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PC, M.D.: How Political Correctness Is Corrupting Medicine
Drawing on a wealth of information, much of it never before revealed, PC, M.D. documents for the first time what happens when the tenets of political correctness-including victimology, multiculturalism, and the rejection of fixed truths and individual autonomy-are allowed to enter the fortress of medicine. Consider these examples: 1. A professor at the Harvard School of Public Health teaches her students that racial discrimination causes high blood pressure among blacks-an unsubstantiated and dangerous "truth" 2. Nationwide, consumer-survivors preach against involuntary commitment of the severely mentally ill, arguing for their "right" not to be treated 3. Baltimore's Commissioner of Health proposes distributing heroin to addicts, claiming they are too oppressed to help themselves The consequences of putting politics before health are far-reaching, argues Sally Satel. Patients are the ultimate victims of these disturbing trends. Meanwhile, PC medicine diverts taxpayer money that could be better spent delivering health care, providing proven therapies, and rigorously investigating new ones. PC, M.D. is a powerful wake-up call to the medical profession and to patients.
304 pages, Hardcover
First published November 30, 2000
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140 people want to read
About the author
Sally L. Satel
5 books24 followersSatel is a psychologist, lecturer at Yale School of Medicine, and the W. H. Brady Fellow at the American Enterprise Institute.
She earned a bachelor's degree from Cornell University, a master's degree from the University of Chicago and an MD degree from Brown University. She completed her residency in psychiatry at Yale University. In 1993 and 1994, she was a Robert Wood Johnson Health Policy Fellow with the U.S. Senate Committee on Health, Education, Labor and Pensions.
She earned a bachelor's degree from Cornell University, a master's degree from the University of Chicago and an MD degree from Brown University. She completed her residency in psychiatry at Yale University. In 1993 and 1994, she was a Robert Wood Johnson Health Policy Fellow with the U.S. Senate Committee on Health, Education, Labor and Pensions.
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October 24, 2017I read this book in less than a day. It takes brass balls to write a book like this. It takes all that feel-good, consensus-building, politically-motivated crap that we're dealing with these days and shows how, when applied to a field that will not reward complaints about "the patriarchy" or "white privilege" with better clinical outcomes, the consequences of these ideologies can be disastrous.
Satel takes the refreshing viewpoint that results are politics-independent. She is more concerned about creating the greatest number of capable doctors to create the greatest good for the largest number of people at the lowest cost, regardless of what implications the methods of doing that will have on social justice or modern "civil rights" movements. And as she effectively argues, the logic that says that mixing medical science with political agendas is harming patients.
I was so fascinated I could almost recall everything she said in this book. In the first part of the book, she examines how the "civil rights movement" of consumer-survivors, who are 'survivors' of mental health treatment, have opposed policies that allow involuntary commitment of unstable people, despite evidence that such treatment is often extremely helpful and cost-efficient compared to the alternatives. Furthermore, she explodes the myth that the mentally ill are "as safe as the rest of us." This justifies involuntary commitment on the basis of protection of others. What if Jared Loughner had been committed and treated instead of allowed to run wild despite a long history of mental illness? Further, they are pushing for reform that allows mental health patients to become "equal participants" in planning their care, participating in their own diagnosis as treatment plan. But...they're not capable of diagnosing themselves, because they're sick. Even if you're against involuntary commitment, the ways that this movement has exerted its influence in mental health programs is frightening for other reasons, perhaps the biggest one being that it hurts those the most that it purports to protect. The most sick need the most help, but the politically-savvy consumer survivors are making it harder and harder to make the interventions necessary to change the outcomes for these patients.
Next, she takes on therapeutic touch and corrosion of nursing standards that have come about, according to her sources, as a response to the "patriarchy" of medicine, which she proves does not exist any longer. These practices are unscientific, and therapeutic touch was debunked by a nine-year-old girl for a science fair project. They have not shown results in clinical trials, but nursing organizations have forced them into nursing curricula throughout the country, wasting time and money that should be spent training nurses in proven therapeutic practices. Instead, we're seeing the proliferation and semi-legitimization of practices like aromatherapy and energy-flow in nursing practice as an alternative to the coldly clinical procedures of doctors. Nurses see these practices as a way to even the "power differential" between themselves and doctors (who nurses tend to view as the patriarchy, despite a significant representation by women at this level). They view "orders" as reaffirming a male-hierarchy system that doesn't allow for the intuition and healing through connection that caregivers value. Only, as Satel shows, when 'connection' replaces 'treatment' we get to see clearly whose methodology produces better outcomes.
