The Best a Doctor Can Be by Pat Conrad MD

It’s a simple recipe, actually, tried and true for decades.  Pick an action or event so awful that no sane person could disagree with trying to oppose or eradicate it.  Then attach your own politics or ideological goal, and attack any opposition to it as somehow supportive of the original awful occurrence.  Then add nuts (optional).

 A Stanford University pediatric anesthesiologist named Alyssa Burgart knows how to work this formula.  As an academic with the Stanford Center for Biomedical Ethics, she knows that certain pronouncements from preferred sources brook no disagreement.

 Dr. Burgart is ostensibly taking on the topic of physician-initiated sexual assault, a horrible act that no sane person could accept. 

She cites a study of 280 ethical violations over an 8-year span, 95 of which were sexual assault.  Burgart references the fashionable #MeToo craze, stating, “It should come as no surprise that 100% of the cases DuBois and colleagues found were perpetrated by men, and greater than 85% of victims were women.”  Okay, rapists are far more likely to be men than women, and their victims more likely to be physically weaker females. 

 She cites the Agency for Healthcare Research and Quality as defining “sexual assault in the health care space as a ‘never event,’ an event that should never occur and is always preventable.'”  But since that is already a gruesome crime, who cares what the AHRQ thinks?  Bureaucrats, apparatchiks, and attention seeking academics, that’s who.  Burgart says, ” A broken system forgives doctors in every state,” and states there is “a lack of clearly defined consequences” for doctors who commit assault.  Obviously that is wrong, and those states should correct themselves immediately.  The article cited by Burgart is chock full of awful, completely inexcusable anecdotes, the perpetrators of which, we can all agree, should not be practicing medicine any longer. 

 So why did I say “ostensibly?”  Burgart:  “In a sample where 100% of perpetrators are men, I know one thing for certain: More men in leadership positions in medicine is not the solution.”  So we are to believe that the depraved, often insane, criminal assaults of a very few result in a lack of proper leadership?

 Burgart:  “Egregious ethical violations by individuals are the downstream symptoms of the systemically gendered culture of medicine, from training to the bedside to the boardroom. For women, who are affected both as physicians and as patients, we are in a unique position to see how the bigger picture of gender inequity is harming us — physically, emotionally, and professionally.”  Uh-oh.  So the problem is that there are too many men in medicine?

 Burgart:  “A growing body of evidence indicates that patients in the hands of women are safer: Women’s patients have lower readmission rates … and lower mortality… and more women in operating rooms promotes cooperative behavior (a quality essential for preventing medical errors).”  Apart from practicing all the lines for MOC exams and mandatory state license renewal CME’s, this colleague is flatly stating that men are the problem in medicine. 

“The medical profession has a moral imperative to achieve gender equity in our highest echelons. The sooner, the better, for every patient’s safety and well-being.”  So this about making medicine safer for patients, and who could oppose that? 

 Except it’s not.  Burgart:  “Fear of sexual harassment, sexual assault, and being dismissed for being a woman are the hidden curriculum of girlhood.”

– “Men have historically dominated medical leadership, and continue to do so, with 85% of department chairs still occupied by men. The #MeToo and #TimesUp movements have society finally acknowledging that men do not understand and cannot represent the lived experiences of women and that it is costing us human capital.”

–  “Gender equity is the moral imperative. Women deserve equality and patients deserve a safe haven. Women physicians protect patients in their practices, and any organization that fails to root out inequity is effectively shortchanging its patients and their safety. Women physician leaders protect patients and health care workers by promoting a perspective that is sorely lacking today.”  

This is not about protecting patients.  This is about gender politics and using a criminal act to justify quotas.  That is a dubious position for an ethics expert to take.

In a time when all physicians are being targeted from every direction, we should be able to count on each other as colleagues, without counting quotas or worrying that we’ll get blackjacked for being born with the wrong chromosome.  Dr. Burgart’s credentials are impressive, and I’m sure she is an excellent physician.  It’s too bad that she, by her own words, would be unwilling to assume the same about so many of us.

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