Saturday, February 11, 2012

Do Medical School Acceptance Rates Reflect Preferences for Preferred Minority Groups?

The chart above (click to enlarge) is an update of  the chart from this CD post from about a year ago, showing medical school acceptance rates for Asians, whites, Hispanics and blacks based on data from the Association of American Medical Colleges (AAMC) for the years 2009-2011 (aggregated).

For 2011, the average GPA of students applying to medical schools was 3.53 and the average total MCAT score was 28, and the chart displays the acceptance rates for students applying to medical schools with average GPAs (3.40-3.59) and average MCAT scores (27-29) in the highlighted blue column, and the acceptance rates for those students with slightly higher and slightly lower than average GPAs and test scores in the other columns.  In other words, the table displays acceptance rates by race and ethnicity for students applying to medical school with average academic credentials (or just slightly above or below average).  Here are some observations:

1. For those students applying to medical school with average GPAs (3.40 to 3.59) and average MCAT scores (27-29), black applicants were almost three times more likely to be admitted than their Asian counterparts (85.9% vs. 30%), and 2.4 times more likely than their white counterparts (85.9% vs. 35.9%).  Likewise, Hispanic students with average GPAs and average MCAT scores were about twice as likely to be accepted as white applicants (68.7% vs. 35.9%), and more than twice as likely as Asian applicants (68.7% vs. 30%). 

2. For students applying to medical school with slightly below average GPAs of 3.20-3.39 and slightly below average MCAT scores of 24-26 (first column in the table), black applicants were more than 8 times as likely to be admitted as Asians (67.3% vs. 7.7%), and more than 5 times as likely as whites. 

Bottom Line: In my previous post, I concluded that the medical school acceptance data suggest that medical schools must have admission policies that favor blacks and Hispanics over Asian and white students.  Even if factors other than GPA and MCAT scores (which are probably the two most important ones) are considered for admission to medical school, wouldn't it still be very hard to conclude that admissions policies to medical schools are completely "race-neutral" and completely free of any racial preferences? 


Here's why the issue is important: In some states like California and Michigan, racial preferences in college admissions are prohibited.  For example, Proposal 2 in Michigan states:   

"The University of Michigan, Michigan State University, Wayne State University (all three have medical schools), and any other public college or university, community college, or school district shall not discriminate against, or grant preferential treatment to, any individual or group on the basis of race, sex, color, ethnicity, or national origin in the operation of public employment, public education, or public contracting."

The AAMC doesn't provide acceptance data by individual medical school, so we can't conclude that any of the three medical schools in Michigan are practicing racial favoritism in admissions, but it's clear that Michigan state law now expressly prohibits that practice.  And based on national data, is there any conclusion other the obvious one - that U.S. medical schools must be considering race as one important factor in admissions, at least for preferred minority groups (blacks and Hispanics) over non-preferred minority groups (Asians) and whites?   

97 Comments:

At 2/11/2012 10:40 AM, Blogger AIG said...

Incredible. Maybe there's a way I can legally change my race.

 
At 2/11/2012 10:49 AM, Blogger Evergreen Libertarian said...

I would like to know more but I do know of a reason that this might be acceptable. Some African-Americans do not feel comfortable seeing white doctors. More black medical professionals might result in better care for blacks.

 
At 2/11/2012 10:59 AM, Blogger Methinks said...

Why is racism acceptable if it's black people practicing it, Evergreen?
And why do you think that dumber doctors will result better care for black people?

Do you have any statistics on black racism that prevents blacks from going to the doctor because the doctor is white? I'm just wondering how widespread this problem is since this is the first I've heard of it.

 
At 2/11/2012 11:24 AM, Blogger hal said...

dunno, but medical schools should grow and compete with each other. why do they turn away so many students?

If the student can pay, let them in. Whether they pass is up to them.

Over time, as enrollments swell, tuition prices will go down, because competition will heat up.

good medical schools should have a campus in every state.

 
At 2/11/2012 1:07 PM, OpenID Sprewell said...

hal, a medical student once told me that the acceptance rate into medical school is really low, but then most of those accepted graduate. Given that the AMA carefully controls how many new medical graduates enter the field each year, keeping the rate flat over the last 30 years despite a rising population, that's the reason you don't see true competition. Why they turn away so many students, though I don't know the exact reasons for that, is not as important as why there aren't new medical schools being started all the time. And that's because the AMA has been intensely lobbying to keep the number of schools down. You're assuming that there's real competition in the medical school market, when the truth is that the AMA has captured the govt "regulators," just like any other special interest group.

 
At 2/11/2012 1:51 PM, Blogger Buddy R Pacifico said...

Here is the University of Michigan Medical School Admissions Team.

Here is a viedo of what might attract prospective minority students to the University of Michigan Medical School: a second interview.

Hmmm.

 
At 2/11/2012 2:33 PM, Blogger bix1951 said...

giving preference to low income people might account for it
or giving preference to graduates of public schools or
giving preference to people with bad credit scores
or maybe some other ways to legally game the system
preference to people with unusual first names?

 
At 2/11/2012 2:50 PM, Blogger Evergreen Libertarian said...

re Methinks. Maybe racism has nothing to do with it. Maybe history does. Just maybe black Americans realize that they were once held as slaves by whites and are reluctant to deal with whites today because of that history.

There are also some studies showing that blacks receive substandard care compared to whites. Why that occurs is another issue.

 
At 2/11/2012 2:52 PM, Blogger Tom said...

Fighting (imaginary) discrimination with discrimination. Orwell was right.

 
At 2/11/2012 3:04 PM, Blogger AIG said...

" that's the reason you don't see true competition."

Right. Medical schools are known for what cakewalks they can be.

"is not as important as why there aren't new medical schools being started all the time"

Right. Because starting a medical school is about as easy as adding a medical program to the University of My Neighbor's Cat Online School of Jamaica. How many universities, of all types, started in the past decade, has been even marginally successful? Grand conspiracy.

 
At 2/11/2012 3:41 PM, OpenID Sprewell said...

AIG, 81% of all medical students graduate within 4 years, 96% within 10 years. If you think that isn't extremely high, please tell me what other postgraduate degree even comes close to that: I'm not holding my breath. I'm not saying it's easy to graduate from med school, but it's certainly not that hard if everybody finishes. :) And there's an easy way to test how hard it really is: let anybody in who passes minimal requirements and isn't getting the govt to pay their tuition and see how much the attrition rate goes up. As long as they're willing to pay and potentially fail out, that should be up to them.

As for your nonsense about how hard it is to start a university, you don't need to start a university to start a medical school, plus there are monopoly accreditation issues to starting a university also. And given how much money you can make from med school tuition, there would be plenty of new med schools started, if they didn't have to go through the AMA mafia to get accredited. It is hilarious how you are seemingly completely ignorant of how the existing universities and doctors block competition, yet blindly claim that there just aren't enough people willing to start med schools or universities. Yet another example of your crazy bias in favor of academia, which I'm guessing comes from your getting your salary cut by those academic conmen, ie you're part of the scam too.

 
At 2/11/2012 4:13 PM, Blogger PeakTrader said...

Many black Americans had fewer opportunities than white Americans for 200 years in this country, which helps explain why there are fewer affluent black Americans.

AMA apologizes to black doctors for racism
7/10/2008

While blacks represent roughly 13 percent of the U.S. population, less than 3 percent of the nation’s 1 million doctors and medical students are black, Adams noted.

And according to 2006 data on AMA’s Web site, less than 2 percent of AMA members and voting delegates are black.

“We’ve got a lot of work to do,” Adams said.

 
At 2/11/2012 5:14 PM, Blogger AIG said...

"AIG, 81% of all medical students graduate within 4 years, 96% within 10 years. If you think that isn't extremely high, please tell me what other postgraduate degree even comes close to that: I'm not holding my breath. "

Yep. And which grad program has the selection criteria medical schools do? Or do you think that all grad programs are created equal? (of course you probably do).

And one they finish medical school, what happens next on their road to becoming doctors? Is that it?

" but it's certainly not that hard if everybody finishes. :)"

That must be it. Not the high selectivity.

" As long as they're willing to pay and potentially fail out, that should be up to them."

You don't get to tell schools that they should let anyone who "can pay" get in. THEY get to decide what selection criteria they want for their schools. you think if 100,000 people just showed up at Johns Hopkins tomorrow and said "here is my money, let me take classes", the school would be able to function as it does now?

Its incredibly strange that "free market" proponents make arguments that a school should NOT BE ALLOWED to be selective about who it accepts. Strange how you don't tell employers that they should NOT BE ALLOWED to select employees. Oh wait, you actually do say that when you say employees should NOT BE ALLOWED to select on the bases of academic credentials.

A lot of "SHOULD NOT BE ALLOWED" going on here for supposedly free market proponents.

 
At 2/11/2012 5:15 PM, Blogger AIG said...

"As for your nonsense about how hard it is to start a university, you don't need to start a university to start a medical school, plus there are monopoly accreditation issues to starting a university also. "

Hundreds of "higher education institutional" (since you don't like the word university) have popped up just in the last decade. 99.9% of them are a waste of time. Being smart as you are, can you formulate a hypotheses as to why there are such astronomical failure rates in this industry?

"And given how much money you can make from med school tuition, there would be plenty of new med schools started,"

There is a lot of money to be made in a lot of fields, which also have enormous failure rates and enormous barriers to entry (which have NOTHING to do with all that you said). There is enormous barriers to entry in medical education, because hospitals tend to hire people who graduated from Johns Hopkins more so than from the University of the Rocky Mountains of Trinidad and Tobago Online. Yes I know...its not fair.