Following along in the feminist vein, Satel takes on the powerful women's health advocacy organizations that lobby for money to support women's health projects, using the oft-heard complaint that women have been under-represented in clinical trials and research funding. Where this has been true, Satel demonstrates the very logical reasons for the discrepancy (such as studying the most-afflicted, most available population for a given condition, in order to save money, effort, and to ensure that further more expensive studies will have interesting results.) She uses the example of heart-disease, which traditionally studies men, even though women are often afflicted later in life as well. But the reasons to use men in these clinical trials is perfectly clear. Since women tend to contract heart complications later in life than men, they're rarely able to perform the stress tests that men presenting with the same condition can, and the studies tend to take longer and thus be more expensive. Besides, studies tend to indicate that in conditions that are shared between the sexes, there is often little difference in the outcomes of interventions between the genders, and when such differences are indicated, gender-specific follow-up studies are already the norm. Besides that, in recent years women have also been over-represented in studies of conditions affecting both genders, to the tune of 62/100 participants in such studies being women. As far as gender-specific conditions, such as breast-cancer study, Satel shows that women are actually over-represented in terms of funding and number of studies performed on single-sex populations. A salient example is breast cancer, which we all admit is terrible. However, it receives incredibly generous funding considering its incidence and mortality rate. Way more than, for example, prostate cancer, which has a higher incidence rate and more devastating side effects for intervention, and suffers from a highly-inaccurate test that has resulted in numerous unnecessary prostatectomies. The lethality of prostate cancer is difficult to compare to breast cancer directly, because different age ranges are affected very differently for each cancer. However, no studies have implied that prostate cancer is considerably less dangerous than breast cancer. That's one example. Satel also notes, as a counter-point to the rhetoric surrounding the women's health advocacy organizations, that it seems almost funny for a group to claim the relative importance of study into their own health so vehemently when women already live six years longer than men on average.
She then turns her attention to the subject of a controversy that erupted in South Carolina when a hospital serving pregnant mothers in a crack-riddled area required mandatory drug-testing for mothers in their third trimester, and threatened legal intervention for mothers who failed to abstain from drugs during that time. According to Satel, the program was showing success in lowering the incidences of premature birth and complications caused by the stimulant cocaine, when a lobby spoke up and declared that the hospital was violating these mother's civil rights by requiring this testing. This lobby saw the drug problem as indicative of social oppression of these women, and they forced the hospital to drop its policy. All in all, this lobby accused the hospital of denying a minority culture (drug-users) and essentially victim-blaming, since these women have been driven to use drugs by social pressures. At the expense of the health of both baby and mother, these advocates protected the mother's 'right' to continue using drugs. Satel uncovers a culture of user-moms who support each other with information on how to use drugs while being a parent (and we're talking crack-rocks, kids, not just marijuana). Kids growing up in this culture are disproportionately abused and neglected. Though I personally am pro-choice and feel that a fetus should not be considered a person until it is birthed and living, this situation contains a dilemma for my position. You can't be abusing a non-person, but intentionally bringing to life a person who is at an elevated risk for birth defects and complications doesn't seem like the kind of act that I can condone in good conscience. Something to think about. Anyway, Satel's point is that this advocacy group that overturned the policy, motivated an agenda that characterizes these (mostly black) women as helpless victims of racism, sexism, and cruel hospital administrators, peeled back a program that all evidence shows was making a positive impact, and had gained the praise of numerous people who were affected by it.
