Multiculturalism

[KSaiyu]

I'll reply later, but basically there's a misunderstanding going on. Multiculturalism is good for medicine, but as it is here (UK) can be disastrous. This is due to the less stringent rules on who can practice, and the communication barriers. I didn't mention that the consultant was actually Indian too, but trained here - like I said multiculturalism is the future but we aren't heading the right way. I will expand but I wanted to clear that up before anyone gets the wrong impression.

 

[Scaff]

Can you please (as I'm starting to lose track of the number of times its been brought up) stop taking specific examples (that in all honesty we only have your anecdote as evidence for) and presenting it as the norm across the entirety of the UK.

 

[KSaiyu]

Same here. Average Primary Care pay is $221k. Even converting pounds to dollars, it still doesn't compare.

http://www.forbes.com/sites/bruceja...o-221k-for-primary-care-396k-for-specialists/

You will be hard pressed to find an average GP wage for British doctors because of the reluctance to divulge that information. In fact the government is currently in the process of forcing practices to release the information.

You didn't explain how the immigration system and your medical community interact, you just said it is a joke. How so? I can't compare it to our J1 Visa system (a non-issue for naturalized immigrants) if I don't know how it works.

This is because of our lax attitude to practicing HCPs (Healthcare Professionals). We assume that all medical degrees are equal, and don't really examine doctors before they are let loose on the wards/GP surgeries. We keep it like that because we know that our healthcare system is FUBAR and has to rely on substandard workers to plug the gaps. This is why you will see a lot of sub par FMGs in failing/average hospitals - domestically trained professionals stay clear of those posts.

Not understanding how multiculturalism in medicine is bad if America is doing it right. I'm alive today because of doctors from India, Eastern Europe, Peru, Brazil, and Asia. One is even British. Some of my doctor's names: Elbtl, Subchyk, Aboud, Kim, Prabhu.

Simple, you put patient safety, or rather the costs of litigation in cases of malpractice ahead of the 'we are all equal' mantra.

While, I have to agree that this is a bad way to handle things and reduce notes, particularly as amiodarone can have some severe side effects (I take it and metoprolol) and it should not just be lumped in as an either or drug. This case should have been referred to the electrophysiologist. I assume the patient already was seeing one, as they have a pacemaker.

Yes the patient will have one of the best teams working with him as it is a London teaching hospital, but you know what they say about being as strong as the weakest link. Incidentally when the consultant read the Regs report she was confused which is exactly the reason why you relay information to the rest of the team.

However, I don't see how this has to do with multiculturalism. A bad doctor is a bad doctor, no matter who they are.

It's not. I'm saying it's to do with the absurd notion that all cultures and therefore all medical schools/doctors are equal. They aren't.

I was left paralyzed by a white American male. That's not evidence that white American males are bad doctors and having them be a large portion of our doctors is a bad thing. It just means that this one, very specific doctor will never touch me again. I have had trust and competency issues with doctors of all colors, ethnicity, and sex. The aforementioned British doctor (a white female) is one that I have come close to requesting I no longer be seen by because she lets the fellows do all the doctoring and then she makes her diagnosis based on their notes. She has literally walked in five minutes after I saw the fellow, stood and talked to me, suggested a medicine change, and never once picked up her stethoscope or touched me

I have an intolerance for incompetence, nothing else. That neurologist I mentioned in another post was White British. The Consultant I complained to my matron about was White British.

Basically, I don't see how being a Foreign Medical Graduate played a role in this person being a bad doctor. Nothing is connecting the two

At the age he is and the training stage he is at I'd be prepared to say any graduate from a British medical school would have handled that day better.

If you are trying to say you have bad doctors coming in to replace the good doctors who are heading out, this is the case anywhere that a potential health workforce shortage exists. You don't have enough doctors (for any reason) and you take whatever you can get, so long as they pass the minimum requirements. Here in Kentucky a national program offers to pay off student loans for doctors willing to relocate to rural areas. Of course, this draws in more doctors who are unable to compete in a large city. So, the rural areas where these doctors go are often left with a choice between no doctor and a subpar doctor. But our subpar doctors are as equally likely to be natural-born as they are to be foreign-born. In fact, if the foreign-born doctor is not a naturalized citizen and is just working on a J1 Visa Waiver (a work visa beyond the allotted amount, waived of the limitations due to need) the doctors are likely to be better because their status can be lost and it only takes one prejudiced person to file complaints that will get them investigated. They have to be impeccable to avoid problems

This is what I want! This is what Australia has to attract doctors to rural areas!!
Medical professionals KNOW this is how it should be but we have weak leaders in government.

