"The medical profession of the twentieth century was a hegemon; today, it is a regional power. When a hegemon loses status..."

"... it can take a few paths. It can aim for restoration—bringing back the empire—which in this case would probably focus on gatekeeping. It can retreat, which might mean abdicating medicine’s broad public role, perhaps in favor of a narrow focus on earnings and technical skills. The last—and, in my view, the best—path is reinvention. Doctors can remake their profession by embracing the multi-polar medical landscape they now inhabit, and by acting as a kind of system stabilizer: working with other powers to help shape rules, norms, and relationships. A superpower may act as though it can stand alone, but middle powers know the value of diplomacy and coalition-building. Reinventing the medical profession will require greater engagement with the world outside of hospitals and clinics. Many physicians are taking to social media.... A growing number of doctors seem interested in leading health-care companies themselves or in running for office.... Diplomacy also requires a willingness to stand in opposition to others.... A few weeks ago, a dozen former F.D.A. officials, all of them physicians, wrote that they were 'deeply concerned' about 'the latest in a series of troubling changes'...."

Writes Dhruv Khullar, in "The Role of Doctors Is Changing Forever/Some patients don’t trust us. Others say they don’t need us. It’s time for us to think of ourselves not as the high priests of health care but as what we have always been: healers" (The New Yorker).

"Well, Ann, I did in fact read the whole thing, and a more pustulent agglomeration of rubbish I've never seen. That glossary alone — about half the length — is pure screwballery."

Said Michelle Dulak Thomson in the comments to my post where I'd written: "Here's the [54-page] AMA document. It is fascinating. I read a lot of it, and I suspect that absolutely no one will read the whole thing."

"The American Medical Association put out a 54-page guide on language as a way to address social problems — oops, it suggests instead using the 'equity-focused' term 'social injustice.'"

"The A.M.A. objects to referring to 'vulnerable' groups and 'underrepresented minority' and instead advises alternatives such as 'oppressed' and 'historically minoritized.'... I’m all for being inclusive in our language, and I try to avoid language that is stigmatizing. But I worry that this linguistic campaign has gone too far, for three reasons. First, much of this effort seems to me performative rather than substantive. Instead of a spur to action, it seems a substitute for it.... Second, problems are easier to solve when we use clear, incisive language. The A.M.A. style guide’s recommendations for discussing health are instead a wordy model of obfuscation, cant and sloppy analysis. Third, while this new terminology is meant to be inclusive, it bewilders and alienates millions of Americans. It creates an in-group of educated elites fluent in terms like BIPOC and A.A.P.I. and a larger out-group of baffled and offended voters, expanding the gulf between well-educated liberals and the 62 percent majority of Americans who lack a bachelor’s degree — which is why Republicans like Ron DeSantis have seized upon all things woke."

Writes Nicholas Kristof in "Inclusive or Alienating? The Language Wars Go On" (NYT).

Here's the AMA document. It is fascinating. I read a lot of it, and I suspect that absolutely no one will read the whole thing. Talk about things that are not inclusive: it excludes everyone. But that's the reason for long bureaucratic documents — to create an impression that something complicated has been worked through but to make it impossible to check the work. I mean, it's possible, but no one will do it. 

There are a lot of tables and diagrams, and these jump out as more readable than the rest. I spent some time absorbing this diagram:

 

Shouldn't the "deep" part be at the bottom? Are they using a pyramid the way the government used the old "food pyramid" — just to represent the size of the particular groups of things? And what's with the yellow arrow pointing upward? What is this gravity-defying process?

"[Trump] added that Oz had said he was in 'extraordinary health, which made me like him even more (although he also said I should lose a couple of pounds!).'"

"He also stated, without any specific evidence for his claim, that 'women, in particular, are drawn to Dr. Oz for his advice and counsel. I have seen this many times over the years.'"

From "Trump endorses Dr. Oz in Pennsylvania Senate race, a key battleground/The former president wades into a closely watched contest" (WaPo). 