But why stop there with the rhetoric about victim-blaming? Satel brings it back home to her profession, where she sees deep inroads cut by a movement in psychiatry that emphasizes multiculturality, acceptance, and victimhood in place of the traditional psychiatric model of identifying difficulties, developing coping and management strategies, and reviewing patient experiences to determine opportunities for improvement in both behavior and treatment strategies. This new movement, which has made its farthest inroads in Maine, views people as no more than the helpless result of society's prejudices toward your demographic group and any personal traumas that you may or may not have experienced. Psychiatry courses in cultural sensitive are often required and can act as barriers to employment in certain hospitals and practices, where "multicultural treatments" are offered. In these treatments, the "victims" are made aware of all of the ways in which society has been prejudiced against them, and informed not of coping strategies, but of ways to become politically active to seek legislative redress. Satel goes on in disturbing length about all the various manifestations of this mentality from the quack psychiatrists of the 1980's that were treating patients in such a way that they implanted false memories of abuse into their patients (remember that famous case where a girl accused her father of raping her, then tragically he was imprisoned for 10 years, until the woman finally got the courage to come forward and admit that the event had never happened in fact, but her and her therapist had been in a method of treatment that caused her to think that it had?), to the absurd and demeaning practices at college campuses where students are taught that white students are inherently racist against their peers of color, and taught about ways to be more culturally-sensitive. In Carnegie Mellon this manifested itself as a presentation wherein our freshman class sat in an auditorium where administrators told us that given the chance, we men would rape and assault these women, so it was especially important for the women to be mistrustful of us. Satel argues that there is a growing culture of victimhood, wherein status is earned with the sobbiest sob stories, and people who speak out against it are considered traitors or liars. This is easy enough to see in my own life. Concepts like 'personal responsibility' don't apply to these "victims" who claim that they are too distressed to hold a job and collect disability and welfare, while simultaneously acting as (presumably) competent counselors to other "victims" and savvy political lobbyists. Something doesn't quite make sense here. Of course, this wouldn't be an issue if it were simply a matter of making The View and Oprah even harder to watch, but these counselors championing treatments by reliving trauma and assuming the victim mentality forevermore are gaining momenting in promulgating their kind into psychiatry offices across the nation, and informing political person on their own agendas and securing funding for themselves. Some might wonder "But is this treatment more valid?" The answer to the question is that these practices have yet to be clinically-tested, as of the time of printing of the edition of this book that I read. But we do know that other treatments that these methods replace are proven to be effective in a significant portion of patients.
I often feel like I'm stumbling around looking for some sign of human intelligence these days. The effects of politcally-correct mindset in my experience are frustrating to people who are seeking to gain deeper objective insight into issues of importance. For example, you can't have a real discussion about the state of racism in this country right now with most people, because the minute you entertain the idea that racism may not be as serious now as people make it out to be, you're accused of being insensitive, "white-priveleged", "victim-blaming", and any other number of undefined but popular terms. The prevailing attitude is that if you're not a victim, then you don't deserve to have an opinion on these issues. The problem is that if you only allow the opinions of the "victims", you already know what kind of commentary you're going to get. This is how vocal minorities happen--because the complacent majority is shamed in to keeping quiet. Today's intellectual atmosphere is like a lonely swamp. Every step just leaves you deeper in muck. You can't say anything meaningful without ending up in the much of having offended the minority du jour. You just want to sink into the mud and give up, like Artax. But this book is like a signal flare that rises above that swamp. It is so thorough, so well-researched and cited, and clinical in its approach and damning in its reproach that it gives me hope. There are people out there who care about what's true.
Satel takes the refreshing viewpoint that results are politics-independent. She is more concerned about creating the greatest number of capable doctors to create the greatest good for the largest number of people at the lowest cost, regardless of what implications the methods of doing that will have on social justice or modern "civil rights" movements. And as she effectively argues, the logic that says that mixing medical science with political agendas is harming patients.
I was so fascinated I could almost recall everything she said in this book. In the first part of the book, she examines how the "civil rights movement" of consumer-survivors, who are 'survivors' of mental health treatment, have opposed policies that allow involuntary commitment of unstable people, despite evidence that such treatment is often extremely helpful and cost-efficient compared to the alternatives. Furthermore, she explodes the myth that the mentally ill are "as safe as the rest of us." This justifies involuntary commitment on the basis of protection of others. What if Jared Loughner had been committed and treated instead of allowed to run wild despite a long history of mental illness? Further, they are pushing for reform that allows mental health patients to become "equal participants" in planning their care, participating in their own diagnosis as treatment plan. But...they're not capable of diagnosing themselves, because they're sick. Even if you're against involuntary commitment, the ways that this movement has exerted its influence in mental health programs is frightening for other reasons, perhaps the biggest one being that it hurts those the most that it purports to protect. The most sick need the most help, but the politically-savvy consumer survivors are making it harder and harder to make the interventions necessary to change the outcomes for these patients.
Next, she takes on therapeutic touch and corrosion of nursing standards that have come about, according to her sources, as a response to the "patriarchy" of medicine, which she proves does not exist any longer. These practices are unscientific, and therapeutic touch was debunked by a nine-year-old girl for a science fair project. They have not shown results in clinical trials, but nursing organizations have forced them into nursing curricula throughout the country, wasting time and money that should be spent training nurses in proven therapeutic practices. Instead, we're seeing the proliferation and semi-legitimization of practices like aromatherapy and energy-flow in nursing practice as an alternative to the coldly clinical procedures of doctors. Nurses see these practices as a way to even the "power differential" between themselves and doctors (who nurses tend to view as the patriarchy, despite a significant representation by women at this level). They view "orders" as reaffirming a male-hierarchy system that doesn't allow for the intuition and healing through connection that caregivers value. Only, as Satel shows, when 'connection' replaces 'treatment' we get to see clearly whose methodology produces better outcomes.