 
At 2/11/2012 5:15 PM, Blogger AIG said...

But life, like markets, is about SIGNALS. If you signal that you aren't good enough to get into Johns Hopkins, then your next school or employer is going to recognize that there must be something missing. True or not, its the way all human activity functions.

"It is hilarious how you are seemingly completely ignorant of how the existing universities and doctors block competition, yet blindly claim that there just aren't enough people willing to start med schools or universities."

In every industry there are those that block competition. The whole purpose of a business is to block competition. If they can block competition by having their CUSTOMERS, ie the hospitals, agree with them, than I have no problem with it. That is no argument for failing to recognize that this pattern happens everywhere in higher education...almost every single new university is either a diploma mill, or has no credibility.

And of course, there is already plenty of stratification, but the market doesn't want more stratification, it wants more quality.

"Yet another example of your crazy bias in favor of academia, which I'm guessing comes from your getting your salary cut by those academic conmen, ie you're part of the scam too."

The only one with a "bias" here is you and those here who keep insisting that everyone else in the world, and throughout history, has been wrong about the way they approach academic certification. You don't stop to ask yourself, ok so if everyone behaves this way, and everyone has been behaving this way since the concept of a degree was started, what are the reasons this has happened and what are the reasons it continues to exist.

Instead, you automatically assume that everyone must be wrong because you have thought of a way that you think is better. Except that your way, is neither different nor better; its exactly the same way, only delivered through a different methodology (online reduces costs, but other than that it makes no difference in the type of content it delivers. It does, whoever, clearly have many more weaknesses that outweigh the benefits)

And then you make some pretty un-free market propositions, such as saying that employers and customers should not be allowed to select on whatever bases they think is better for them, and then that they should not be allowed to use signals of past performance for selectivity.

 
At 2/11/2012 6:23 PM, OpenID Sprewell said...

AIG, Ah, I see, so you admit that I was right, that almost all medical school students graduate, only now you have an excuse for why that is. There's no doubt that graduation rates are a function of selectivity and difficulty of the curriculum, but when only 4% don't graduate, the point is that you could probably bring your selectivity down or make your curriculum harder, as that is a ridiculously low attrition rate that has no reason for being. I started off by noting that medical school acceptance rates are very low, so I obviously don't think all grad schools are as selective, but you obviously can't read- didn't they teach you how at your university? ;) - so you then act as though I didn't acknowledge that first.

"And one they finish medical school, what happens next on their road to becoming doctors? Is that it?"

What does happen next, that prevents them from becoming doctors? Nothing, which is why the medical school acceptance rate is the only real barrier, since most pass through medical school easily.

"You don't get to tell schools that they should let anyone who "can pay" get in. THEY get to decide what selection criteria they want for their schools."

No shit, please point to where I did. I'm saying what they would be doing if they weren't controlled by the AMA, that's completely different from saying they should be forced to do it. All I want is a free market where the AMA doesn't get to control the medical school process. By arguing against me, all you're doing is arguing for maintaining the excessive govt control that is already in place, seemingly because it is already the status quo and you are either too dumb to realize it or incapable of reading the references I gave you.

 
At 2/11/2012 6:25 PM, OpenID Sprewell said...

"you think if 100,000 people just showed up at Johns Hopkins tomorrow and said "here is my money, let me take classes", the school would be able to function as it does now?"

No, which is why John Hopkins will be put out business by online learning soon enough.

"Its incredibly strange that "free market" proponents make arguments that a school should NOT BE ALLOWED to be selective about who it accepts. Strange how you don't tell employers that they should NOT BE ALLOWED to select employees. Oh wait, you actually do say that when you say employees should NOT BE ALLOWED to select on the bases of academic credentials.

A lot of "SHOULD NOT BE ALLOWED" going on here for supposedly free market proponents."

Please point to one use of "SHOULD NOT BE ALLOWED" by anyone in this thread. Oh wait, you are the only one using such language, as a straw man that you can accuse others of. I talk about what would happen in a free market, but as an anarcho-capitalist, I'd never think of using the govt to make it happen. All I want is to get the govt out of the market, so that the AMA can't use the govt to control the medical market. And ultimately the govt is irrelevant, as new online technology is about to destroy the universities and replace most doctors with medical decision software. All I do is keep trumpeting this inevitable transition through creative destruction, I can't help it if you are too dense to follow the argument.

 
At 2/11/2012 6:30 PM, OpenID Sprewell said...

"Hundreds of "higher education institutional" (since you don't like the word university) have popped up just in the last decade. 99.9% of them are a waste of time. Being smart as you are, can you formulate a hypotheses as to why there are such astronomical failure rates in this industry?"

I will once you can provide some evidence to back up your claim that hundreds have been started or what metric you're using to call the new schools a waste compared to old schools. Of course I know that 99.9% of new schools are a waste of time, as that's true of the old schools also. :)

"There is a lot of money to be made in a lot of fields, which also have enormous failure rates and enormous barriers to entry (which have NOTHING to do with all that you said). There is enormous barriers to entry in medical education, because hospitals tend to hire people who graduated from Johns Hopkins more so than from the University of the Rocky Mountains of Trinidad and Tobago Online. Yes I know...its not fair."

I see, so the reason the number of medical school graduates has been flat since 1980 is because hospitals only hire Hopkins grads and nobody else. That argument is so ridiculously stupid that I know even you cannot believe it. The alternate hypothesis is that the AMA is using their lobbying power to prevent new med schools from going forward, that's the argument that makes much more sense and was also made in the Forbes link I gave.

 
At 2/11/2012 6:56 PM, OpenID Sprewell said...

"But life, like markets, is about SIGNALS. If you signal that you aren't good enough to get into Johns Hopkins, then your next school or employer is going to recognize that there must be something missing. True or not, its the way all human activity functions."

No shit, but as usual this idiotic aside of yours has nothing to do with whether the AMA is using their lobbying power to stop new John Hopkins's from getting started.

"In every industry there are those that block competition. The whole purpose of a business is to block competition. If they can block competition by having their CUSTOMERS, ie the hospitals, agree with them, than I have no problem with it. That is no argument for failing to recognize that this pattern happens everywhere in higher education...almost every single new university is either a diploma mill, or has no credibility."

Do you even read the crap you write? First, you start off with some basic econ that everybody already knows, then make a completely disconnected jump to flatly and ridiculous state that all new schools suck. If I needed any more evidence that you must be part of the university scam, after a ridiculous sweeping statement like that, not anymore.

"And of course, there is already plenty of stratification, but the market doesn't want more stratification, it wants more quality."

You can't supply it if you can't get into the market in the first place. Think about it.

 
At 2/11/2012 6:59 PM, OpenID Sprewell said...

"The only one with a "bias" here is you and those here who keep insisting that everyone else in the world, and throughout history, has been wrong about the way they approach academic certification. You don't stop to ask yourself, ok so if everyone behaves this way, and everyone has been behaving this way since the concept of a degree was started, what are the reasons this has happened and what are the reasons it continues to exist."

You must be completely ignorant of the history of the university if you think it was always used this way. It was originally for some monks and then for the kids of the rich, as a finishing school. It is only within the last century that it has been repurposed for a much larger role, but unfortunately many of the traditional aspects have been kept around, that are now useless, like the 4-year degree. And I have said there will still be certification online, but unlike current degree certification, it will actually mean something.

"Instead, you automatically assume that everyone must be wrong because you have thought of a way that you think is better. Except that your way, is neither different nor better; its exactly the same way, only delivered through a different methodology (online reduces costs, but other than that it makes no difference in the type of content it delivers. It does, whoever, clearly have many more weaknesses that outweigh the benefits)"

I have detailed many times how online certification will be completely different and how the content will be completely different, because they won't waste your time with useless subjects like math or outdated English literature. That you are too stupid to understand and remember these distinctions is not my problem.

 
At 2/11/2012 6:59 PM, OpenID Sprewell said...

"And then you make some pretty un-free market propositions, such as saying that employers and customers should not be allowed to select on whatever bases they think is better for them, and then that they should not be allowed to use signals of past performance for selectivity."

The only person making "un-free market propositions" here is you, because you support maintaining the govt-controlled status quo. All I'm saying is that we should get the govt completely out and let the free market work, which you then lie and say means that I want the govt to interfere in the market to do what I want, when I never called for that.

 
At 2/11/2012 8:35 PM, Blogger Ron H. said...

Evergreen: "Maybe racism has nothing to do with it. Maybe history does. Just maybe black Americans realize that they were once held as slaves by whites and are reluctant to deal with whites today because of that history."

Do you have any support for this bizarre, racist claim, or are you just making it up?

What about black Americans whose ancestors were NOT held as slaves? Are they also uncomfortable visiting white doctors, even white doctors whose ancestors never owned slaves?

Would black Americans be OK with an Asian doctor?

"There are also some studies showing that blacks receive substandard care compared to whites. Why that occurs is another issue."

Point to those studies please.

 
At 2/11/2012 10:15 PM, Blogger AIG said...

"but when only 4% don't graduate, the point is that you could probably bring your selectivity down or make your curriculum harder, as that is a ridiculously low attrition rate that has no reason for being"

So your objection is that medical schools do too good of a job at selecting applicants in order to efficiently use their resources. INSTEAD...you say...they should use their resources less effectively by doing a poorer job at selecting people, because of some nonsensical reason which you can't elaborate.

