1. An aptitude for UNDERSTANDING medical and scientific research. I really couldn’t care less if they are brilliant scientists themselves. I sure as shit don’t care if they’re good at physics. I want them to know that epidemiology can never establish causation. Correlation does not establish causation. Period. Ever.

I want them to know they need to read their journals weekly, and that they can’t rely on the authors’ conclusions but need to read the WHOLE paper and draw their own conclusions. The ability to understand basic genetics and MZ vs. DZ twin vs. parental concordance is needed. Knowledge of the relative scientific strengths and weaknesses of quantitative and qualitative research should be firmly in place as well. With rare or currently untreatable illnesses, and even healthy conditions like pregnancy where you can’t just randomly assign treatment and no-treatment groups, following a population clinically is both ethical and informative.

2. An ability to LISTEN to what patients say and what they don’t say, and draw correct conclusions then check with the patient (and witnesses) to clarify. This can be done in seconds in an emergency. A couple of social work courses in assessment would instill this critical ability.

3. A basic understanding of human psychology, including but not limited to: human developmental stages; motivated behaviors (thirst, sleep, hunger, breathing, pain, pleasure) that are not under a person’s control; a class on the biological basis of addiction (neurologically similar to epilepsy) as opposed to psychological dependence (which happens equally with marijuana, hugs, and asthma inhalers), and last but not least the common mental illnesses.

4. Female anatomy, physiology and health (including pregnancy) as a medical norm equivalent to male anatomy, physiology and health.

5. While we’re at it, how about a grounding in health (including pregnancy) on which to build a separate and parallel knowledge of pathology. I want doctors to recognize the natural variation in human phenotypes, and the effects that harsh or oppressive environments have on individuals and groups over time.

6. Economics, including a thorough review of the cost of treatment and medication compared to the typical income levels of different populations, so that they will not label poor people “non-compliant”.

7. Ethics – so that when they see other doctors abusing or butchering patients, they REPORT them to the police. And so when they are having trouble themselves, they seek help instead of harming patients and relying on other doctors to cover for them.

8. A medical history class detailing health and science fads that are still with us today. Positive fads are important, but aversion fads are critical to understanding that one’s own biases can cloud clinical and scientific reasoning.

I’d rather be treated by an English Literature BA or Auto Mechanics AD with those skills than a double major Biochem/Physics undergrad without them. It amounts to ten undergraduate classes at the most, only two semesters even for relative slackers.

And while we’re at it, I want working interns, residents and attendings to get at least 8 hours of sleep in 24. I’ve nearly been killed by doctors who were so sleepy they couldn’t have counted to ten if asked. Fortunately, either nurses took over and TOLD the comatose docs what to do, or I was an asshole and demanded a doctor who was competent to make legal decisions, let alone diagnoses and treatment decisions. How can people emerge from even a basic biology class without understanding that humans need sleep?

And can I just say that I wore my “Fat is a Phenotype, Not a Disease” tee shirt to my doctor’s office this morning and was met with cheers from staff, and shown off to everyone? I LOVE my doctor and his staff!

But…

Doctors receive absolutely no science education in med school, hence their sometimes astonishingly stupid beliefs about health. Med students are made to dissect and identify and memorize things, but there is no training in the scientific method, statistics, research design or the difference in importance between lab values and health outcomes. Statins (which lower cholesterol values but INCREASE death rates) would be prescribed about one thousandth as often if doctors understood the research on them.

Certainly there are doctors who are also scientifically literate, but it’s usually sheer coincidence when it happens. *sigh*

I don’t watch TV really (not by choice, just don’t have cable and haven’t been able to get the new digital box to work with TiVo – because once you’ve have a TiVo, you can’t just go back), so admittedly I’m not up on the latest TV news show trends, but is covering Internet gossip about a woman’s body considered news now?

I’m listening to The Ron Reagan Show right now, and he just got through talking about the new Fat Hysteria Topic: “Our New Surgeon General is… *gasp* a FAT WOMAN!!!!”

Here are a couple comments of his choice comments, made to some children’s health advocate he is interviewing on the subject:
“Now that she’s Surgeon General, she’s more or less ~obligated~ to lose weight! *chortle chuckle*”… or “It’s a great opportunity for her! [to ~finally~ lose some weight]!!”

or, while the interviewee was describing a community program at her schools to where local farmers bring in fresh produce for the kids: “What do you think about ~her~ being, maybe, someone who ~hasn’t~ had enough fresh fruits and vegetables in her life?”

Ordinarily I like Ron Reagan, although the two nights he interviewed Marianne he was a bit smarmy… but OMG tonight??? I haven’t heard him EVER be this ~patronizing~, this ~condescending~, this… NASTY (and all in his cheerful peppy voice)…. ever.

I’m an anthopologist, so I’m very well versed in scientific method, that’s how we do our work. But a new treatment or drug shouldn’t be rushed out as safe, when it’s not. My brother also died from stupidity, unfortunately his own, when he let a doc talk him into an ‘alternative’ and totally untested treatment for his lymphoma. The treatment caused his death, and if he had taken the standard treatment for lymphoma, he’d been cured and still be alive today. Bottom line here, M.D.’s are still ppl, they make mistakes, and it is in your own best interest to educate yourself ( which is what we here are doing, to combat the obesity myth.)

Let’s hope our new SG is good to go, and hopefully she won’t get brainwashed by the politicians. ;)

Pinky, you are so right about affordability of healthy food. I have been working on a study of urban agriculture, where ppl in depressed areas w/o access to fresh food are growing it themselves. Google ‘urban agriculture’, you’ll find some very interesting reads. I would like to see the SG looking into this, it is a cheap and fairly easy remedy for good fresh food for inner city lower income areas.

Also interesting is how some have freaked out over the *bodies* of some of Obama’s potential and actual female political and judicial nominees. Some objected to Elena Kagan’s possible nomination to the Supreme Court because of her weight and Sotomayor’s nomination because of her weight and diabetes. Seizure-prone Chief Justice Roberts didn’t go through anything like this. Now we have Regina Benjamin who has the nerve not to look like Surgeon General Barbie.

http://jezebel.com/5315443/female-nominees-continue-to-face-scrutiny-over-their-size-weight?skyline=true&s=x