Appendix 46b - If We Were Really Interested in Helping People

by Michael Greger, MD and United Progressive Alumni

[ Medical School Resources | Appendices | Discussion ]

The real public health problem, of course, is poverty - Wendell L. Willkie

Faculties and schools of medicine were held to be, "failing in too many instances to produce socially responsible doctors who unequivocally recognize medicine as a social good, not a commercial commodity" according to one of the Macy Foundation's National Seminars on Medical Education. The foundation suggested that a period of social service be required of all medical students to, "improve the social sensitivity of physicians."[502]

From a study in JAMA: "Lower socioeconomic status is probably the most powerful single contributor to premature morbidity and mortality, not only in the United States but worldwide."[503] Although the proportion of adult mortality attributable to poverty has increased in the last two decades, quoting from Academic Medicine, "medical encounters usually do not deal with the social causes of suffering, which leads to doctors' overlooking social change as a possible healing option; when they do consider larger social issues in their patient encounters, their interventions often maintain the existing social order."[504]

From Getting Doctored:

Rounds are allegedly unidealogical, but they are not. Their ideology is an unquestioning acceptance of the social, political and economic status quo. Rounds school physicians in the avoidance of broader social concerns and teach them an approach to medicine that ignores its socio-political context.[505]

In his book The Politics of Medical Encounters, Waitzkin gives an example:

When a professional encourages mechanisms of coping and adjustment, this communication conveys a subtle political context. By seeking limited modifications... which preserve a particular institution's overall stability, the practitioner exerts a conservative political impact. Despite the best conscious intents, the practitioner thus helps reproduce the same institutional structures that form the roots of personal anguish.[506]



[502] Sandroni, S. "Context of Social Awareness." Southern Medical Journal 82(1989):1545-1546.

[503] Williams, RB. "Lower Socioeconomic Status and Increased Mortality." Journal of the American Medical Association 279(1998):1745-1746.

[504] Wear, D. "Professional Development of Medical Students." Academic Medicine 72:1056-1062.

[505] Shapiro, M. Getting Doctored Santa Cruz, CA,: New Society Publishers, 1987:125.

[506]Waitzin, H. The Politics of Medical Encounters New Haven:Yale Un iversity Press, 1991.



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