Also: "'No teacher should ever be allowed to teach far left gender theories to our children without parental consent,' Trump said. 'It’s truly child abuse, plain and simple.'"

Who is this Obamacare critic that Donald Trump has picked as Secretary of Health and Human Services?

Tom Price is an orthopedic surgeon who has been a member of Congress for 6 terms. He isn't just a critic of Obamacare. He's been offering detailed alternative bills going back to 2009, when Democrats got to work on Obamacare.

“Congressional Democrats and the Obama administration blatantly ignored the voices of the American people and rammed through a hyperpartisan piece of legislation that will have a disastrous effect on our nation’s health care system,” Mr. Price said shortly after Mr. Obama signed the bill in 2010....

The legislation Mr. Price has proposed, the Empowering Patients First Act, would repeal the Affordable Care Act and offer age-adjusted tax credits for the purchase of individual and family health insurance policies. The bill would create incentives for people to contribute to health savings accounts; offer grants to states to subsidize insurance for “high-risk populations”; allow insurers licensed in one state to sell policies to residents of others; and authorize business and professional groups to provide coverage to members through “association health plans.”...

My link goes to a  NYT article that warns us that Price has the vantage point of a doctor and needs "a broader perspective" that looks after the "needs of Medicare beneficiaries, Medicaid patients and taxpayers who finance those programs." We're also told that Price is "a strong conservative," "a member of the Tea Party Caucus," but "no bomb thrower": "He works within the system and has led two groups that promote conservative policies in the House."

We're told that Price has a 100% rating from the National Right to Life Committee.

And: "Gay rights groups have also been critical of Mr. Price." Why? The only evidence of hostility to gay people is that when the Supreme Court found a constitutional right to same-sex marriage, Price called it "a sad day for marriage" and "a further judicial destruction of our entire system of checks and balances." I'd like to hope that his opinion — about the meaning of marriage and the importance of judicial restraint — has nothing to do with anything health-related.

The surgin' surgeon.

"Carson Surges Past Trump in Latest Bloomberg Politics/Des Moines Register Iowa Poll."

Trump asks "Who is [Ben Carson] to question my faith?" — "I’m a believer, big league, in God. I will hit back on that."

And he does hit back — here, talking to Chris Cuomo — and questions Ben Carson's faith.



Cuomo takes it on faith that religion is a "cornerstone" of Ben Carson's "existence," but Trump points out, quite correctly, that we don't know that.

Why is it the norm to accept that people sincerely hold the religious beliefs they assert? I like that Trump is challenging that where it really should be challenged: When someone (like Carson) is using religion to leverage a bid for political power. Why does Cuomo accept assertions of religion from Carson when Carson doesn't accept it for Trump and where Trump isn't forefronting religion as a reason why we should want Trump to have power?

Cuomo bolsters his belief in Carson with: "He's a 7th Day Adventist, I mean, it's something he talks about a lot." That's quite silly. What does affiliation with a particular sect prove about the depth or substance of one's faith? And what does talking about it a lot prove?

Trump refers to Carson's quoting the Bible about humility the other day "And it looked like he had just memorized it about 2 minutes before the quote." That's a pretty accurate observation! Check it out:



The quoted verse is: "By humility and the fear of the LORD are riches, and honour, and life."

Hey, I'm glad I looked that up, because I kept reading Proverbs 22 and found: "The mouth of strange women is a deep pit: he that is abhorred of the LORD shall fall therein."

"Trump, the businessman, tells Americans how the financial system is rigged against them. Carson, the brain surgeon, tells them how they are being denied knowledge."

"It doesn’t seem to matter that he is a man of science who does not believe in evolution and has called climate change 'irrelevant': he is an ideologue with the trappings of a technocrat.... In lieu of specifics, Carson tends to say that as a surgeon he has experience 'doing complex things' and making snap life-or-death decisions."

