Was your PA program "woke"?

[d-wade]

21 minutes ago, Boatswain2PA said:

Your OB rotation was going to be at a PP abortion center?  That's nuts.

I had several rotations that counted as OB, and first-assisted on a C-section on my 1st day of my 2nd rotation.  Wound up assisting in delivering of probably 20 babies through my rotations.  Never did an elective abortion, never will.

Pretty sure they changed that definition with the DSM-V.  

Problem with psychological research is that it is mostly junk and not repeatable.  https://www.smithsonianmag.com/science-nature/scientists-replicated-100-psychology-studies-and-fewer-half-got-same-results-180956426/
 

Per the DSM V, gender dysphoria diagnosis:

In adolescents and adults gender dysphoria diagnosis involves a difference between one’s experienced/expressed gender and assigned gender, and significant distress or problems functioning. It lasts at least six months and is shown by at least two of the following:

1. A marked incongruence between one’s experienced/expressed gender and primary and/or secondary sex characteristics
2. A strong desire to be rid of one’s primary and/or secondary sex characteristics
3. A strong desire for the primary and/or secondary sex characteristics of the other gender
4. A strong desire to be of the other gender
5. A strong desire to be treated as the other gender
6. A strong conviction that one has the typical feelings and reactions of the other gender

In children, gender dysphoria diagnosis involves at least six of the following and an associated significant distress or impairment in function, lasting at least six months.

1. A strong desire to be of the other gender or an insistence that one is the other gender
2. A strong preference for wearing clothes typical of the opposite gender
3. A strong preference for cross-gender roles in make-believe play or fantasy play
4. A strong preference for the toys, games or activities stereotypically used or engaged in by the other gender
5. A strong preference for playmates of the other gender
6. A strong rejection of toys, games and activities typical of one’s assigned gender
7. A strong dislike of one’s sexual anatomy
8. A strong desire for the physical sex characteristics that match one’s experienced gender

 

Gender Identity Disorder, was removed from the DSM though.

Edited September 19, 2019 by d-wade

[d-wade]

14 minutes ago, rev ronin said:

Which research was this?  I wasn't aware that there had been much more than expert guesswork and retrospective analyses.

Mental health and gender dysphoria: A review of the literature.

https://www.ncbi.nlm.nih.gov/pubmed/26835611

Studies investigating the prevalence of psychiatric disorders among trans individuals have identified elevated rates of psychopathology. Research has also provided conflicting psychiatric outcomes following gender-confirming medical interventions. This review identifies 38 cross-sectional and longitudinal studies describing prevalence rates of psychiatric disorders and psychiatric outcomes, pre- and post-gender-confirming medical interventions, for people with gender dysphoria. It indicates that, although the levels of psychopathology and psychiatric disorders in trans people attending services at the time of assessment are higher than in the cis population, they do improve following gender-confirming medical intervention, in many cases reaching normative values. The main Axis I psychiatric disorders were found to be depression and anxiety disorder. Other major psychiatric disorders, such as schizophrenia and bipolar disorder, were rare and were no more prevalent than in the general population. There was conflicting evidence regarding gender differences: some studies found higher psychopathology in trans women, while others found no differences between gender groups. Although many studies were methodologically weak, and included people at different stages of transition within the same cohort of patients, overall this review indicates that trans people attending transgender health-care services appear to have a higher risk of psychiatric morbidity (that improves following treatment), and thus confirms the vulnerability of this population.

[TexasPA28]

The article in the WSJ is spot-on.

Does climate change affect health?  Absolutely.  

Is it good of doctors in general to comment on the role of global warming as a public health mission?  Sure

However it is absolutely ABSURD to spend precious clinical time ranting on global warming to an individual patient when there are 10 more relevant things that affect their immediate health status.    It's better to spend 60 minutes talking about medication compliance to a COPDer than to spend 1 minute talking about climate change.

What the "elite" academic liberals don't understand is that time with patients is limited.  We don't have time to spend 2 hours talking about gender identity, climate change, sexual preference, homelessness, food availability, poverty, racism, etc

[Guest thatgirlonabike]

11 hours ago, TexasPA28 said:

 

What the "elite" academic liberals don't understand is that time with patients is limited.  We don't have time to spend 2 hours talking about gender identity, climate change, sexual preference, homelessness, food availability, poverty, racism, etc

And that is the root of the problem.  We should but we can't and we do all of our patients a disservice by not addressing these issues.  So I hope these issues continue to be taught in hope that someday we can fix our medical system and address the whole patient.   The main thing my time as a Community Paramedic instilled in me is the fact that illnesses don't occur in a vacuum and neither should the practice of medicine.  