Amazing

" I started off by noting that medical school acceptance rates are very low, so I obviously don't think all grad schools are as selective, but you obviously can't read"

:) You said they are "low by comparison". If you are comparing to something else, you must think they are...you know...comparable :)

"What does happen next, that prevents them from becoming doctors? Nothing, which is why the medical school acceptance rate is the only real barrier, since most pass through medical school easily."

Right. Residency is something unheard off.

"I'm saying what they would be doing if they weren't controlled by the AMA"

Of course they would not.

"All I want is a free market where the AMA doesn't get to control the medical school process. By arguing against me, all you're doing is arguing for maintaining the excessive govt control that is already in place"

The AMA isn't a government organization. It doesn't have even 1/10 of the imaginary power you place upon it.

"No, which is why John Hopkins will be put out business by online learning soon enough."

Yes. Johns Hopkins has been running into a lot of problems with its traditional education activities. Online surgery instruction is the way to go.

 
At 2/11/2012 10:16 PM, Blogger AIG said...

"Please point to one use of "SHOULD NOT BE ALLOWED" by anyone in this thread. Oh wait, you are the only one using such language, as a straw man that you can accuse others of"

:) Your whole argument is that medical schools should not be allowed to be selective and should accept anyone who shows up at their door with money. :)

" I talk about what would happen in a free market,"

You have NO CLUE what would happen in a "free market", if indeed one is missing now. Because you have NO CLUE about the business models that best fit the needs of the CUSTOMERS of medical schools, ie the hospitals.

You only know how to hit one note; online instruction. You got nothing else of value.

"All I want is to get the govt out of the market, so that the AMA can't use the govt to control the medical market. "

That is a very noble goal of yours. But if you have NO CLUE about the market which you are talking about, and NO CLUE about what free markets are, and how they operate, you will be hard pressed to convince anyone.

"as new online technology is about to destroy the universities and replace most doctors with medical decision software"

WOW you are silly :)

"I will once you can provide some evidence to back up your claim that hundreds have been started or what metric you're using to call the new schools a waste compared to old schools."

Evidence? You have google don't you? Type "online schools", see what you get :)

 
At 2/11/2012 10:21 PM, Blogger AIG said...

"I see, so the reason the number of medical school graduates has been flat since 1980 is because hospitals only hire Hopkins grads and nobody else. That argument is so ridiculously stupid that I know even you cannot believe it."

That wasn't the argument I made, of course :) getting into medical school is probably the hardest thing any student will ever do. There can be a dozen major reasons why the numbers are stagnant. You, of course, don't bother to think of any.

"The alternate hypothesis is that the AMA is using their lobbying power to prevent new med schools from going forward"

Of course, but its a stupid hypothesis. Its an investment of hundreds of millions of dollars to start a medical school, and an investment in decades of reputation building. Clearly, those little barriers never crossed your mind.

Which is why it makes no sense for anyone to invest in building a new medical university from scratch, when it is a lot easier to expand on existing institutions. So while overall "enrollment" may not have gone up, quality surely has. (and the auxiliary fields of medicine, nurses, pharmacists, biomedical scientists etc, have gone up)

Of course, those US medical students who can't make it to US medical schools, have other alternatives. Except that since some of the other foreign schools that they go to have failure rates of 70-80%, you can imagine what sort of quality you get.

 
At 2/11/2012 10:23 PM, Blogger AIG said...

"No shit, but as usual this idiotic aside of yours has nothing to do with whether the AMA is using their lobbying power to stop new John Hopkins's from getting started."

Funny, cause you think that SIGNALS of the student's prior performance should NOT be taken into consideration when making a selection. So which is it, "no shit", or "shit"?

"First, you start off with some basic econ that everybody already knows, "

Except for you...

" then make a completely disconnected jump to flatly and ridiculous state that all new schools suck"

Prove me wrong :)

"You can't supply it if you can't get into the market in the first place. Think about it."

Of course you can get into the market.

"And I have said there will still be certification online, but unlike current degree certification, it will actually mean something."

Ah!! Yes!! I should burn my undergrad and master degrees. They are totally useless. I should instead enroll for a 2-week PhD degree from the University of Northern Southwestern Rocky Mountain California University of America, Online. The only question remains, a PhD in what?

"I have detailed many times how online certification will be completely different and how the content will be completely different, because they won't waste your time with useless subjects like math or outdated English literature."

Yes. Math. What a waste of time. I just want an engineering degree, Gosh darn it! I don't need no stinking math for that!

"because you support maintaining the govt-controlled status quo"

Yes. The government told my employer to hire me because I have a degree. Its in one of them law thingies, somewhere.

"All I'm saying is that we should get the govt completely out and let the free market work"

I agree. Guess what would happen if the government got completely out of higher education? The first thing that would happen, is that 100% of the online schools would immediately disappear. They exist only because of student loans. A lot of lesser traditional universities would disappear too...and most of the surviving universities would cost more and their graduates attract even higher salaries :) (you know, that whole supply side of supply and demand, shifting)

"which you then lie and say means that I want the govt to interfere in the market to do what I want, when I never called for that."

I never said you wanted the government to do anything, you just pretend like YOU can tell universities and employers what they SHOULD do (ie, not allow them to be selective :) ).

Imagine this, government disappeared tomorrow from higher education. Will schools STILL be selective? Will employers STILL be selective? What do you think?

 
At 2/11/2012 10:47 PM, Blogger AIG said...

See here's you problem Sprewell, you read a lot of garbage online at Mises dot org, or the likes, and then proceed to create a fantasy world, and a fantasy explanation, for some incredibly complex market problem. (well, you probably don't. The numbskull imbeciles at Mises dot org probably do, and you just repeat it)

Lets see, lets assume that indeed the numbers have remained stagnant for MD graduates, AND that the quality of them has remained stagnant (this second one, is clearly not true). Lets think of another possible reason for this.

Well, if indeed technology is revolutionizing medicine, this means that technology, and individuals who specialize in other medical activities other than those directly relevant to MDs, would be experiencing a growth.

So...for example, if a medical procedure which 10 years ago would have required an MD to perform, today can be performed by a nurse with some sort of medical device.

Lets see what is happening in those auxiliary jobs:

Graduations of nurses in the US has increased by nearly 10% per year for the past decade :)

Schools offering biomedical engineering degrees DOUBLED in the past decade, while the number of BME graduates has increases by 13% per year.

Pharmacy graduates have increased by about 5% per year for the past decade.

I'm sure there's other fields which also contribute to the overall medical industry, which I'm missing out here.

So here's an alternative explanation for you :)

As medicine becomes more technological and more scientific, relying more on new medicines and new devices and technologies, the overall number of MDs demanded may well remain flat, or flattening, while the demand for other professions which contribute more directly to these new technologies and medicines, and which use them more regularly than doctors...increases :)

I'm sure if you looked at numbers of investment in medical devices and in medical biochemistry etc, you'd also see great increases.

So it turns out this industry isn't as 1 dimensional as the imbeciles at Mises dot org might think it is, and there certainly isn't only 1 reason why something may occur in a particular labor market. THERE MAT be very legitimate and market-driven reasons, hard as it is for you to believe.

 
At 2/11/2012 10:59 PM, OpenID Sprewell said...

"So your objection is that medical schools do too good of a job at selecting applicants in order to efficiently use their resources."

No, my objection was that obviously there is no lack of qualified candidates if everybody graduates. Since that's the case, my prescription was to allow more med schools to open. How you think med schools would be less efficiently using their resources if they have more paid dropouts, who are very profitable for every other university scam, who knows, but it's perfectly fitting with your ignorance of business and economics.

"INSTEAD...you say...they should use their resources less effectively by doing a poorer job at selecting people, because of some nonsensical reason which you can't elaborate.

Amazing"

No, I said that we could test how hard med school really is by letting more people in. The only thing amazing here is that you cannot understand even this basic argument and reproduce some garbled notion that has nothing to do with, demonstrating your constant inability to read and understand the english language. Let me guess, you skipped that class in college, am I right?

"You said they are "low by comparison". If you are comparing to something else, you must think they are...you know...comparable :)"

Of all the moronic things you've written, this may be one of the dumbest. First off, I never used the quoted phrase. Second, if you think simply comparing two things makes them "comparable," as in similar, you are clearly way too dumb for me to have this conversation with.

 
At 2/11/2012 11:00 PM, OpenID Sprewell said...

Sprewell - "What does happen next, that prevents them from becoming doctors? Nothing"

AIG - "Right. Residency is something unheard off."

Try sticking to the topic. How many medical residents drop out? If you cannot make any claim that their attrition rate is high, then your point is irrelevant.

"The AMA isn't a government organization. It doesn't have even 1/10 of the imaginary power you place upon it."

Right, and the NRA and AARP aren't govt organizations either and that's why they have no power. XD Really, you couldn't be funnier if you tried.

"Yes. Johns Hopkins has been running into a lot of problems with its traditional education activities. Online surgery instruction is the way to go."

Most doctors aren't surgeons and surgeons don't really specialize in med school, mostly in the residency afterwards. Your argument is equivalent to saying that since you usually still need to go to a university lab to do nuclear research, therefore all those going to university today must still need to go, despite almost none of them ever touching nuclear research. Only an academic apologist could make an argument so dumb, yet you repeatedly make this type of argument.