From a New Yorker piece by Amy Davidson about Ben Carson. (Open to nonsubscribers.)

Kelley Paul is here to soften Rand Paul for you, and she's got a book of essays about women and the bonds they forge called "True and Constant Friends."

That phrase, "women and the bonds they forge," comes from the New York Times, which has a article about Kelley Paul titled "Kelley Paul Has a Task: To Make Her Husband More Approachable."

“Rand’s personality is kind of ‘Cut to the point,’ ” she said... “I think in some ways people respond better to that, but we’ll see. We’ll see what the country wants.”...

“He’s the last person in the world who would ever be dismissive of someone [e.g., Savannah Guthrie] because they’re a woman. I mean the last person,” Mrs. Paul went on, pointing out that his partner in his ophthalmology practice in Kentucky was a woman. “Someone could make the argument that perhaps he should be more poised, he needs to be smoother with this. And that’s legitimate,” she added.

5 quick reactions:

1. Is she making him more approachable, or is she trying to make us want to be tough and appreciate the value of a "cut to the point" style? I would prefer the latter!

2. "Cut to the point" is a good metaphor when talking about a surgeon. Isn't it weird that there are two surgeons running for the GOP nomination? Is the surgeon mentality what we want in a President?

3. Did Kelley Paul really write that book? I see it comes out today. The full title is "True and Constant Friends: Love and Inspiration from Our Grandmothers, Mothers, and Friends." I can't bring myself to add that to my Kindle. From the description at that Amazon link: "Kelley explores the universal themes of hardship, determination, commitment, family, independence, optimism, friendship and love — and illuminates the power of the female bond that enriches all our lives." That exploration of everything takes up all of 144 pages, including the photography, which seems to be of gentle, happy women in sunlight and earthtones:



4. In the NYT's expression "women and the bonds they forge," I detect a deliberate insinuation that the traditional, relationship-oriented female life is, metaphorically, slavery. The oldest meaning of "bond" is "Anything with which one's body or limbs are bound in restraint of personal liberty; a shackle, chain, fetter, manacle," and the word "forge" calls attention to the fabrication of iron devices.

5. The campaign's second video, which features Kelley, really is excellent, but in saying that I'm aware that my standards for video are quite different from the way I think about books. With video, I'm more likely to observe from a distance as if I were someone else watching this and being affected (even though I personally resist the sentimentality and cheeseball expressiveness):

How to say something perfectly dumb.

It's easy to say something dumb, but it takes something special to say something as dumb as "Not sure when @SenRandPaul became a doctor, but says Ebola can spread from a person standing 3ft away #uhmm." That, from a CBS producer named Katy Conrad, who was being sarcastic about when Rand Paul, who is a doctor, "became a doctor." Well, I think you just have to get lucky to say something that perfectly dumb.

"Meet the Press" covered Rand Paul's pro bono eye surgery in Guatemala and larded it with impugnment of his motives.

"Meet the Press"'s Chris Janning accompanied the ophthamalogist senator and got plenty of access, but she took so many shots at him behind his back that it was ludicrous:

CHRIS JANSING: And now to a Meet the Press exclusive: A journey to Guatemala with Kentucky Senator -- and Doctor -- Rand Paul. Top Republicans eyeing a run for president in 2016 have spent a lot of time in two key battleground states: 20 visits to Iowa, 10 more to New Hampshire. But so far, only Paul has turned a foreign country into a unique photo op.... 

Footage of poverty-stricken eye patients.

CHRIS JANSING: ... A mission to restore sight, and hope, to the poorest of the poor. And if it all plays well to American voters it could further Rand Paul's personal mission, too -- to position himself for a race for president.

Oh, please.

What's with all the doctors running for Congress?

"Where do we get this idea that a background in medicine is particularly apt for lawmakers?" I asked on this blog 2 weeks ago.