[Marinejiujitsu]

And that is the root of the problem.  We should but we can't and we do all of our patients a disservice by not addressing these issues.  So I hope these issues continue to be taught in hope that someday we can fix our medical system and address the whole patient.   The main thing my time as a Community Paramedic instilled in me is the fact that illnesses don't occur in a vacuum and neither should the practice of medicine.  

I disagree. That is a political stance trying to indoctrinate are young people. With that said, medical and PA schools should stick to learning medicine. That's what NPs been dealing with which hasn't helped their pathophysiology. Learning social is issues should be kept in sociology and liberal studies.

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[Brigid2010]

2 hours ago, thatgirlonabike said:

And that is the root of the problem.  We should but we can't and we do all of our patients a disservice by not addressing these issues.  So I hope these issues continue to be taught in hope that someday we can fix our medical system and address the whole patient.   The main thing my time as a Community Paramedic instilled in me is the fact that illnesses don't occur in a vacuum and neither should the practice of medicine.  

I'd upvote this 1,000,000 times over...

[Marinejiujitsu]

I disagree. That is a political stance trying to indoctrinate are young people. With that said, medical and PA schools should stick to learning medicine. That's what NPs been dealing with which hasn't helped their pathophysiology. Learning social is issues should be kept in sociology and liberal studies.

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Let me rephrase. I partially agree except when medicine/medical school should not be forced to change due to "woke" ideas. If your not a compassionate person, you shouldn't be in medicine. A compassionate person transcends all political and religious stances.

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[GetMeOuttaThisMess]

I’m upset because my feelings weren’t taken into consideration by forcing me to look up what the heck “woke” even means. Now I know and I won’t ever get that time back. There’s enough stuff to learn in school without having to deal with the social issues of the day. Learn about that in pre-recs.

[swooshie1]

On 9/19/2019 at 7:32 PM, TexasPA28 said:

....

We don't have time to spend 2 hours talking about gender identity, climate change, sexual preference, homelessness, food availability, poverty, racism, etc

Wow.  Must be nice to live and practice in an area where HOMELESSNESS, FOOD AVAILABILITY, POVERTY are NOT issues you need to address !  I practice rural medicine and these are daily issues I discuss. If gender identity, climate change (YES IT IS affecting my patients: increased fire danger due to dry conditions, now anytime high winds occur, which is almost daily during this time of year,  the electric company is shutting down power to avoid another Paradise fire situation) sexual preference, racism are things my patients want and need to discuss, you bet I take the time to discuss them.

[Marinejiujitsu]

Wow.  Must be nice to live and practice in an area where HOMELESSNESS, FOOD AVAILABILITY, POVERTY are NOT issues you need to address !  I practice rural medicine and these are daily issues I discuss. If gender identity, climate change (YES IT IS affecting my patients: increased fire danger due to dry conditions, now anytime high winds occur, which is almost daily during this time of year,  the electric company is shutting down power to avoid another Paradise fire situation) sexual preference, racism are things my patients want and need to discuss, you bet I take the time to discuss them.

I know people that work at PGE and they say it just gets harder and harder, people don't allow them on their property to take care of brush around the power lines and other equipment, therefore its getting more and more of a risk. Fires may flare up peoples asthma but they shouldn't teach us how to control fires therefore climate change is obsolete.

Now I think the powers that be should focus on climate control rather than thinking stopping fossil fuels would do anything.

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[Boatswain2PA]

5 hours ago, swooshie1 said:

(YES IT IS affecting my patients: increased fire danger due to dry conditions, now anytime high winds occur, which is almost daily during this time of year,  the electric company is shutting down power to avoid another Paradise fire situation)

Have you had a patient who had a medical condition, or exacerbation, directly attributed to climate change?  

Edited September 21, 2019 by Boatswain2PA

[TexasPA28]

8 hours ago, swooshie1 said:

Wow.  Must be nice to live and practice in an area where HOMELESSNESS, FOOD AVAILABILITY, POVERTY are NOT issues you need to address !  I practice rural medicine and these are daily issues I discuss. If gender identity, climate change (YES IT IS affecting my patients: increased fire danger due to dry conditions, now anytime high winds occur, which is almost daily during this time of year,  the electric company is shutting down power to avoid another Paradise fire situation) sexual preference, racism are things my patients want and need to discuss, you bet I take the time to discuss them.

Nonsense.  Please tell me the name of your clinic so I can come shadow you.  Unless you are seeing 10 patients or less per day there's no freaking way you are talking to your patients about poverty, homelessness, racism, global warming on every visit.

 

[rev ronin]

2 hours ago, TexasPA28 said:

Nonsense.  Please tell me the name of your clinic so I can come shadow you.  Unless you are seeing 10 patients or less per day there's no freaking way you are talking to your patients about poverty, homelessness, racism, global warming on every visit.