 
At 2/11/2012 11:13 PM, OpenID Sprewell said...

Sprewell - "Please point to one use of "SHOULD NOT BE ALLOWED" by anyone in this thread. Oh wait, you are the only one using such language, as a straw man that you can accuse others of"

AIG - "Your whole argument is that medical schools should not be allowed to be selective and should accept anyone who shows up at their door with money. :)"

As usual, you cannot supply any evidence so you don't provide any, then you double down by repeating your lie.

"You have NO CLUE what would happen in a "free market", if indeed one is missing now. Because you have NO CLUE about the business models that best fit the needs of the CUSTOMERS of medical schools, ie the hospitals."

I know enough to know that around half of doctors don't work in hospitals, which you are obviously too ignorant to know. As for who's clueless about business models in a free market, I see that you've now decided to just make crazy ad hominem assertions, with no evidence whatsoever.

"You only know how to hit one note; online instruction. You got nothing else of value."

I have sketched out how online learning will lead to a complete reimagination of both certification and what material is worth learning. That you are too dumb to follow those arguments and so think that all that will happen is that instruction will move online is all I get out of your crazy claim.

 
At 2/11/2012 11:33 PM, OpenID Sprewell said...

"That is a very noble goal of yours. But if you have NO CLUE about the market which you are talking about, and NO CLUE about what free markets are, and how they operate, you will be hard pressed to convince anyone."

And yet it is you who keeps saying things that show you are completely clueless about both the med school market and markets generally, with all the evidence I've pointed out so far. So yes, I may not be able to convince one as ignorant as you, but who cares what someone who can't even grasp the basics thinks.

"Evidence? You have google don't you? Type "online schools", see what you get :)"

You made the crazy claim, it's not up to me to prove it. Of course, you don't because you can't.

"That wasn't the argument I made, of course :) getting into medical school is probably the hardest thing any student will ever do. There can be a dozen major reasons why the numbers are stagnant. You, of course, don't bother to think of any."

That was the essence of your argument, which you now run away from, as usual. And so far, I'm the only one who has given a reason for why the med school graduate numbers are "stagnant:" the AMA blocks more med schools from opening, plus I backed it up with a link. You instead acknowledge that the numbers are stagnant, despite a rising population, and magically wish that fact away as some "free market" outcome that makes no sense.

"Of course, but its a stupid hypothesis. Its an investment of hundreds of millions of dollars to start a medical school, and an investment in decades of reputation building. Clearly, those little barriers never crossed your mind."

First you say that I didn't give any other reason, then you say my reason is stupid. This is the kind of mental midget I'm dealing with. XD Millions of dollars are no object to the kind of people who want more doctors and already give billions to medical research. As for reputation, that too can be bought by hiring away well-known practitioners, as that's where reputation comes from, the medical practitioners who earn it, not the name on the building.

 
At 2/12/2012 12:23 AM, OpenID Sprewell said...

"Which is why it makes no sense for anyone to invest in building a new medical university from scratch, when it is a lot easier to expand on existing institutions. So while overall "enrollment" may not have gone up, quality surely has. (and the auxiliary fields of medicine, nurses, pharmacists, biomedical scientists etc, have gone up)"

You show your business ignorance yet again. It is usually cheaper to start from scratch because building onto an existing institution will inevitably cost more, as they try to extort anyone they can and you have to carve out new space in their existing institution. So let me get this straight, when they put more money into existing institutions, they don't add to enrollment but magically make the quality go up? This claim is so out of left field, I'm not even sure how to respond. Who cares how much auxiliary professions have gone up, when the AMA has carefully crafted the law so that only the doctors are legally allowed to prescribe drugs or perform various other medical acts. Nobody goes to see a "biomedical scientist" when they break their leg, so they're irrelevant to this discussion.

"Of course, those US medical students who can't make it to US medical schools, have other alternatives. Except that since some of the other foreign schools that they go to have failure rates of 70-80%, you can imagine what sort of quality you get."

Perhaps their failure rates are so high because they operate in a real free market where they actually have competition? Nah, couldn't be that.

"Funny, cause you think that SIGNALS of the student's prior performance should NOT be taken into consideration when making a selection. So which is it, "no shit", or "shit"?"

I've repeatedly said that the currently worthless degree certification will be replaced with more granular and specific online certifications, ie replacing a weak signal with a stronger, more specific signal. The fact that you cannot grasp this and keep idiotically claiming that getting rid of degree certification means there will be no certification, I cannot think of better evidence that this entire conversation is way over your head.

 
At 2/12/2012 12:25 AM, OpenID Sprewell said...

Sprewell - " then make a completely disconnected jump to flatly and ridiculous state that all new schools suck"

AIG - "Prove me wrong :)"

Why would I try to disprove a moronic statement like that when you never tried to prove it yourself? :)

"Ah!! Yes!! I should burn my undergrad and master degrees. They are totally useless. I should instead enroll for a 2-week PhD degree from the University of Northern Southwestern Rocky Mountain California University of America, Online. The only question remains, a PhD in what?"

You keep your undergrad and masters degrees? I don't even know where mine is. A PhD is a degree, therefore it is entirely worthless in online learning. Why you can't grasp even this basic claim, that the notion of a degree itself is worthless, is a task for either a psychiatrist or some sort of teacher in remedial education.

"Yes. Math. What a waste of time. I just want an engineering degree, Gosh darn it! I don't need no stinking math for that!"

If you had any brains or knowledge of what most engineers do on a day-to-day basis, you'd know that the vast majority do almost no math, which is mostly handled by software and CAD tools. Of course, you are too dumb to know this and so swallow the line given by the university scam, which forces engineers to do a bunch of antiquated math that they'll never use in practice.

 
At 2/12/2012 12:28 AM, OpenID Sprewell said...

"Yes. The government told my employer to hire me because I have a degree. Its in one of them law thingies, somewhere."

I was summing up by referring to your outlandish claim that what we have now is a free market in med schools, not the reality where the AMA keeps the flow of new med school grads down. Your moronic twaddle, about how I'm supposedly claiming that people shouldn't be free to use whatever signals they want, was such a blatant lie that I didn't bother demolishing it yet again.

"I agree. Guess what would happen if the government got completely out of higher education? The first thing that would happen, is that 100% of the online schools would immediately disappear. They exist only because of student loans. A lot of lesser traditional universities would disappear too...and most of the surviving universities would cost more and their graduates attract even higher salaries :) (you know, that whole supply side of supply and demand, shifting)"

Clearly you don't agree that the govt should get out of education as you seem ignorant of all the ways it is already interfering and claim that the education market is already free market in most regards. I agree that most online schools would crash without govt-backed student loans, but even more traditional schools would also, so that's besides the point. As for your idiotic claim that the survivors would raise tuition prices, hardly possible without the govt pumping money in and the govt keeping competition out. It is perfectly characteristic of your simplicity and ignorance that you think a major move like getting the govt out of education would only be modeled by moving one curve on a simplistic supply-demand graph.

"I never said you wanted the government to do anything, you just pretend like YOU can tell universities and employers what they SHOULD do (ie, not allow them to be selective :) )."

Sigh, how would I tell them what they should not be allowed to do without govt interference? You keep making up this claim that I said what they "should not be allowed to do," then claim that has nothing to do with govt. It's stupidity layered on stupidity.

 
At 2/12/2012 12:29 AM, OpenID Sprewell said...

"Imagine this, government disappeared tomorrow from higher education. Will schools STILL be selective? Will employers STILL be selective? What do you think?"

Who cares if they're selective or not, when many more schools will spring up without the AMA or current universities using the govt to keep new competitors out. As for employers, they may still be selective, but for online learners and trying to keep the dumbo degreed like you out. :)

"See here's you problem Sprewell, you read a lot of garbage online at Mises dot org, or the likes, and then proceed to create a fantasy world, and a fantasy explanation, for some incredibly complex market problem. (well, you probably don't. The numbskull imbeciles at Mises dot org probably do, and you just repeat it)"

I have already told you before that I don't read mises.org. Your continuing inability to grasp or retain basic facts is actually somewhat astounding. It is amazing that you are so easy to call those who actually understand these subjects and propose useful changes names, when you are clearly too ignorant to even grasp the basic facts. XD

"Lets see, lets assume that indeed the numbers have remained stagnant for MD graduates, AND that the quality of them has remained stagnant (this second one, is clearly not true). Lets think of another possible reason for this."

You already admitted the former and you're the first to state the latter.

 
At 2/12/2012 12:34 AM, OpenID Sprewell said...

"So...for example, if a medical procedure which 10 years ago would have required an MD to perform, today can be performed by a nurse with some sort of medical device.

Lets see what is happening in those auxiliary jobs:

Graduations of nurses in the US has increased by nearly 10% per year for the past decade :)

Schools offering biomedical engineering degrees DOUBLED in the past decade, while the number of BME graduates has increases by 13% per year.

Pharmacy graduates have increased by about 5% per year for the past decade.

So here's an alternative explanation for you :)

As medicine becomes more technological and more scientific, relying more on new medicines and new devices and technologies, the overall number of MDs demanded may well remain flat, or flattening, while the demand for other professions which contribute more directly to these new technologies and medicines, and which use them more regularly than doctors...increases :)"

This argument is profoundly stupid, let me count the ways. Of course medical technology has gone up, so there will be more people employed using it, like biomedical engineers or technicians doing MRIs or CAT scans. But those things were never done by doctors, the technologically-assisted medical procedures that would have been done manually by a doctor before are usually still done by the doctor. The reason the nurses are probably going up is that the doctor sticks to those high-value procedures, and because there just aren't enough doctors, more patients with low-level ailments are then farmed out to nurses. As for pharmacy grads, that's probably driven by the increasing overuse of pharmaceuticals, nothing else.