What is going on with this promotion of doctors in the American political scene? There's something odd and excessive about our respect for them. We must trust and depend on them when we have medical problems, but why are we bent on installing them in political office? Let's think more carefully about the sort of minds that go into medicine and whether we are not overvaluing them as political candidates.

Now, the NYT is looking into the doctors-and-Congress phenomenon:

With a few exceptions, these physician legislators and candidates — there are three dozen of them — are much alike: deeply conservative, mostly male, and practicing in the specialty fields in which costs and pay have soared in recent years...

The Times quotes 2 members of Congress who are doctors, one a Republican and one a Democrat. The Republican, Tom Coburn, a family doctor, says doctors are "frustrated" over changes in the practice of medicine. The Democrat, Jim McDermott, a psychiatrist, looks into the psyche of doctors and says: "They want to have their hands right there on the handle so they can pull it one way or another."

As for the reason so few of them are liberal... [McDermott] said he believed that politically conservative physicians were more likely to chafe at the direction of changes in health care, with greater oversight by the government and a more regulated role for the private sector.

That undercuts McDermott's need-to-control analysis. He's implying that liberal physicians are the ones who accept government control. I can see how to harmonize McDermott's 2 statements. The Congress has already pulled the handle very far in the liberal direction, so the liberal doctor doesn't need to go to Congress to pull the handle back the other way. The liberal doctor is accepting if things as they are because that's what he likes, and he appreciates the way Congress has been pulling the handle. (Or as Bob Dylan once sang: "The vandals took the handles.")

By the way, when a psychiatrist talks about pulling the handle, one simply must cry phallic symbol, and don't tell me sometimes a handle is just a handle. McDermott's handle was always a metaphor, and the image of Congress as a place where a lot of guys get their hands right there on the handle so they can pull it is just too rich to ignore. From the 3rd variation on the top-voted meaning of "circle jerk" at Urban Dictionary:

When a bunch of blowhards - usually politicians - get together for a debate but usually end up agreeing with each other's viewpoints to the point of redundancy, stroking each other's egos as if they were extensions of their genitals (ergo, the mastubatory insinuation). Basically, it's what happens when the choir preaches to itself.

Okay. Let's get on back on the pavement, thinking about the government. The NYT article under consideration here indicates that the GOP is recruiting physicians to run for office and there's something about doctors — at least the ones who say yes — that responds to the call:

“When you’re a Type A surgeon, as I am, one thing leads to another,” said Representative Tom Price, a Georgia Republican who is an orthopedic surgeon. “The next thing you know, somebody is asking you to run for office.”

Mixing up the medicine... with politics.

The handsome doctor laughs at (other people's) death and runs for office.

Do we really want doctors representing us in Congress?

I'm linking to The Daily Mail's coverage of this story because it's got some nice pictures showing the physical attractiveness of the physician Milton Wolf and his family and in spite of the British paper's inability to write clearly about whether this man is running for the Kansas state senate or the U.S. Senate. (It's the latter, but DM repeatedly writes "Kansas Senate.")

Where do we get this idea that a background in medicine is particularly apt for lawmakers? How many doctors are there in Congress anyway?

2012 was again a landmark election in terms of physician candidates, with 50 physicians running as challengers or in open seats for federal office at one point during the cycle.  The 113th Congress will welcome two new physicians to the House of Representatives.

Twenty physicians are currently serving in the 113th Congress which include three senators, 16 representatives and one delegate. Seven of these members of Congress are graduates of AMPAC’s Candidate Workshop and/or Campaign School.

I know some people are leaning toward assisting Wolf — here's Instapundit — but why empathize with a man who flaunts his lack of empathy? Here's the direction I lean: What is going on with this promotion of doctors in the American political scene? There's something odd and excessive about our respect for them. We must trust and depend on them when we have medical problems, but why are we bent on installing them in political office? Let's think more carefully about the sort of minds that go into medicine and whether we are not overvaluing them as political candidates.