Medicine Needs Critical Thinking, not Critical Theory

 There are signals that the widespread misunderstanding seen in the last four years is finally changing, with many individuals questioning the handling of the Covid situation. Trust in healthcare providers and institutions has decreased significantly. For this trust to be restored, accountability for past actions must be prioritized, along with eliminating conflicts of interest, reducing Big Pharma's influence on public policy, and reforming medical education and organized medicine.

A major reason for our current challenges is the lack of effective leadership in the medical field. The strategies implemented over the last four years were based on long-standing philosophies. There is a need to rethink the criteria for entering and progressing in medical professions.

In 1999, key organizations shifted from a structure-based to a competency-based system in medical education. This new approach focuses on demonstrating actual abilities rather than just spending time in training activities. The Six Core Competencies included patient care, medical knowledge, communication skills, professionalism, practice-based learning, and systems-based practice.

The American Association of Medical Colleges also established a set of 15 Core Competencies for new medical students in 2011, which included skills like service orientation, teamwork, ethical responsibility, and critical thinking. In 2023, these were updated to emphasize cultural awareness and interpersonal skills alongside traditional competencies.

Allopathic medical schools require standard applications that capture personal information, academic history, relevant experiences, evaluations from referees, and personal statements. The AAMC encourages applicants by sharing inspiring stories of diverse admissions, which may alleviate concerns about the demographic make-up of successful candidates.

However, how admissions committees evaluate this information remains unclear, particularly concerning how they value core competencies and cultural values. The holistic evaluation process lacks transparency, leaving questions about the actual significance of cultural awareness and humility.

While many applicants have commendable stories of overcoming adversity to reach their goals, some concerns have emerged regarding the potential for "ableism" in medicine. The challenge remains in balancing the inclusion of physicians with disabilities against the need for patient safety and efficacy in care.

This difficult balance raises questions about the extent to which impaired physicians can serve patients effectively and when accommodations become unreasonable. Personal experiences of medical professionals highlight the need for transparency in defining limits and capabilities.

There has been increasing scrutiny on the influence of Diversity, Equity, and Inclusion (DEI) initiatives on the standards of prestigious educational institutions, questioning where equity for physicians may conflict with the health needs of patients. The recent shift towards a merit-based system at the University of Austin marks a significant questioning of the DEI paradigm.

Moreover, the rigid imposition of ideologies in the medical field has echoes in historical errors, including the political affiliations of certain physicians during the Nazi regime, demonstrating a troubling intersection of ethics and legal practice. Lessons must be learned to ensure that such moral failures are not repeated.

To avoid repeating dark chapters in history, the focus must be on individual value, conscience protection for medical professionals, and prioritizing ethical considerations over legalism. The language used in medicine must foster a respectful culture that emphasizes patient welfare over abstract societal ideals.

Current medical practice often strays from these ethical principles, especially highlighted during the Covid pandemic. Past experiences suggest that many future doctors may excel in ways not immediately evident in traditional evaluations.

The relationship between moral reasoning and clinical performance needs reevaluation to ensure future leaders in healthcare are adequately prepared. Essential leadership skills and critical thinking must be emphasized in medical education, incorporating these elements as early as possible in the training process.

Hillsdale College represents an organization that could implement critical reforms in early education concerning health professions, emphasizing the balance of character, ethics, and intellectual excellence. Developing a well-rounded approach from an early stage can greatly prepare future healthcare professionals to navigate the complexities of patient leadership responsibly and effectively.

https://brownstone.org/articles/medicine-needs-critical-thinking-not-critical-theory/