It is quite hilarious how you try to mix in the large concurrent growth of medical technology and pharmaceuticals and then try to moronically claim that doctors aren't necessary because nurses are supposedly doing their job with new technology or the even more ludicrous claim that pharmacists have taken over some of the doctors' former work because of new tech?! Your attempts at explanation are even more dim-witted than your attempts at criticism.

 
At 2/12/2012 12:36 AM, OpenID Sprewell said...

"So it turns out this industry isn't as 1 dimensional as the imbeciles at Mises dot org might think it is, and there certainly isn't only 1 reason why something may occur in a particular labor market. THERE MAT be very legitimate and market-driven reasons, hard as it is for you to believe."

It is the height of comedy for an imbecile like you to run around calling people who know more than you names. XD Yes, there may be other reasons, but since you cannot provide anything even half-way plausible, I wonder why you keep grasping for unknown "maybes." Could it be that you are gainfully employed in one of these scams and so will try to keep defending them no matter how painfully dumb your arguments are?

Alright, I've had enough laughs at your ignorance and dumb arguments. As funny as it is to repeatedly demolish your silly arguments, it does get boring eventually. All I want to know is what do you do for a living: which part of these scams are pulling your little piece of grift from? Are you some faceless bureaucrat at some college, the kind Mark always rails against? Or are you connected to the giant medical scam in this country somehow? I've already asked you this question before on a different thread, but you ran away without answering, even though I said there that I have nothing to do with academia, other than having attended for my bachelor's and grad school years ago and seen first-hand what a big scam it is.

 
At 2/12/2012 1:18 AM, Blogger randian said...

While blacks represent roughly 13 percent of the U.S. population, less than 3 percent of the nation’s 1 million doctors and medical students are black, Adams noted.
That's exactly what you'd expect. Blacks have an average IQ of 85. If it takes a 115 IQ to make med school, that's one standard deviation for whites but more than two standard deviations for blacks.

 
At 2/12/2012 1:19 AM, Blogger randian said...

This comment has been removed by the author.

 
At 2/12/2012 3:32 AM, Blogger PeakTrader said...

Randian, blacks also have less wealth and income. What's your point?

 
At 2/12/2012 9:03 AM, Blogger Methinks said...

Maybe racism has nothing to do with it. Maybe history does. Just maybe black Americans realize that they were once held as slaves by whites and are reluctant to deal with whites today because of that history.

Maybe. Do they not realize that they were also held as slaves by other black people?

I do find it amusing that Americans seem to think that the institution of slavery was a racist institution unique to the united states.

There are studies to show all kinds of things. I'm rarely as interested in the study as I am in the methodology. For instance, Dr. Campbell concluded that the China study showed that animal protein causes cancer and they've now even done a movie about it (Forks over Knives). In fact, the data from the study shows that subjects not fed animal protein had higher rates of mortality snd that higher animal protein was protective against cancer at lower (read: more normal) exposure to aflatoxin (a carcinogen). Nevermind. He doesn't mention that because won't help him push his agenda.

Are there any studies to show what kind of care blacks get from black doctors or are you just assuming that black doctors all love "their own kind"?

 
At 2/12/2012 1:58 PM, Blogger randian said...

What's your point?
That blacks having a much lower representation in med school compared to their population has a non-racist explanation: there are too few blacks smart enough. Explaining their lower incomes and wealth easily flows from this observation.

 
At 2/12/2012 4:18 PM, Blogger Lammert said...

Son, important relative didn't make the grade....???


Saturation Macroeconomics: Gobbledy-Gook or the Real Deal?

Time for a new mathematical model, a new paradigm, for macroeconomics?

Is there a patterned science representing the time dependent evolution of macroeconomics?

The last paragraph of the Economic Fractalist main page http://www.economicfractalist.com/ ....

The ideal growth fractal time sequence is X, 2.5X, 2X and 1.5-1.6X. The first two cycles include a saturation transitional point and decay process in the terminal portion of the cycles. A sudden nonlinear drop in the last 0.5x time period of the 2.5X is the hallmark of a second cycle and characterizes this most recognizable cycle. After the nonlinear gap drop, the third cycle begins. This means that the second cycle can last anywhere in length from 2x to 2.5x. The third cycle 2X is primarily a growth cycle with a lower saturation point and decay process followed by a higher saturation point. The last 1.5-1.6X cycle is primarily a decay cycle interrupted with a mid area growth period. Near ideal fractal cycles can be seen in the trading valuations of many commodities and individual stocks. Most of the cycles are caricatures of the ideal and conform to Gompertz mathematical type saturation and decay curves.



For the Wilshire, the US composite equity index March 09 to October 2011 was a 4 phased Lammert growth and decay fractal series..

x/2.5x/2x/1.5x :: 5/13/10/7 months. That's an empirical real system observation - available to all - of the time dependent workings of the macroeconomic system.

2005 was the description, the hypothesis - March 2009 to October 2011 was the empirical asset valuation evolution...

The flash crash on 6 May 2010 ..... does that not meet second fractal criteria?

"A sudden nonlinear drop in the last 0.5x time period of the 2.5X is the hallmark of a second cycle and characterizes this most recognizable cycle."

Maybe this is all occurring by chance alone .... Likely.... Very very very likely ....not.

 
At 2/12/2012 5:57 PM, Blogger PeakTrader said...

Randian says: "...there are too few blacks smart enough. Explaining their lower incomes and wealth easily flows from this observation."

Are you implying blacks are sub-human?

 
At 2/12/2012 6:03 PM, Blogger AIG said...

"No, my objection was that obviously there is no lack of qualified candidates if everybody graduates. "

The obviousness of your sentence is far from clear.

"Try sticking to the topic. How many medical residents drop out? If you cannot make any claim that their attrition rate is high, then your point is irrelevant."

The point is that you didn't get that completing medical school was not the only step remaining. You also don't understand that within medical schools, people don't only graduate with MDs. Those who can't cut it for an MD, often transfer to another program within the medical school.

"This argument is profoundly stupid, let me count the ways. Of course medical technology has gone up, so there will be more people employed using it, like biomedical engineers or technicians doing MRIs or CAT scans. But those things were never done by doctors, the technologically-assisted medical procedures that would have been done manually by a doctor before are usually still done by the doctor. "

:) You still don't understand. If diagnoses can be carried out more effectively through these means, and treatment can be delivered more effectively through these technologies, then the overall number of patients a doctor can cycle through increases considerably. You do more, with less.

Its capitalism at work, yet you just can't comprehend it.

"The reason the nurses are probably going up is that the doctor sticks to those high-value procedures, and because there just aren't enough doctors, more patients with low-level ailments are then farmed out to nurses. As for pharmacy grads, that's probably driven by the increasing overuse of pharmaceuticals, nothing else."

Yes. Your typical explanation of how everyone else is stupid and doesn't know anything, except for you. Pharmacists going up must be because of over-medication! I know this, because I read it on the internet.

"It is quite hilarious how you try to mix in the large concurrent growth of medical technology and pharmaceuticals and then try to moronically claim that doctors aren't necessary because nurses are supposedly doing their job with new technology or the even more ludicrous claim that pharmacists have taken over some of the doctors' former work because of new tech?!"

:) Its actually a real explanation. But I am impressed at your inability to understand what it means.

Good job.

 
At 2/12/2012 6:10 PM, Blogger AIG said...

"You already admitted the former and you're the first to state the latter."

So here you are demonstrating your inability to understand that gains are not to be made only in quantitative terms, but also in qualitative terms. So regardless of the fact that no new schools and no increase in graduation numbers is seen...QUALITY could have improved considerably.

With greater quality, the need for greater numbers, may not exist.

 
At 2/12/2012 8:04 PM, Blogger randian said...

Are you implying blacks are sub-human?

No, I'm saying blacks aren't as smart as whites on average.

 
At 2/12/2012 8:25 PM, OpenID Sprewell said...

AIG, it is clear by the fact that you cannot even read and grasp the english language as written that any discussion of how academia and much of current medicine are scams is both way over your head and something you're willfully blind to, likely because you get your cut off one of these scams. I'll note that you still refuse to say how you make money, that continued omission combined with your embarrassingly stupid rejoinders is all I need to know that responding to you is a waste of my time.

 
At 2/13/2012 1:31 AM, Blogger PeakTrader said...

randian says: "...blacks aren't as smart as whites on average."

Blacks aren't as rich as whites on average either.

And they didn't have the same opportunities as whites over many generations.

 
At 2/13/2012 10:17 AM, Blogger Melanie & Jed DeHaven said...

Interesting, wonder what the gender breakdown is for accepted candidates.

 
At 2/13/2012 10:23 AM, Blogger JustOneGroup said...

Re:

"Evergreen: "Maybe racism has nothing to do with it. Maybe history does. Just maybe black Americans realize that they were once held as slaves by whites and are reluctant to deal with whites today because of that history."

Do you have any support for this bizarre, racist claim, or are you just making it up?"

Let me say two things - Tuskegee, and Michelle Obama. (Or is that three things?