Following along in the feminist vein, Satel takes on the powerful women's health advocacy organizations that lobby for money to support women's health projects, using the oft-heard complaint that women have been under-represented in clinical trials and research funding. Where this has been true, Satel demonstrates the very logical reasons for the discrepancy (such as studying the most-afflicted, most available population for a given condition, in order to save money, effort, and to ensure that further more expensive studies will have interesting results.) She uses the example of heart-disease, which traditionally studies men, even though women are often afflicted later in life as well. But the reasons to use men in these clinical trials is perfectly clear. Since women tend to contract heart complications later in life than men, they're rarely able to perform the stress tests that men presenting with the same condition can, and the studies tend to take longer and thus be more expensive. Besides, studies tend to indicate that in conditions that are shared between the sexes, there is often little difference in the outcomes of interventions between the genders, and when such differences are indicated, gender-specific follow-up studies are already the norm. Besides that, in recent years women have also been over-represented in studies of conditions affecting both genders, to the tune of 62/100 participants in such studies being women. As far as gender-specific conditions, such as breast-cancer study, Satel shows that women are actually over-represented in terms of funding and number of studies performed on single-sex populations. A salient example is breast cancer, which we all admit is terrible. However, it receives incredibly generous funding considering its incidence and mortality rate. Way more than, for example, prostate cancer, which has a higher incidence rate and more devastating side effects for intervention, and suffers from a highly-inaccurate test that has resulted in numerous unnecessary prostatectomies. The lethality of prostate cancer is difficult to compare to breast cancer directly, because different age ranges are affected very differently for each cancer. However, no studies have implied that prostate cancer is considerably less dangerous than breast cancer. That's one example. Satel also notes, as a counter-point to the rhetoric surrounding the women's health advocacy organizations, that it seems almost funny for a group to claim the relative importance of study into their own health so vehemently when women already live six years longer than men on average.
She then turns her attention to the subject of a controversy that erupted in South Carolina when a hospital serving pregnant mothers in a crack-riddled area required mandatory drug-testing for mothers in their third trimester, and threatened legal intervention for mothers who failed to abstain from drugs during that time. According to Satel, the program was showing success in lowering the incidences of premature birth and complications caused by the stimulant cocaine, when a lobby spoke up and declared that the hospital was violating these mother's civil rights by requiring this testing. This lobby saw the drug problem as indicative of social oppression of these women, and they forced the hospital to drop its policy. All in all, this lobby accused the hospital of denying a minority culture (drug-users) and essentially victim-blaming, since these women have been driven to use drugs by social pressures. At the expense of the health of both baby and mother, these advocates protected the mother's 'right' to continue using drugs. Satel uncovers a culture of user-moms who support each other with information on how to use drugs while being a parent (and we're talking crack-rocks, kids, not just marijuana). Kids growing up in this culture are disproportionately abused and neglected. Though I personally am pro-choice and feel that a fetus should not be considered a person until it is birthed and living, this situation contains a dilemma for my position. You can't be abusing a non-person, but intentionally bringing to life a person who is at an elevated risk for birth defects and complications doesn't seem like the kind of act that I can condone in good conscience. Something to think about. Anyway, Satel's point is that this advocacy group that overturned the policy, motivated an agenda that characterizes these (mostly black) women as helpless victims of racism, sexism, and cruel hospital administrators, peeled back a program that all evidence shows was making a positive impact, and had gained the praise of numerous people who were affected by it.