Can you please (as I'm starting to lose track of the number of times its been brought up) stop taking specific examples (that in all honesty we only have your anecdote as evidence for) and presenting it as the norm across the entirety of the UK.

All due respect I think I've earned the right to speak about the NHS's problems. If I haven't perhaps you will listen to an ex-surgeon's thoughts. I hear he moonlights as a teacher at a pretty good medical school

 

[FoolKiller]

@KSaiyu I had a longer response typed out but it got lost due to some weird error when my work computer logged me out. Usually I just log back in and it goes on as normal, but this time it didn't.

I will just paraphrase it.


Health workforce shortages are a very wide spread problem. First you place all your bad doctors and then you bring in other doctors. Some of them will be good and some will be bad. Half of all doctors were at the bottom half of their graduating class. Here we are even allowing nurses and pharmacists practice a form of primary care. If you want to talk about a mindset that thinks all medical degrees are alike, there you go.

All multiculturalism has done is put a more diverse face on all doctors, good or bad.

 

[Scaff]

All due respect I think I've earned the right to speak about the NHS's problems. If I haven't perhaps you will listen to an ex-surgeon's thoughts. I hear he moonlights as a teacher at a pretty good medical school

At what point did I say you don't have the right to speak about the NHS's problems?

I didn't, so don't infer that I did. That however doesn't mean that you can take your specific examples and turn them into country wide norms. Its potentially mislead and you have been asked to stop doing so, yet it would seem that those polite requests have been ignored.

As such from this point on you will supply specific, independently verifiable sources to back up your claims.

 

[KSaiyu]

I can't comply with that. I put patient safety above everything else and I'm gagged enough by my Trust. If I'm going to be banned then so be it, but I'm exposing the NHS for anyone interested.

Foolkiller that is similar to what we are doing - other professionals are taking on more medically geared roles. Have to disagree on the good and bad doctors always existed to this degree as a bad doctor from some of the
Countries we employ from wouldn't have been accepted onto our foundation program if they trained here. It is as simple as that. Basically what we need is a similar system to your "Board" exams.

 

[Scaff]

I can't comply with that. I put patient safety above everything else and I'm gagged enough by my Trust. If I'm going to be banned then so be it, but I'm exposing the NHS for anyone interested.

The AUP is not optional, nor is it selective.

You have been asked repeatedly to stop making claims that you are unable to substantiate, the site can not and will not give you a pass on that and then expect others to follow the AUP, as such you last post is going to be edited and should you continue in this manner then the penalties for breaking the AUP will be put into place.

If you want to post unsubstantiated claims to an on-line audience then start a blog, but GTP is not the place to do that and given that without substantiation no one is able to verify how accurate or even if your claims are even real.

Your future as a member of the site is entirely in your hands.

 

[KSaiyu]

If anyone's interested in the English NHS PM me for my email until I get a blog. 👍

 

[FoolKiller]

Foolkiller that is similar to what we are doing - other professionals are taking on more medically geared roles. Have to disagree on the good and bad doctors always existed to this degree as a bad doctor from some of the Countries we employ from wouldn't have been accepted onto our foundation program if they trained here. It is as simple as that. Basically what we need is a similar system to your "Board" exams.

I can't speak to NHS. I'm not sure how it works. I also can't say outside of Kentucky how the good/bad ratio plays out.

There are two things that I have experienced in a lifetime of seeing multiple doctors:

1) As a child my parents were always questioning, getting second opinions, and being a general pain for doctors. It was life or death and they wouldn't accept poor service or risk malpractice.

2) My parents and grandparents for themselves have a very stubborn, "I do what the doctor says" mentality, even with a pharmacist in the family telling them the medicine they were prescribed is not recommended for their issue or could interact with their other medicines.