This is from a NY Times profile of Ms. Obama in 2008:

" In the mostly black neighborhoods around the hospital, Mrs. Obama became the voice of a historically white institution. Behind closed doors, she tried to assuage their frustrations about a place that could seem forbidding.

Like many urban hospitals, the medical center’s emergency room becomes clogged with people who need primary care. So Mrs. Obama trained counselors, mostly local blacks, to hand out referrals to health clinics lest black patients felt they were being shooed away.

She also altered the hospital’s research agenda. When the human papillomavirus vaccine, which can prevent cervical cancer, became available, researchers proposed approaching local school principals about enlisting black teenage girls as research subjects.

Mrs. Obama stopped that. The prospect of white doctors performing a trial with black teenage girls summoned the specter of the Tuskegee syphilis experiment of the mid-20th century, when white doctors let hundreds of black men go untreated to study the disease.

“She’ll talk about the elephant in the room,” said Susan Sher, her boss at the hospital, where Mrs. Obama is on leave from her more-than-$300,000-a-year job.

I infer that the elephant is distrust by blacks of a white-led medical establishment. Of course, the other elephant is whether a Harvard-educated prospect for First Lady should be fanning those doubts or quenching them, but stil...

 
At 2/13/2012 10:29 AM, Blogger Rob said...

It is all about the SOCIAL JUSTICE. Did you ever wonder what the term meant?

 
At 2/13/2012 10:30 AM, OpenID motionview said...

You are the race you write down on the piece of paper. If I were a student of Asian ancestry in the US today I would absolutely mark "African-American" on my application. Reverse Cloward-Piven the bastards. Why not? Is the college going to do a blood test?

 
At 2/13/2012 10:52 AM, Blogger geezer said...

As a retired health care worker with 46 years of experience in the
acute health care world, this just
validates my personsl rule to NOT
go to a doctor who has graduated in the last 15-20 years who is Black or Hispanic or to accept a
referral by my primary care doctor to a specialist under the same
circumstances. I really don't care what color the doctor is, but I do care that he was 'average or below average' when he entered medical school.

 
At 2/13/2012 11:02 AM, Blogger JAL said...

Re getting into medical school etc.

My understanding is that it is harder to get into veterinary school (fewer schools) than med school. How many black vets are there? Will a black pet owner take their dog to a white vet?

(See how silly that is Evergreen?)

I worked as a RN in an elightened hospital in that most "enlightened" part of the US -- Appalachia -- 25 years ago. Professionally speaking I never heard or saw a black patient (from my side of the operation behind the nurses station, in the room or regarding meds) discriminated against. Can it happen? I am sure it does. And if so / when so you will find that old white patients are right up there.

Blacks tend to be (maybe I speak of the Southesast mostly) a bit more sophisticated and knowlegeable and realistic than Evergreen gives them credit for. Seriously -- how many people in serious pain are going to say "I'll die before I see a white doctor." Sheesh (Just check out the emergency rooms...)

If so, it's time to grow up. We are not living in a bubble any more.

And as for picking a doctor based on race, that probably is a factor, but in a community which creates a climate offering good medical care it might be less so.

Many women prefer women physicians for their OB-Gyn stuff. What's the parallel?

If I said I, as a white, was not comfortable seeing a black (or Asian or hispanic) doctor what would I be?

 
At 2/13/2012 11:06 AM, Blogger Unknown said...

My father graduated medical school in three years, because of WWII. There were no summer breaks for the students. As for the people who say that the AMA is trying to keep the number of doctors at a set level. I say that is a bunch of BS. We need a bunch of great new doctors. I can only pray that we get them.

 
At 2/13/2012 11:15 AM, Blogger misterdregs said...

Approximately half of medical school classes are women. From my observations in 25 years of anesthesiology practice, there will always be a physician shortage for this reason alone.

I have run across only a handful of female surgeons who work as hard (caseload) as the AVERAGE male surgeon. At the last hospital I worked at, there was a group of three female surgeons who didn't do as much surgery as one really busy male surgeon.

And while I can't think of a single man who voluntarily dropped out of medicine, I personally know of a half dozen women (usually married to another doctor in a high pay specialty) who have simply quit in early or mid career.

 
At 2/13/2012 11:15 AM, Blogger misterdregs said...

This comment has been removed by the author.

 
At 2/13/2012 11:58 AM, Blogger jc013 said...

I was wondering about a gender breakdown of the same chart as well.

 
At 2/13/2012 11:58 AM, Blogger Mike said...

I'm only going to see Asian doctors from now on. They are obviously the smartest given the discrimination they have to overcome.

 
At 2/13/2012 11:59 AM, Blogger Mike said...

This comment has been removed by the author.

 
At 2/13/2012 12:05 PM, Blogger randian said...

randian says: "...blacks aren't as smart as whites on average."

Blacks aren't as rich as whites on average either.

Are you seriously arguing that average intelligence has no effect on average wealth?

You have the order of causation wrong. Being rich doesn't make you smart. Being smart can make you rich.

 
At 2/13/2012 12:25 PM, Blogger Swami said...

"Maybe history does. Just maybe black Americans realize that they were once held as slaves by whites..."

Evergreen- unless they have PERSONALLY experienced that slavery, that's a form racism.

My family experienced violent crime perpetrated by minority members. Would I be racist to avoid a black or Hispanic doctor because of that?

 
At 2/13/2012 12:26 PM, Blogger Swami said...

"Maybe history does. Just maybe black Americans realize that they were once held as slaves by whites..."

Evergreen- unless they have PERSONALLY experienced that slavery, that's a form racism.

My family experienced violent crime perpetrated by minority members. Would I be racist to avoid a black or Hispanic doctor because of that?

 
At 2/13/2012 12:51 PM, Blogger Fins2theRight said...

Only a couple of posters have noted the pernicious effect of this discrimination: it will cause patients to prefer an Asian or white physician whenever possible. It's tragic that black and hispanic physicians are now the products of a system of affirmative action that has created the assumption that they are less capable than their Asian or white counterparts. When I need a neurosurgeon, someone find me an Asian, please.

 
At 2/13/2012 1:03 PM, Blogger bobby said...

Having now read through all of the comments above, it has become clear to me that, as a white male, the socially responsible thing for me to do is to only patronize black female doctors who attended on-line medical schools and residencies.

Of course, this assumes that "socially responsible" means that my goal is to kill off the ruling white male cohort.

 
At 2/13/2012 1:17 PM, Blogger JustOneGroup said...

Re:

"If I said I, as a white, was not comfortable seeing a black (or Asian or hispanic) doctor what would I be?"

A statistician? Well, a poor statistician, since the Asians clearly overcome the most prejudice.

I continue to hope that JAL can pick up on my point (from 10:23 AM) about Ms. Obama, Tuskegee, and sistrust of white doctors by blacks.

The gist, from a 2008 NY Times profile:

"She also altered the hospital’s research agenda. When the human papillomavirus vaccine, which can prevent cervical cancer, became available, researchers proposed approaching local school principals about enlisting black teenage girls as research subjects.

Mrs. Obama stopped that. The prospect of white doctors performing a trial with black teenage girls summoned the specter of the Tuskegee syphilis experiment of the mid-20th century, when white doctors let hundreds of black men go untreated to study the disease."

Leadership and racial conciliation from the Harvard-educated.

 
At 2/13/2012 2:18 PM, Blogger Don M said...

The AMA was forced into developing a Physician Assistant program by a court case.

They didn't want it.

They permitted it only if they all PAs had to work for a doctor, so the doctor could skim some profits off their 'supervision' of the PA.

 
At 2/13/2012 2:22 PM, Blogger Don M said...

Don't write down the wrong race. You see, they are allowed to lie to you, telling you that they don't discriminate based on race. You are not allowed to lie to them, telling them you are a different race to make their discrimination work for you.

There is only one catch, and that is Catch-22.

 
At 2/13/2012 3:08 PM, Blogger kmg said...

I will only ever go do a doctor who is a white male or Asian male.

No women, no black men. Period.

My health matters more to me than some ridiculous notion of 'political correctness' that has gone beyond parody.

 
At 2/13/2012 3:35 PM, Blogger storkdoc said...

Sprewell, your comments, wow just wow. You betry an ignorance of how med. school works.

I'm a doctor. I made it through med school and I graduated. First I like to point out that I graduated Summa cum laude from undergrad with a BS in Biology. I never really thought that undergrad was all that hard.

But med school, that was HARD. There is a huge amount of information to absorb in 2 short academic years before starting your clinicals.

Why does almost everyone graduate? Because we are the people who can work our asses off. We didn't get there by kicking back and cruising on by. Everyone I know from med school is very smart and a hard worker. You can't get through if you're not that. If you try to flunk out, the school will try and try and try to get you to learn the material and pass. Because it is a great loss for the school as well as for the student if you flunk out.

Why don't more med schools open? Well where are you going to get all the people you'll need to teach these students. Most doctors go into private practice and don't want to teach. Even now it is hard for the med schools to have all the instructors that they need.

And finally, the AMA has nothing to do with how many medical schools there are

 
At 2/13/2012 3:36 PM, Blogger RS said...

Guess the moral of the story is to RUN as fast as you can from any physician who is black or hispanic.

How's that for unintended consequences?

