 21 and 29 -- the years that I was in medical school and doing my residency. Though I had not been physically raped, my body's energy system had been emotionally and psychologically 'raped' by my medical training -- something I had not been consciously aware of at the time."

Dr. Satel uses the "rape" story to highlight the extreme nature of the women's health lobby, which says that the "rape" during Dr. Northrup's male-dominated medical training is emblematic of the sexist oppression that exists in every aspect of the medical system. Dr. Satel goes on to debunk this oppression theory by quoting a variety of statistics, including the number of women now enrolled in medical school, women's participation in clinical trials, and health dollars spent on breast cancer research compared with dollars spent on other types of cancer research. Her point: Women are not second-class citizens in the medical community.

As physicians, you are infinitely more qualified to debate the merits of Dr. Satel's arguments than I am. But I found P.C. M.D. to be a timely discourse of a topic that permeates many of the institutions of today's society and, as Dr. Satel argues, is coming your way. What effect will the indoctrinologists have on the practice of medicine? The answer to that question rests with you.

Note: This column originally appeared in print as "15 Minutes."

Booth, a former Professional Issues editor, is now studying law. To comment on this column contact Professional Issues Editor Damon Adams by email (damon.adams@ama-assn.org) or at 312-464-5411.