In my world, doctors have always been fallible. To those who are generally healthy they go years without getting exposure to doctors in a way that can reveal a problem. I'm not so sure that your experience of things becoming worse isn't more directly linked to the fact that you are closer to the situation now.

I know that I for one did not know the shortage issues we faced until my job got me involved. I lived in a big city. We had plenty of quality doctors to choose from.


As I understand things under the NHS (correct me if I am wrong), you are assigned a GP. That is who you see and you have to make a request to see a different one. If this is true that could make all the difference. Here we get to go to any doctor we want. I can travel across the country to find a GP I like and take a flight every time I visit them. Choice creates competition, which creates better service overall. The only issue is that a workforce shortage puts people unable to travel in a situation where they are stuck with whatever is in their small town, but that is not an issue a more government involved system can fix.

 

[Scaff]

As I understand things under the NHS (correct me if I am wrong), you are assigned a GP. That is who you see and you have to make a request to see a different one. If this is true that could make all the difference. Here we get to go to any doctor we want. I can travel across the country to find a GP I like and take a flight every time I visit them. Choice creates competition, which creates better service overall. The only issue is that a workforce shortage puts people unable to travel in a situation where they are stuck with whatever is in their small town, but that is not an issue a more government involved system can fix.

With the NHS you register with a surgery and have access to the GPs who work for that surgery, don't agree with what one says and you can ask another (I have done in the past).

You do of course also have the option of going private (and many doctors outside of GP work both privately and for the NHS), in which case you can see anyone you (or your medical insurance) can afford.

 

[KSaiyu]

As I understand things under the NHS (correct me if I am wrong), you are assigned a GP. That is who you see and you have to make a request to see a different one. If this is true that could make all the difference. Here we get to go to any doctor we want. I can travel across the country to find a GP I like and take a flight every time I visit them. Choice creates competition, which creates better service overall. The only issue is that a workforce shortage puts people unable to travel in a situation where they are stuck with whatever is in their small town, but that is not an issue a more government involved system can fix.

Close. You can see the doctors within that surgery but frequently their clinics book up before you are able to make another appointment and the really good ones end up spending less time having clinics and more time running the surgery/dealing with the NHS. This leads to the unsightly queues that can go around the block during winter months. As a result the bulk of clinic times can be spent staffed by locums or FMGs. I can give anecdotal experience of talking with a partner in a busy practice who chose to relocate and a private psychiatrist who spent years working in the NHS but well....yeah.

Long story short if you want good primary care either pray you get a good GP who's free (extremely rare where I live) or get medical insurance.

Primary care shortages aren't restricted to our country, but none as far as I'm aware so acutely and so drastically. I also wonder if other countries can maintain standards why can't we?

EDIT: Oh, and re: the approach to multiculturalism with regards to students a Professor at ICSM (Imperial, one of the top medical schools in the world) said that one of the worst things in the admissions process is that tick box for ethnicity/religion. No I didn't tape record it, but I will say lying about such things is a violation of my ethical obligations and as such could prevent me applying for a GMC licence so make of it what you will.

 

[Carbonox]

http://www.thelocal.de/20150626/refugee-school-calls-for-uniform-modesty

Nice job, Germany. Visiting cultures are obviously more important than your own.

 

[KSaiyu]

http://www.thelocal.de/20150626/refugee-school-calls-for-uniform-modesty

Nice job, Germany. Visiting cultures are obviously more important than your own.

Oh you didn't realise? We're not allowed to voice an opinion when working in the education sector anymore.

Please ignore us as we cover up child grooming outside our school gates in case it influences upcoming elections.

 

[Dotini]

It's funny that we decry pedophilia on the one hand, and on the other we allow, even encourage, high school girls bare upper thighs and upper breasts in addition to heavy makeup.

 

[KSaiyu]

Kind of like the double standards we show to victims of sexual assault by a teacher depending on their gender

 

[Dotini]

That's funny, but there have been numerous female teachers arrested, fired and/or jailed in my community for sex with male students.

 

[Imari]

It's funny that we decry pedophilia on the one hand, and on the other we allow, even encourage, high school girls bare upper thighs and upper breasts in addition to heavy makeup.

Only if you think that men are so rabid that they can't restrain themselves in the presence of bare flesh.