 
At 2/13/2012 3:54 PM, OpenID Sprewell said...

storkdoc, wow just wow, comments like yours are precisely why I don't consider doctors to be very bright. Yes, it's true that doctors have to absorb a lot of information in med school, but that's not an argument for not letting more applicants in, particularly since almost all the current students graduate. You claim that a med school flunkie "is a great loss for the school" but you don't really say what that means, ie is that merely symbolic or actually economic. I've pointed out earlier in this thread that most college dropouts are very profitable for most colleges, but you don't seem to be able to provide any argument to contradict that for med school dropouts. You claim that more med schools don't open only because they don't have enough teachers, perhaps you don't need a doctor to teach? Most subjects are pretty specific and don't need previous medical experience anyway, ie you don't need a doctor to teach you human physiology.

Your claim that "the AMA has nothing to do with how many medical schools there are" is flatly contradicted by the info from the Forbes link I gave above:

"The AMA convinced lawmakers to shut down 'deficient' medical schools, drastically paring back the supply of doctors almost 30% over 30 years. No new medical schools have been allowed to open since the 1980s.

Still, the AMA along with other industry organizations until recently had issued dire warnings of an impending physician 'glut' (whatever that means beyond depressing member wages), even convincing Congress to limit the number of residencies it funds to about 100,000 a year. This imposes a de facto cap on new doctors every year given that without completing their residencies from accredited medical schools, physicians cannot obtain a license to legally practice medicine in the U.S."

Hmm, who do I believe, a member of the anti-competitive AMA who flatly states the opposite with no evidence whatsoever or all the cited evidence of the AMA's anti-competitive lobbying? Gee, I wonder, I wonder. ;) No wonder so many of you doctors are so incompetent, if this is the level of reasoning you bring to the table.

 
At 2/13/2012 4:02 PM, Blogger misterdregs said...

Storkdoc is 100% correct.

Remember when you were starting junior high and they said it was going to be different and you'll have to study more. Same thing starting high school. I figured college work might be harder, but for the most part I didn't work very hard. (I only worked hard compared to the average guy in the frat house.)

Just about the time I figured school just wasn't all that hard, I hit the two years of basic sciences in med school. Pretty much EVERY class was as hard as organic chemistry or physics. And it was difficult going from being an A student with little effort to now being a decidedly average student.

The selection process weeds out those incapable of doing the work. If you loosened the admissions standards and dropped those who couldn't cut it, the pressure to cheat, sabotage your classmates, etc. would be tremendous. Especially if you were paying $50000 a year to be there.

 
At 2/13/2012 4:15 PM, OpenID Sprewell said...

misterdregs, if it is so important that the "selection process weeds out those incapable of doing the work," why do we allow a 10-year graduation rate of only 62% for other post-graduate degrees (according to the AAMC pdf I linked above), 34% lower than med school? Should we then bring down all admission levels for all degrees down to the level of doctors, simply because you claim to magically know beforehand who will complete and who will fail out? Aah, I see, it is because you don't want to pressure those poor unqualified students to "cheat, sabotage your classmates, etc." It's not because you're scared of the competition and the increased supply of perfectly-qualified doctors driving your wages down, I see. :D Please, you doctors are so deluded and dense that you're bringing intellectual knives to a gunfight with your dumb arguments, and the amazing part is that you still think you'll win. XD

 
At 2/13/2012 4:38 PM, Blogger randian said...

And finally, the AMA has nothing to do with how many medical schools there are

Not formally. The problem is states won't grant you a license without graduating from an AMA-accredited school. That's how the AMA controls how many med school slots there are nationally: they will pull your accreditation if you expand an existing med school faster than they want you to, and they won't accredit new med schools that want to compete with existing ones.

 
At 2/13/2012 5:36 PM, Blogger misterdregs said...

Sprewell, to compare professional school graduation rates to liberal arts is comparing apples and oranges. Graduation rates in law and veterinary school are (surprise!) in excess of 90% as well. You may not like the model adopted for professional education in this country, but it seems remarkably consistent.

And most PhD students aren't paying tuition, but are working instead in exchange as teaching assistants. So, they are not racking up debt to the degree that professional school students are. The average medical school debt is $156,456. Let's say you plan on flunking out one third of incoming medical students. Who in their right mind would gamble taking on those sort of debts (even one half of it) on a 33% chance of having no usable credential and having wasted one to three years for nothing. YOU might be that f***ing dumb, but that's just an impression I get from your posts.

 
At 2/13/2012 5:53 PM, Blogger storkdoc said...

Sprewell you still seem ignorant and you make bad assumptions. As we all know that can make an ass out of you.

I am, like most physicians, not an AMA member. Their politics are not my politics and I do not support them.

I guess you missed this article in the NY Times:
http://www.nytimes.com/2010/02/15/education/15medschools.html Which discusses the 2 dozen new medical schools that have opened or are about to open in the US. I don't think the AMA is capping that.

Next you fail to understand that the rate limiting step for the production of new doctors is not the first 2 years of medical school. Nope it is not that.

It's the final 2 years plus the residency years that limit education. That's because the final 2 years are more like an apprenticeship than school. You follow around the top dogs and learn from them. Since not every wants to do that or is good at that, it limits the number of new doctors that you can have.

Residency is more of the same. It's learning from other doctors. This is where there is a shortage of teachers. Not the first 2 years.

Why do the medical schools work so hard so students won't flunk out. We there is a shortage of doctors who will teach. Taking a course like anatomy requires the use of a human cadaver which can be in short supply. And, as I have done both, dissection of a virtual cadaver is not the same. But I think the primary reason for the school is prestige. They like to be able to say that they graduate 97% of their enrollees. This means to potential students that the school is picking the right student. One that is smart and committed. If too many flunk out, no one will want to go to that school. Med School is a huge time, money, and effort commitment. If there is a high possibility that you'll flunk out why would you go there.

In undergrad, I worked at a pharmacy 40 hrs a week in addition to taking a full time academic load. I couldn't do that in med school. The time demand was overwhelming. It's not as easy as you seem to think it is.

 
At 2/13/2012 5:55 PM, Blogger storkdoc said...

Sprewell you still seem ignorant and you make bad assumptions. As we all know that can make an ass out of you.

I am, like most physicians, not an AMA member. Their politics are not my politics and I do not support them.

I guess you missed this article in the NY Times:
http://www.nytimes.com/2010/02/15/education/15medschools.html Which discusses the 2 dozen new medical schools that have opened or are about to open in the US. I don't think the AMA is capping that.

Next you fail to understand that the rate limiting step for the production of new doctors is not the first 2 years of medical school. Nope it is not that.

It's the final 2 years plus the residency years that limit education. That's because the final 2 years are more like an apprenticeship than school. You follow around the top dogs and learn from them. Since not every wants to do that or is good at that, it limits the number of new doctors that you can have.

Residency is more of the same. It's learning from other doctors. This is where there is a shortage of teachers. Not the first 2 years.

Why do the medical schools work so hard so students won't flunk out. We there is a shortage of doctors who will teach. Taking a course like anatomy requires the use of a human cadaver which can be in short supply. And, as I have done both, dissection of a virtual cadaver is not the same. But I think the primary reason for the school is prestige. They like to be able to say that they graduate 97% of their enrollees. This means to potential students that the school is picking the right student. One that is smart and committed. If too many flunk out, no one will want to go to that school. Med School is a huge time, money, and effort commitment. If there is a high possibility that you'll flunk out why would you go there.

In undergrad, I worked at a pharmacy 40 hrs a week in addition to taking a full time academic load. I couldn't do that in med school. The time demand was overwhelming. It's not as easy as you seem to think it is.

 
At 2/13/2012 6:11 PM, Blogger randian said...

If too many flunk out, no one will want to go to that school

So that's why MIT and CalTech have a shortage of students wanting to attend their engineering, math, and physics programs?

 
At 2/13/2012 6:12 PM, Blogger misterdregs said...

So storkdoc, do you think it was "D" in physics or one in organic that made sprewell change his major from pre-med?

 
At 2/13/2012 6:19 PM, Blogger misterdregs said...

"So that's why MIT and CalTech have a shortage of students wanting to attend their engineering, math, and physics programs?"

I would bet over 90% of the students accepted to their graduate programs DO finish.

Ah yes, here it is?

"For example, among those entering the School of Science from 1996 to 2001, approximately 90 percent graduated with a masters or doctoral degree."

http://web.mit.edu/accreditation/report/selfstudy/chapter06.html

It's all the nearly useless (in a purely economic sense) MAs and PhDs in sociology, English Lit, Women's Studies, etc. that drag down the completion rate in non-professional schools.

 
At 2/13/2012 6:28 PM, Blogger boinky said...

Discriminate? Nothing new about that.
I started medical school in the mid 1960's. Up to about 1960, they had a Jewish Quota (20 percent) a black quota (one student) and no women...I repeat, NO WOMEN.Even in 1967, my class had 14 women out of a class of 187.

One professor said the Jewish quota was needed because without it they would fill the class.

so you see, some things never change.

 
At 2/13/2012 6:36 PM, Blogger keeperusa said...

There is a LOT of mis-information here. ANY graduate of ANY medical school must pass the USMLE's to graduate (2 tests during med school, one after)so all docs must meet this basic requirement. The REAL hangup to getting more Docs is NOT med schools...it is residency positions which are PAYING positions in hospitals and with so many hospitals closing they are in shorter supply than ever. If you don't pass the 3 years of residency...you don't get to practice. You could graduate 100000 more docs but not have one more practicing doctor...for even today, there are med school grads who do not get residencies despite having passed both school and the exams required to be a doctor.