I talk to my homeless patient about his homelessness.  I've had a number of my patients forced to move against their will, if not outright evicted, over the years. I talk to my minority patients about racism, most often about how I expect it will affect their ability to get a job after they're done with worker's comp retraining.

I have yet to see any reason to discuss global warming or climate change; those are macro-level discussions.  The closest I get to discussing politics with patients is when I'm testing their grip strength, I'll have them squeeze my fingers, and then say "Great, now pretend I work for the IRS and do that again."

It is not my job to change my patients' belief systems using my influence as a medical provider; I believe that to be inappropriate and unprofessional.  But if I were going to do so, I'd try and get them to be more forgiving of themselves and others, more willing to let go of hate and anger, more willing to let go of burdens... But I digress.

If those personal belief upgrades resulted in more social responsibility, hooray. But ultimately, there's enough individual pain, sadness, selfishness, desperation, despair, shame... I would attack those first, because they can make my patients' lives better as they let go of those one by one.

[GetMeOuttaThisMess]

Rev, you're also in a unique situation, somewhat similar to where I'm at to where we aren't "moving the meat" like so many others.  I'm glad that you, and some of us others, are allowed time to partake in these discussions.

[rev ronin]

1 hour ago, GetMeOuttaThisMess said:

Rev, you're also in a unique situation, somewhat similar to where I'm at to where we aren't "moving the meat" like so many others.  I'm glad that you, and some of us others, are allowed time to partake in these discussions.

Thanks.  I can be surprisingly stubborn when I am motivated by the health and well being of my patients, which is what took me out of IT security and into medicine in the first place.  I've got enough experience in (passed my 10,000 hours some time ago) that I am going to keep burrowing into that niche, where I can make my employer money AND do good medicine.

[pursuitofPA]

It’s good to see people who actually realize though Medicine is surely a business, our patients are still human. Social issues certainly have a place in medicine and definitely medical education. 

[Boatswain2PA]

On 9/27/2019 at 2:10 AM, pursuitofPA said:

It’s good to see people who actually realize though Medicine is surely a business, our patients are still human. Social issues certainly have a place in medicine and definitely medical education. 

I'm sure all of us "actually realize" this.  

[pursuitofPA]

1 hour ago, Boatswain2PA said:

I'm sure all of us "actually realize" this.  

Too bad the comments on the post say otherwise.

[Boatswain2PA]

4 hours ago, pursuitofPA said:

Too bad the comments on the post say otherwise.

Really?  Which comments make you think that we don't "actually realize" the social determinants of health, medicine, and healthcare?

[heyeng]

I was asked about my privilege and by that they were referring to my white privilege. Nevermind I've been in the military for 16 years, enlisted, or the fact I took time off to work in a rural EMS... It was pathetic. I was asked how I would treat patients of different backgrounds and I explained that every patient I've treated has received the best care I'm capable of, no exceptions. That was turned into me viewing cultural differences as an extreme negative. All those years working 60 hour weeks on a farm I never got my privilege card.

[Marinejiujitsu]

I was asked about my privilege and by that they were referring to my white privilege. Nevermind I've been in the military for 16 years, enlisted, or the fact I took time off to work in a rural EMS... It was pathetic. I was asked how I would treat patients of different backgrounds and I explained that every patient I've treated has received the best care I'm capable of, no exceptions. That was turned into me viewing cultural differences as an extreme negative. All those years working 60 hour weeks on a farm I never got my privilege card.

I wish someone told my parents we were supposed to have white privilege.

I grew up in a condemned house in a broken family with random homeless people and ex cons living on the couch of all races. My white privilege tells people that I wouldnt understand though. I live in silicon valley now and would have died to grow up in one of the houses in the ghettos over here.

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[Guest PAhopeful85]

Question for the woke people on here:

How can a transgender be born in the wrong body if gender is just a social construct? And wouldn’t re-education make more sense in that case instead of surgery? You know, since gender is all make believe?

Edited October 10, 2019 by PAhopeful85

[Marinejiujitsu]

Oh, we are doing the poor, white pity party thing in here now?

You must have came from a middle class family. A lot of us had to join the military to get out of the ghettos and poverty. Well, i guess more of people think I'm more Mexican though so white privilege doesn't apply. Lol.

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[Marinejiujitsu]

I think being "woke" is overblown. Its mainly white liberal middle class politicians or systemic organizations/schools. Most average people aren't woke especially all the so call poor white people, blacks, mexicans, and asians, being woke blows their minds away.

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[CAAdmission]

I've seen what woke looks like. Please keep me on the Propofol drip.