I don't see that there's any paradox in thinking that pedophilia is bad, yet allowing people of all ages to dress how they want. Dressing up in nice clothes is not an invitation to be raped. I mean, are women who attend nudist camps continually fending off anyone with a penis or what?

My own opinion is that having skin out there is fine. The only reason a man with a bare chest and a women with a bare chest is different is because people aren't used to it.

 

[Dotini]

Children as young as 9 are capable of the sex act. I suppose some cultures treat this differently.

 

[niky]

Many do. But we are supposedly enlightened enough to understand that nine-year olds cannot raise children properly (definitions vary on what properly means) given the demands of our modern society. Which is why we criminalize sex with nine-year olds.

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What an incredibly over-the-top reaction to that Facebook post. Of course, if I hated Muslim headscarves so much, I would certainly not be teaching in a school whose students are primarily Muslim. Buggers the mind, really, when there are quite a few schools the staff member could go to where the niqab is banned.

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Then again, not all Muslims really care for the niqab, and many are even opposed to making it compulsory uniform for girls at Muslmi schools. Stating you don't like the niqab on Facebook, thus, isn't truly racist (errh... religionist?), but then, posting pictures of Muslim women and saying the picture is offensive doesn't come across as a specific criticism of the practice itself...

Still: Stupid all around.

 

[Dotini]

Is morality relative, or is morality absolute?

 

[Carbonox]

Many do. But we are supposedly enlightened enough to understand that nine-year olds cannot raise children properly (definitions vary on what properly means) given the demands of our modern society. Which is why we criminalize sex with nine-year olds.

Pretty sure it has more to do with consent.

 

[prisonermonkeys]

Pretty sure it has more to do with consent.

It's called capacity - since everyone develops at the same rate, the law takes this development onto account. Capacity refers to your ability to make decisions based on an understanding of the consequences. Alcohol affects your brain, causing short-term changes in judgement and behaviour, and so the law needs to recognise that a person must appreciate that there are consequences to their actions when drinking. Likewise, smoking has been demonstrated to cause lethal health complications, which a person must accept before they light up. And so in the same way, anybody who is engaging in sexual activity must have the ability to recognise the consequences of their action. The law recognises that nine year-olds cannot consent to sex because they don't have the capacity to address it. Developmentally, they're not at the point where they can handle it.

 

[LeMansAid]

Many do. But we are supposedly enlightened enough to understand that nine-year olds cannot raise children properly (definitions vary on what properly means) given the demands of our modern society. Which is why we criminalize sex with nine-year olds.

You make it sound like if your Mum was willing to go guarantor, you'd be perfectly fine as a nine year old to get jiggy and get preggy.

http://www.thelocal.de/20150626/refugee-school-calls-for-uniform-modesty

Nice job, Germany. Visiting cultures are obviously more important than your own.

From the article....

These boys, who come from a culture where for women it is frowned upon to show naked skin, follow girls and bother them without realizing.

He makes that sound like they kind of "accidentally" happen to "bother" them. I'll leave "bother" to the imagination.

Reminds of this nasty piece of work.... http://www.theguardian.com/world/2006/oct/26/australia.marktran

A senior Muslim cleric in Australia has sparked a furore by comparing women who do not wear a headscarf to "uncovered meat", implying that they invited sexual assault.

Sheik Hilali was quoted as saying: "If you take out uncovered meat and place it outside ... without cover, and the cats come to eat it ... whose fault is it, the cats' or the uncovered meat's? The uncovered meat is the problem. If she was in her room, in her home, in her hijab [the headdress worn by some Muslim women], no problem would have occurred."

A disgusting man.

 

[BobK]

everyone develops at the same rate

That is utter bollocks.

 

[prisonermonkeys]

That is utter bollocks.

You should know perfectly well that the law cannot be written to take into account the individual variages in development and therefore must be applied as a generalisation - just as I should not be spelling this out for you in crayon. This is what happens when you jump the gun for the sake of getting in a cheap shot.

So either show me the nine year-old who has the same capacity as an eighteen year-old and a way for the law to recognise this on an individual level, or keep your utter bollocks to yourself.

