Product Description

From one of America's most outspoken social critics, a searing account of how the wholesale intrusion of political correctness into medicine is creating a toxic healthcare system.

Drawing on a wealth of information PC, M.D. documents for the first time what happens when the tenets of political correctness--including victimology, multiculturalism, rejection of fixed truths and individual autonomy--are allowed to enter the fortress of medicine.

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Product Details

• Amazon Sales Rank: #918831 in Books
• Published on: 2002-01
• Released on: 2002-01-08
• Original language: English
• Number of items: 1
• Binding: Paperback
• 304 pages

Amazon.com Review
The shenanigans of political correctness have been well documented. But most people, even those who keep up with these debates, probably assume they're confined to the liberal arts, rather than the hard sciences. Think again. As Sally Satel shows in PC, M.D., political correctness has also infected the world of medicine and public health--with results that may actually threaten everybody's well-being. Satel begins her well-told exposé by describing the presumption of some health professionals that because the sickest people in society are also disproportionately the poorest, the practice of medicine must address matters of social justice. "Many public health experts see their mission literally as attacking the conditions that lead to poverty and alienation in the first place," writes Satel, a practicing psychiatrist who also lectures at the Yale University School of Medicine. Unfortunately, this has led to the diversion of resources away from what the medical profession does best--the treatment and prevention of injury and disease. "Worse, putting social justice at the core of the public health enterprise undermines individual accountability. People who practice unsafe sex, stick dirty needles in their vein or fail to take their TB medications daily are too often seen as passive victims of malign social forces," writes Satel.

She argues that radical feminism and race-obsessed multiculturalism have no place in the world of medicine. When they have actually secured a place, Satel shows the harm they've done. She describes, for instance, how the Harvard School of Public Health teaches that racial discrimination causes hypertension among African Americans--in short, racism makes you sick. Yet there's no credible evidence to back this startling claim, which may in fact divert attention away from behavioral steps that really can lower blood pressure. Satel has a wonderfully clever term for the people advancing this type of lab-jacket hokum: "indoctrinologist." Theirs is a political vocation, not a medical one. Satel is adept at countering their offensive, but her voice is a lonely one:

Indoctrinologists are making steady inroads in medicine. They now sit at the helm of professional associations and hold impressive posts in schools of public health. They have changed medical school admissions criteria and have infiltrated respected academic journals. They are outspoken, if not shrill, participants in many legislative and political debates.... Their numbers and influence are growing.

That's the bad news. The good news is that Satel has written an outstanding book that exposes their agenda. --John J. Miller

From Publishers Weekly
Yale psychiatrist Satel takes a hard, clinical look at how political correctness has infiltrated the world of medicine and finds that instead of providing the best care available, "injecting social justice into the mission of medicine diverts attention and resources from the effort to find ways of making everyone, regardless of race or sex, better off." By no means does she "defend the status quo," claims SatelAshe recognizes that the history of American medicine is not untarnished (e.g., the shameful 1932-1972 Tuskegee syphilis study). But she believes that though there may be problemsA"one of the most pressing [being] how to deliver health care to everyone affordably"Asexism and racism are not the ugly, systemic issues that the "indoctrinologists" claim them to be. (These indoctrinologists, she says, are found in the academy, whose researchers may produce "second-rate clinical studies"; at the medical journals that publish those studies; in the media, which blows the studies out of proportion; and among politicians who use them as campaign material.) Writing confidently, incisively and even-handedly, Satel aims to debunk many prominent medical studies that have been used to demonstrate that people who suffer from psychoses have been abused by the psychiatric establishment, that American women's health has long been ignored and that promoting the idea of individual responsibility among the disadvantaged (encouraging the poor to take advantage of free health care or people at risk for AIDS to practice safe sex and use clean needles) is prejudicial. General readers will be surprised to find many of their long-held beliefs about American health care turned inside out, but Satel provides cogent arguments that deserve the careful consideration of anyone who believes that better, more affordable health care is obtainable and that politically correct reform is not the way to achieve it.
Copyright 2000 Reed Business Information, Inc.

From The New England Journal of Medicine
In PC, M.D., Satel deplores the "political correctness" (the PC of her title) advocated by some physicians, academics in the fields of nursing and public health, psychologists, social workers, and health lawyers. She defines political correctness as the assumption that the health problems of the poor, members of minority groups, women, and persons with mental illness are mainly a result of their oppression by dominant groups in society. "Indoctrinologists" for political correctness in the health professions have what the author calls a "social empowerment agenda" that "will divert resources from strategies that really work" and is already "making some people sick, or sicker than they need to be."

Satel devotes a chapter to each of seven examples of the effects of this social empowerment agenda. These examples are urging by an "academic elite" that the theory and practice of public health "encompass the quest for social justice"; the participation of former psychiatric patients ("consumer-survivors" of a "medical model" of care) in the delivery of mental health services; the preoccupation of some academic nurses with "fad therapies" and its contribution to the "dumbing down of nursing education"; false claims by leaders of the "modern women's health movement" that women are "not getting sufficient attention from medical research"; a misguided "lawyer-mounted campaign" for the "freedom" of "crack" cocaine-addicted women in South Carolina to use cocaine during pregnancy; simplistic analysis by officials of federal agencies and professional associations of the causes of disparities in access to care and health status between members of minority groups and whites of European descent; and the "strange new world" of "psychotherapy for victims," especially victims of actual or imagined abuse and discrimination.

