4 ms·

one justification I've heard is that doctor like to serve communities they came from. thus, affirmative action ensures minorities have access to doctors.

by kmax12 13y ago

eurleif 13y ago
Why not make admissions based on geography, then?
- SoftwareMaven 13y ago
  Serving the community is a different thing than serving in a community. "The" community tends to be "people like the people I've grown up with and lived around most of my life." I can find a community almost anywhere I live. In other words, a Hispanic doctor from LA might find a comfortable life in Miami serving the Hispanics there[1], whereas he may be completely uncomfortable serving a largely white, affluent neighborhood in the LA basin. 1. I have no idea if this is true or not; I'm just laying out the hypothetical of my GP.
- saraid216 13y ago
  By "geography" do you mean separate urban neighborhoods as well as large rural tracts? Not everyone goes home after they graduate.
- cturner 13y ago
  It's easy to game this, and there's overwhelming evidence that this already happens in related fields. In countries with state schools with geographic catchment (i.e. most of most English speaking countries), the housing market becomes a proxy for education choice. This entrenches class concentration. You end up with entire geographic regions that are exclusive, and others that are outcast. People who want their kids to be able to be at a certain school value catchment housing higher than others would. As a result, there's a slide of people who care about their kids' education towards certain regions. By consequence, there's a drain of people who are focussed on their kids' education in poorer areas. This pushes parents who would otherwise have been easy-going to join in the same game, which re-enforces the pattern. There are plenty of crazy people with a burning, status-seeking ambition to have their child go to medschool (regardless of the wishes of the child). They would absolutely move their address to a catchment for easy access to med school. In the list of the crazy things these crazy people do, this would be among the least surprising. Regarding schools - there's a policy that would kill this and lead to better schools, called vouchers. In this case, parents apply to schools (anywhere) and the schools choose who they take. But it's very difficult to introduce this when you have a large, highly educated segment of your voting population who are struggling with a huge mortgage that they took on to secure their children access to a certain school catchment. As they see it - they've paid for something, and now the evil government is stealing that from them and leaving their children to compete on an even footing with the children of parents who haven't made the same sacrifices. "Outrageous!" Teachers unions also come out hard against vouchers, because it makes the sector more competitive, and that leads to bad teachers getting fired, and wage discrepancy, which undermines the union interest of bringing the sector towards collectivised bargaining. There's social-engineering arguments that say it's better for people use facilities near them to reduce load on transportation or the like. This is petty rubbish, and also often wrong (mass transit gets more efficient and nicer to use with scale, and that leads to less cars), but it gets trotted out in vouchers debate. Public universities tend to operate on a voucher arrangement at the moment. Their example is a tangible example that vouchers is good policy, and that is very valuable in the campaign to bring good policy to public schools.
  - yardie 13y ago
    > Teachers unions also come out hard against vouchers, because it makes the sector more competitive No they are against them because the money for vouchers comes out of the public school budget. In poor areas this can be quite devastating. Unlike the Harlem Children's Zone, most school districts don't have a rich, billionaire uncle giving them millions of dollars each school year. Teacher's also recognize that charter schools have one ability they do not, unload disruptive and under-performing students before test time. > Public universities tend to operate on a voucher arrangement at the moment. Their example is a tangible example that vouchers is good policy, and that is very valuable in the campaign to bring good policy to public schools. Please explain? I've gone to public universities and don't remember vouchers at any point. You were accepted on merit. Tuition was paid based on merit and need. But, unlike public schools, they were free to kick you out at any point.
    - cturner 13y ago
      From some of your criticism, I think you're arguing against a particular attempt to introduce vouchers (one that I'm unfamiliar with) rather than the policy of vouchers. No they are against them because the money for vouchers comes out of the public school budget Maybe they did in a particular campaign. But the public school budget is not a fixed amount of money, and there's no reason that a drive to vouchers couldn't be accompanied by a net increase in money to schools. Your argument is not against vouchers. Teacher's also recognize that charter schools have one ability they do not, unload disruptive and under-performing students before test time. You don't need to have both models. All schools could be voucher schools. Eventually the better ones will chase the others out of business. For disabled students, have a special voucher load for them and let schools specialise. Please explain? I've gone to public universities and don't remember vouchers at any point. It changes from region to region. But in general, there is an applications process where potential students indicate an intention to enter a university. The university has a certain number of spaces available, and tries to fill them. If students don't meet a standard, or it has more demand than there are places, it rejects people. It gets funding based on how many students it gets in. That's a voucher model: student choice + school choice + per-unit funding. From memory, in Swizerland, it's more pronounced. I think students say where they want to go, and the university has to accept them and find a way to make it work. But they get commensurate funding for it. If this is correct, this is quite remarkable. If you live in Switzerland and want to go to the most prestigious university, you just say so and you're there. They're not obliged to give you passing marks once you're there. It takes all the snobbery out of things!
sachingulaya 13y ago
To the person below me--admissions are based on geography. One way they do it is with ridiculous out-of-state fees. When I was thinking about transferring to NEOUCOM in Ohio the tuition was $110k/yr for out of state for the 3rd year...compared to 40k/yr in state. However, thats only one aspect of it. See: https://www.amherst.edu/campuslife/careers/students/gradstudy/health/guide/part2/appendix https://www.amherst.edu/campuslife/careers/students/gradstud...
wildgift 13y ago
I think it's that, but there's some subtlety to it. A minority person seems to be more likely to open a clinic to serve low-income people, perhaps as a side job to doing surgeries. There's also the trust issue between patients and doctors, so having someone who understands a community's needs might achieve better outcomes.
LanceH 13y ago
Another interpretation is that it appeases politicians.

one justification I've heard is that doctor like to serve communities they came from. thus, affirmative action ensures minorities have access to doctors.

by kmax12 13y ago

one justification I've heard is that doctor like to serve communities they came from. thus, affirmative action ensures minorities have access to doctors.

eurleif 13y ago

Why not make admissions based on geography, then?