 

[LeMansAid]

You should know perfectly well that the law cannot be written to take into account the individual variages in development and therefore must be applied as a generalisation - just as I should not be spelling this out for you in crayon. This is what happens when you jump the gun for the sake of getting in a cheap shot.

So either show me the nine year-old who has the same capacity as an eighteen year-old and a way for the law to recognise this on an individual level, or keep your utter bollocks to yourself.

The law isn't "written to take into account..... " but that has nothing to do with a claim that "everyone develops at the same rate". I think you would have done better to concede than go all angsty on @BobK. He even went to the trouble of using a British-ism for goodness sake.

I'm also not so sure that the law cannot be written to cater for individuals (a maturity test is not so far fetched), it's more that it's not really practical.

 

[BobK]

You should know perfectly well that the law cannot be written to take into account the individual variages in development

You said:

everyone develops at the same rate

but you now concede that people do develop at different rates, or "individual vagarities in development". Your two statements are contradictory.

I should not be spelling this out for you in crayon. This is what happens when you jump the gun for the sake of getting in a cheap shot.

And of course upon being challenged you immediately launch an ad hominem attack.

So either show me the nine year-old who has the same capacity as an eighteen year-old

...and you move the goalposts. all that would be needed to show is any two children developing at different rates. Why the bizarre requirement for them to be aged nine and eighteen? Why not fourteen and fifteen?

and a way for the law to recognise this on an individual level

AND a way for the law to recognize this on an individual level? Why that requirement? I'm merely questioning your assertion that everyone develops at the same rate, and I am supposed to supply some sort of legal justification?

keep your utter bollocks to yourself.

Brilliant repartee there.

12-Year-Old Youngest Student of Calif. College
14 Year Old Girl Set to Graduate from College

Well, actually:
List of child prodigies

I'm shocked that someone who purports to be an educator of children is unaware of any of this.

 

[novcze]

http://www.thelocal.de/20150626/refugee-school-calls-for-uniform-modesty

Nice job, Germany. Visiting cultures are obviously more important than your own.

this is really sad ... instead of educating the refugees about how to behave in free society, we just make another concession.

 

[prisonermonkeys]

I'm shocked that someone who purports to be an educator of children is unaware of any of this.

Oh, I am quite aware of the phenomena - but I am also aware that a) they represent statistical outliers and b) the ability of a child to graduate from high school or university ahead of other students their own age does not imply that they have a higher level of maturity, merely a higher level of intelligence.

You have also chosen to ignore the context of my original comments - namely whether or not a nine year-old can comprehend certain situations. My comments took this concept and put it in a legal context. You have completely neglected this, and the minute I attempt to redirect you to this by pointing out that the law can only deal in generalisations, you accuse me of "moving the goalposts" and then come up with this:

I'm merely questioning your assertion that everyone develops at the same rate, and I am supposed to supply some sort of legal justification?

The short answer is that yes, you are supposed to give a legal justification, given that the discussion is about what the law recognises what a person can or cannot do based on their developmental phase.

 

[niky]

Pretty sure it has more to do with consent.

That too. Developmentally, most children at that age are not mentally "adult", which means that we can't consider their consent to be valid. Though there are exceptions.

You make it sound like if your Mum was willing to go guarantor, you'd be perfectly fine as a nine year old to get jiggy and get preggy.

Cannot raise them either financially, socially or emotionally... It has and does happen in some tribal cultures, albeit usually with the support of extended family, but in modern culture, there are many negatives associated with it. As it is, teenage mothers are already at a gross disadvantage to women who wait to have children.

There is some good to promoting abstinence amongst young people (but only alongside comprehensive sex education), and it makes sense given the society they have to move in, and the dangers, but the age at which sex and pregnancy becomes "acceptable" is a very culture-bound thing.

I think, right now, we're close to what's right, as regards to the laws around sex and children, but then, I'm a product of my culture and time, and my opinion might not mean much ten or twenty years down the road.

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Also, not ever likely to get jiggy and preggy. I don't have a uterus.

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Currently, the blanket laws are the best compromise we have... until someone comes out with a foolproof "maturity" test for sex licenses for teenagers.

Which I hope is nothing like as crude as shacking up with the Tribal Shaman for a night.