 
At 2/13/2012 7:15 PM, Blogger misterdregs said...

+1 on the AMA not representing the typical physician in the US. I quit 12 years ago.

The American College of Physicians and Surgeons far better represents the interests and attitudes of private-practice physicians.

 
At 2/13/2012 7:22 PM, Blogger misterdregs said...

Someone asked earlier if there was a similar discrepancy between men and women in med school admission. It seems Prof. Perry has some data from an earlier post on MCAT scores.

http://mjperry.blogspot.com/2010/06/mcat-scores-for-medical-students-by.html

"In the most recent year of 2009, men scored higher on average by 1.50 points (31.6 men vs. 30.1 women), which is a statistically significant difference with a t-statistic of 25.08 from a "difference of means test" (prob = 0.0000)."

In other words, there is ZERO chance that this is a chance phenomenon.

 
At 2/13/2012 7:26 PM, Blogger misterdregs said...

Women have tiny advantage in GPA (although it is slightly lower in science classes and higher in non-premed courses).

https://www.aamc.org/download/161708/data/table23.pdf

 
At 2/13/2012 8:43 PM, Blogger Tea Party at Perrysburg said...

Well, I distinctly remember something about this being in Obamacare. It was something about building more schools for minorities or something. I did a blog post on it but I can't remember details.

This would be in addition to the Office on Minority Health.

 
At 2/13/2012 9:29 PM, OpenID Sprewell said...

misterdregs,

"to compare professional school graduation rates to liberal arts is comparing apples and oranges."

Too bad for you that nobody made that specific comparison. The comparison I cited was made by the AAMC's own pdf and is linked above. I suggest you read it before you go off on irrelevant tangents. And I see no indication that law school graduation rates are in the 90s, the numbers I see are in the 50s after 6 years. If you have some data, present it. My entire point is that med school graduation rates are not "remarkably consistent" with other advanced degrees and so far the data is against you.

How do you know that one third of additional med school applicants would drop out? There's certainly no valid reason to "plan to flunk out" a certain percentage, that should all depend on how they do in their classes. Since 96% now graduate eventually, it's very likely that increased acceptance wouldn't change that number much, up to some threshold of student that you're letting in. As for whether somebody would be dumb enough to go to med school with a higher chance of flunking out, why is that up to you or the med school? If someone wants to pay the money and take that chance, they should be able to find schools that will let them do it, if it weren't for the constant meddling by the govt and the AMA. Of course I was never dumb enough to even consider joining such a profession of mediocrities. :)

As for my physics grades, considering I was taking advanced physics classes up till grad school for my physics-heavy engineering major, don't make me laugh. I suspect that the physics classes that I took even in the first year of my engineering degree, which I usually aced, were much harder than the silly pre-med physics classes that you're still whining about. :)

 
At 2/13/2012 9:33 PM, OpenID Sprewell said...

storkdoc, must be nice to claim that the AMA doesn't do anything to limit med schools, then when provided evidence otherwise, just sidestep the issue and say you're not a member and that's not your problem, even though you conveniently benefit from their anti-competitive lobbying. Your own linked article notes that "The Commonwealth is one of nearly two dozen medical schools that have recently opened or might open across the country, the most at any time since the 1960s and ’70s." Gee, I wonder why so few schools opened in the intervening decades? Those recent schools were already addressed in the Forbes article I linked, which mentioned that after decades of the AMA chokehold on med schools, they've finally had to let up a little bit recently, as even they cannot deny the reality so long. Of course, we don't know how many of those planned schools will actually be allowed to open, so let's see.

You apparently don't know how to read if you think I fail to understand residency, as I also addressed residency in one of the quotes in my comments above. If you believe that what "rate limits" the number of doctors is that none of the established doctors want to teach them, please provide some evidence for your claim. Your explanation sounds silly, considering how many doctors there already are, but surely if that's the reason, you can provide some evidence of such a medical prof shortage.

 
At 2/13/2012 9:34 PM, OpenID Sprewell said...

Your notion that "no one will want to go to that school" that flunks out more than 97% of the students is beyond silly: why does anyone attend other schools that have much higher dropout rates and often with similarly high costs? As I said before, you don't have any evidence that letting in more students would cause more to flunk out either. Considering that the US population has grown by 50% since 1980 but the number of med school graduates has stayed flat, it's much more likely that a 50% increase in entrants would also do fine. And ultimately, it's not up to you, the AMA, or the govt whether there should be 200 medical schools or 300 or who should be entering. That should be up to those who want to put their money up backing a new med school or studying at one. Unfortunately, that's not what's allowed to happen today, because of silly arguments like the ones you're making.

"It's not as easy as you seem to think it is."

Where did I say that? You seem to think you know what I think, yet again with no evidence.

keeperusa, the quote I pasted above notes how the AMA also tried to keep the amount of residencies down, so if you think that's the real bottleneck, don't worry, the AMA was tried to tighten that up too. ;)

 
At 2/13/2012 11:13 PM, Blogger storkdoc said...

Well Sprewell , I think that you think it's easy because you said I wasn't smart. You wrote, "I don't consider doctors to be very bright." Since I am a doctor, therefore you don't consider me to be very bright.

So if I'm not bright and I made it through medical school then it seems you would believe that its not that hard.

But then again you haven't gone through medical school, so your opinion about whether it's hard or not is about as valid as mine about engineering school. I suspect that engineering school is hard. But I am also convinced that I could have easily done that had I wanted to. But for some reason you seem to have a chip on your shoulder about doctors.

As for physics, I always enjoyed physics and took much more than a basic physics class. I never whined about my physics classes. Since I took AP physics in high school I was required to take more advanced physics in college.

I also enjoyed my advanced math classes as well. Having a father with a BS in Mathematics probably helped.

Next I teach medical students and residents. We have about 80 doctors in my multi-specialty group but only about 15 of us are willing to teach. The rest can't be bothered because teaching is inefficient. Teaching slows you down, the students and residents make mistakes that you have to correct..etc

Medscape's Physician compensation report for 2011 showed that 14% of physicians were in academic medicine. To Train more physicians you'll need more academic doctors.

I won't take more than 1 med student and 1 resident at a time... Again this training of residents is the rate limiting step. The residents expect to be paid. On average it is now more than $40,000 per year. Much better than the $21,000 per year I made when I was a resident. The primary funding for resident medical education is Medicare, and we all know how that's going.

You seem to believe that opening more schools will fix the problem. I think you believe that the problem is lack of competition between doctors. I think you believe that more doctors will reduce costs by reducing physician salaries. But physician salaries account for only 10% of the cost of medicine.

If you open up 10 new medical schools this year, you will see your new doctors begin to practice between 7 to 14 years from now depending on what specialty they match in. New schools won't solve your issue immediately

And finally we don't compete on salary. The best and the worst docs get paid the same by the insurance companies, they get the same from Medicare and Medicaid. I can't advertise that I'm the best obstetrician in the word and then charge more. Well I could charge more but I could only get that from people who pay cash. It makes no difference to the third party payers. Good or bad if I sent them the CPT code 59510 (global fee for a s-section) I'll get paid the same as the worst obstetrician in the world who also sends in that code

 
At 3/16/2012 2:05 PM, Blogger elliot gould said...

Some African-Americans do not feel comfortable seeing white doctors. More black medical professionals might result in better care for blacks.

This is complete B.S. You don't know what the hell you're talking about. And stop calling yourself a libertarian. Talking out your ass like that, you can only be a "progressive." True libertarians are about data.

 
At 3/16/2012 2:06 PM, Blogger elliot gould said...

Some African-Americans do not feel comfortable seeing white doctors. More black medical professionals might result in better care for blacks.

This is complete B.S. You don't know what the hell you're talking about. And stop calling yourself a libertarian. Talking out your ass like that, you can only be a "progressive." True libertarians are about data.

 
At 4/14/2012 12:11 AM, Blogger poodlekiss1922 said...

Here's some data for you: There are about 40,000 white applicants for medical schools each year. There are about 3,500 black applicants to medical school each year. There acceptance rates are higher because the applicant pool is so much smaller. The smaller the applicant pool, the less competitive it becomes. Every medical school selects students that will add heterogeneity and diversity. Blacks and latinos are underrepresented in medicine, Asians and Whites are overrepresented. http://www.msnbc.msn.com/id/25614966/ns/health-health_care/t/ama-apologizes-black-doctors-racism/#.T4kF1tXkaZQ
Also, the Liasion Committee on Medical Education accredits medical schools. It is a non-profit organization that has nothing to do with the government.

 
At 8/18/2012 2:12 PM, Blogger Pre-Med said...

It also matters how many people are applying with those numbers. The percentages are a bit misleading. If I told you that a medical School class has 160 people. 10 of them are African American, 120 are White and the other 30 are Asian/Indian. What would you rather be? Medical schools are accepting way more White people than blacks. There are just A LOT of white people applying compared to African Americans and that is why the percentages seem so favorable for African Americans.

 
At 11/09/2012 8:31 PM, Blogger William Stein said...

The other factor is that Asians cluster at highly competitive colleges like the University of California system, mostly Berkeley and UCLA, and Ivy Leagues, where the competition is higher, depressing GPAs. Part of this is because Asians are relatively small segment of the population. Whites, blacks and Hispanics are far more numerous, so they represent a far more diverse array of colleges, with correspondingly diverse competitive climates. So, the stated GPAs of Asians probably reflect a higher degree of achievement than the AAMC's figures suggest.

 

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