But why stop there with the rhetoric about victim-blaming? Satel brings it back home to her profession, where she sees deep inroads cut by a movement in psychiatry that emphasizes multiculturality, acceptance, and victimhood in place of the traditional psychiatric model of identifying difficulties, developing coping and management strategies, and reviewing patient experiences to determine opportunities for improvement in both behavior and treatment strategies. This new movement, which has made its farthest inroads in Maine, views people as no more than the helpless result of society's prejudices toward your demographic group and any personal traumas that you may or may not have experienced. Psychiatry courses in cultural sensitive are often required and can act as barriers to employment in certain hospitals and practices, where "multicultural treatments" are offered. In these treatments, the "victims" are made aware of all of the ways in which society has been prejudiced against them, and informed not of coping strategies, but of ways to become politically active to seek legislative redress. Satel goes on in disturbing length about all the various manifestations of this mentality from the quack psychiatrists of the 1980's that were treating patients in such a way that they implanted false memories of abuse into their patients (remember that famous case where a girl accused her father of raping her, then tragically he was imprisoned for 10 years, until the woman finally got the courage to come forward and admit that the event had never happened in fact, but her and her therapist had been in a method of treatment that caused her to think that it had?), to the absurd and demeaning practices at college campuses where students are taught that white students are inherently racist against their peers of color, and taught about ways to be more culturally-sensitive. In Carnegie Mellon this manifested itself as a presentation wherein our freshman class sat in an auditorium where administrators told us that given the chance, we men would rape and assault these women, so it was especially important for the women to be mistrustful of us. Satel argues that there is a growing culture of victimhood, wherein status is earned with the sobbiest sob stories, and people who speak out against it are considered traitors or liars. This is easy enough to see in my own life. Concepts like 'personal responsibility' don't apply to these "victims" who claim that they are too distressed to hold a job and collect disability and welfare, while simultaneously acting as (presumably) competent counselors to other "victims" and savvy political lobbyists. Something doesn't quite make sense here. Of course, this wouldn't be an issue if it were simply a matter of making The View and Oprah even harder to watch, but these counselors championing treatments by reliving trauma and assuming the victim mentality forevermore are gaining momenting in promulgating their kind into psychiatry offices across the nation, and informing political person on their own agendas and securing funding for themselves. Some might wonder "But is this treatment more valid?" The answer to the question is that these practices have yet to be clinically-tested, as of the time of printing of the edition of this book that I read. But we do know that other treatments that these methods replace are proven to be effective in a significant portion of patients.
I often feel like I'm stumbling around looking for some sign of human intelligence these days. The effects of politcally-correct mindset in my experience are frustrating to people who are seeking to gain deeper objective insight into issues of importance. For example, you can't have a real discussion about the state of racism in this country right now with most people, because the minute you entertain the idea that racism may not be as serious now as people make it out to be, you're accused of being insensitive, "white-priveleged", "victim-blaming", and any other number of undefined but popular terms. The prevailing attitude is that if you're not a victim, then you don't deserve to have an opinion on these issues. The problem is that if you only allow the opinions of the "victims", you already know what kind of commentary you're going to get. This is how vocal minorities happen--because the complacent majority is shamed in to keeping quiet. Today's intellectual atmosphere is like a lonely swamp. Every step just leaves you deeper in muck. You can't say anything meaningful without ending up in the much of having offended the minority du jour. You just want to sink into the mud and give up, like Artax. But this book is like a signal flare that rises above that swamp. It is so thorough, so well-researched and cited, and clinical in its approach and damning in its reproach that it gives me hope. There are people out there who care about what's true.
September 5, 2017
A very well written book wtih many shocking details of how political correctness is manifested in the field of medicine. The anti-science corruption in the name of social justice is doing the exact opposite of what medicine should be, which is saving lives. Each chapter was neatly divived up into chronological sub sections. A very good read for those wishing to restock their arsenal in debates against political correctness.
September 2, 2012
What an INCREDIBLE book. I randomly stumbled upon this book while I was on paperbackswap.com and decided I had to have it. Never before have I read such a succinct yet insightful book on the damaging effects of political correctness in the realm of medicine.
Rather than attacking practitioners of political correctness as simply "idiots with an agenda" Dr. Satel delves deeper into why these p.c. practitioners are misguided and are not best serving their patients.
(Will continue review later.)
Rather than attacking practitioners of political correctness as simply "idiots with an agenda" Dr. Satel delves deeper into why these p.c. practitioners are misguided and are not best serving their patients.
(Will continue review later.)
February 8, 2019
This is the worst book I have ever read. Sally is pushing a political agenda and uses many assumptions that she presents as facts, with no backing. She makes wildly presumptuous twists of language and of reality to push reactionary ideas in an attempt to dehumanize people. She calls anything that considers social issues “anti-science” as if there is a mutually exclusive binary between social justice and science. This could not be further from the truth, as natural biological science, human behavior and societal conditions all intersect, and humans cannot be separated from the society in which they are a part of. Every point she makes is a reactionary jeremiad against compassion and nuance. as a psychology scholar, you think she would be able to read her own book and recognize that it is a product of her own personal anger against society’s realization that medicine is much more complicated than previously thought, that her points are merely defense mechanisms against having to learn , having to incorporate disciplines that value empathy (a trait that she vehemently scorns - it’s ok sally it can be scary to admit when you have none) and having to admit that racial and class disparity actually affects people (it can be hard to see when it doesn’t affect you and you hate empathy. Of course by denouncing empathy perhaps you think you can keep others in your bubble, maybe the bubble will pop if it meets the vacuum that you seem to think biological science exists in.)
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