SoftwareMaven 13y ago
Serving the community is a different thing than serving in a community. "The" community tends to be "people like the people I've grown up with and lived around most of my life." I can find a community almost anywhere I live. In other words, a Hispanic doctor from LA might find a comfortable life in Miami serving the Hispanics there[1], whereas he may be completely uncomfortable serving a largely white, affluent neighborhood in the LA basin. 1. I have no idea if this is true or not; I'm just laying out the hypothetical of my GP.
saraid216 13y ago
By "geography" do you mean separate urban neighborhoods as well as large rural tracts? Not everyone goes home after they graduate.
cturner 13y ago
It's easy to game this, and there's overwhelming evidence that this already happens in related fields. In countries with state schools with geographic catchment (i.e. most of most English speaking countries), the housing market becomes a proxy for education choice. This entrenches class concentration. You end up with entire geographic regions that are exclusive, and others that are outcast. People who want their kids to be able to be at a certain school value catchment housing higher than others would. As a result, there's a slide of people who care about their kids' education towards certain regions. By consequence, there's a drain of people who are focussed on their kids' education in poorer areas. This pushes parents who would otherwise have been easy-going to join in the same game, which re-enforces the pattern. There are plenty of crazy people with a burning, status-seeking ambition to have their child go to medschool (regardless of the wishes of the child). They would absolutely move their address to a catchment for easy access to med school. In the list of the crazy things these crazy people do, this would be among the least surprising. Regarding schools - there's a policy that would kill this and lead to better schools, called vouchers. In this case, parents apply to schools (anywhere) and the schools choose who they take. But it's very difficult to introduce this when you have a large, highly educated segment of your voting population who are struggling with a huge mortgage that they took on to secure their children access to a certain school catchment. As they see it - they've paid for something, and now the evil government is stealing that from them and leaving their children to compete on an even footing with the children of parents who haven't made the same sacrifices. "Outrageous!" Teachers unions also come out hard against vouchers, because it makes the sector more competitive, and that leads to bad teachers getting fired, and wage discrepancy, which undermines the union interest of bringing the sector towards collectivised bargaining. There's social-engineering arguments that say it's better for people use facilities near them to reduce load on transportation or the like. This is petty rubbish, and also often wrong (mass transit gets more efficient and nicer to use with scale, and that leads to less cars), but it gets trotted out in vouchers debate. Public universities tend to operate on a voucher arrangement at the moment. Their example is a tangible example that vouchers is good policy, and that is very valuable in the campaign to bring good policy to public schools.
- yardie 13y ago
  > Teachers unions also come out hard against vouchers, because it makes the sector more competitive No they are against them because the money for vouchers comes out of the public school budget. In poor areas this can be quite devastating. Unlike the Harlem Children's Zone, most school districts don't have a rich, billionaire uncle giving them millions of dollars each school year. Teacher's also recognize that charter schools have one ability they do not, unload disruptive and under-performing students before test time. > Public universities tend to operate on a voucher arrangement at the moment. Their example is a tangible example that vouchers is good policy, and that is very valuable in the campaign to bring good policy to public schools. Please explain? I've gone to public universities and don't remember vouchers at any point. You were accepted on merit. Tuition was paid based on merit and need. But, unlike public schools, they were free to kick you out at any point.
  - cturner 13y ago
    From some of your criticism, I think you're arguing against a particular attempt to introduce vouchers (one that I'm unfamiliar with) rather than the policy of vouchers. No they are against them because the money for vouchers comes out of the public school budget Maybe they did in a particular campaign. But the public school budget is not a fixed amount of money, and there's no reason that a drive to vouchers couldn't be accompanied by a net increase in money to schools. Your argument is not against vouchers. Teacher's also recognize that charter schools have one ability they do not, unload disruptive and under-performing students before test time. You don't need to have both models. All schools could be voucher schools. Eventually the better ones will chase the others out of business. For disabled students, have a special voucher load for them and let schools specialise. Please explain? I've gone to public universities and don't remember vouchers at any point. It changes from region to region. But in general, there is an applications process where potential students indicate an intention to enter a university. The university has a certain number of spaces available, and tries to fill them. If students don't meet a standard, or it has more demand than there are places, it rejects people. It gets funding based on how many students it gets in. That's a voucher model: student choice + school choice + per-unit funding. From memory, in Swizerland, it's more pronounced. I think students say where they want to go, and the university has to accept them and find a way to make it work. But they get commensurate funding for it. If this is correct, this is quite remarkable. If you live in Switzerland and want to go to the most prestigious university, you just say so and you're there. They're not obliged to give you passing marks once you're there. It takes all the snobbery out of things!

sachingulaya 13y ago

To the person below me--admissions are based on geography. One way they do it is with ridiculous out-of-state fees. When I was thinking about transferring to NEOUCOM in Ohio the tuition was $110k/yr for out of state for the 3rd year...compared to 40k/yr in state. However, thats only one aspect of it. See: https://www.amherst.edu/campuslife/careers/students/gradstudy/health/guide/part2/appendix https://www.amherst.edu/campuslife/careers/students/gradstud...

wildgift 13y ago

I think it's that, but there's some subtlety to it. A minority person seems to be more likely to open a clinic to serve low-income people, perhaps as a side job to doing surgeries. There's also the trust issue between patients and doctors, so having someone who understands a community's needs might achieve better outcomes.

LanceH 13y ago

Another interpretation is that it appeases politicians.