This book will be controversial. Satel's arguments and rhetoric blend analysis and anger. She can report engagingly on what she has witnessed and read. But she also dispenses harsh and inadequately documented opinions about issues and individual persons. Satel is sympathetic to many of the issues that she accuses "indoctrinologists" of taking to extremes. Thus, she acknowledges that health status has multiple determinants, that members of minority groups have historically had less access to health care and worse health status than other Americans, and that many persons with mental illness and addiction to narcotic drugs have not retained their civil rights. Her complaint is that political-correctness extremists support policies on the basis of ideology rather than evidence. Their strident advocacy increases the difficulty of gaining support for interventions that are both more moderate and more effective.

Satel exaggerates the influence of these advocates. She elevates the status of "PC medicine" by calling it the "fourth era" of American public health, following the "sanitation, biological and lifestyle eras." PC medicine is, however, an insurgency rather than the defining theme of an era. For example, the academics in the field of public health who embrace the extreme version of the "social production of health" that dismays Satel have had little discernible influence on public health practitioners. Similarly, nurses who embrace New Age rhetoric and alternative therapies embarrass many nursing leaders.

Satel overstates her criticism of politically correct professionals in her own field of mental health. Health care providers, managed-care organizations, and public officials in each state make most policy for the care of patients with mental illness; "consumer-survivors" and their sympathizers have a limited role. The courts and the media are increasingly skeptical of persons who, during therapy, recover memories of sexual and physical abuse.

Moreover, Satel is too often an unreliable guide to the issues she discusses. Sometimes she oversimplifies complicated matters. For instance, she claims that public health is a "clinical enterprise" and ignores its other core functions. Similarly, her discussions of harm reduction as an approach to treating substance abusers and of community mental health fail to take into account the history and complexity of these concepts.

She also makes dubious accusations. For example, Satel associates Harvey V. Fineberg and William H. Foege with the extremists among public health advocates because they have expressed opinions that she supports elsewhere in the book. Similarly, she assigns the National Institute of Drug Abuse sole responsibility for defining addiction as a "chronic and relapsing brain disease" and reduces the distinguished history of the Bazelon Center for Mental Health Law to the inaccurate epithet "consumer-survivor advocacy group."

In addition, Satel omits pertinent information that would weaken her case. Describing the success of politically correct nursing in the United Kingdom, for example, she claims that "by 1995 all the traditional nursing schools had closed," that the new schools diverted students' attention to social science and "race and gender awareness," and that "patient care suffered" as a result. She neglects to add, however, that nursing education in Britain, which had been vocational since the 19th century, has recently been integrated into higher education, and that the effect on care of offering degrees in nursing is a controversial issue.

Finally, Satel invents data. For instance, "California has approved legislation requiring their public medical schools to increase the number of training slots for primary care physicians and decrease slots for specialists." Not so: in 1993 and 1994, the California legislature twice passed and Governor Pete Wilson twice vetoed bills to achieve this purpose.

Participants in the health sector have been debating for years the issues that Satel addresses. This book, like Satel's newspaper op-ed articles on similar themes, could make more people aware of these debates. If that happens, it will be regrettable that her publisher did not conduct a rigorous review of the manuscript.

Daniel M. Fox, Ph.D.
Copyright © 2001 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.

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Customer Reviews

Revealing The Truth
The author of this book has done a very excellent job in revealing how the almost cult like mentalities of political correctness, alternative medicine, and paranormal healing have crept into mainstream medicine. She uses logic and a mountain of research data to support her claim that the patient's best interest and scientific research are beginning to take second priority to political correctness and what some would call quackery.

Although the message is disturbing, I actually found reading this book to be very enjoyable. Where else will you find illogical and deceptive assertions made by politically correct advocates actually challenged? For example, a feminist group claims that only 14 percent of NIH (federal) research funds go to women's health issues. And it turns out that this is actually true. But, as the author discovers, you are not told that less than 7 percent goes to research on male diseases and the rest goes to research on diseases that are not gender specific. The book is full of examples like this, where claims made by the so-called experts don't hold up under further scrutiny.

I strongly recommend this book because it discusses controversial issues that truly are a matter of life and death. Cures for diseases such as Alzheimer's and Diabetes will almost certainly be delayed, at best, because of political correctness and other problems mentioned in this book. On the other hand, its hard to read this book and not take some comfort in knowing that there are still many people in the medical profession like Dr. Sally Satel who have the intelligence and courage to stand up for the truth!

What every doctor wanted to say
Satel has done an outstanding job on this book. I found that as I read it, I had a strong urge to jump up and yell, 'right on!' As a professor at a medical school, I wish that all of my fellow faculty would read this. There are some extreme examples in this book but I don't doubt that they are real. This book exposes what many of us have felt but lacked the words and clear thoughts to express.

Medicine in the modern sense is about empirical proof. Some crackpot ideas have panned out as great ideas. Others are not withstanding the test of reality. An idea must be tested and Satel holds some ideas up and examines them with scientific curiosity. Too many of the ideas advanced as modern or post modern therapies are lacking evidence to support their acceptance.

This is a must read for all of us in academic medicine and public health. Satel's critical thoughts need to be reviewed and discussed. I believe that she has brought together some really important ideas.

thought-provoking and disturbing view of modern medicine
Having learned about this book in Objectivist Newsletter, I rushed to buy it and swallowed it all in one day. The assault on rationalism and objectivity is, sadly, a long-standing problem of modern intellectuals, but I was sincerely hoping that this self-defeating irrational approach would be limited to liberal arts. I was wrong. As Dr. Satel very convicingly shows, the field of medicine is not by any means immune to this assault. The problem is, this time we are talking about human lives and well-being at stake. Giving up objectivity and critical thinking of modern science to sentiments like "I don't care how it works or what the studies show, I FEEL it works" is a sure prescription for disaster. Even though I do not share author's pessimism upon the matter, I do think this book is a serious wake-up call for doctors and patients alike.