MisterChris

You're a moderator and you continue to engage in personal attacks, of which breach the TOS.

Are you aware of how bad this looks?

I have sent it to other mods for review, and will accept any punishment I incur, but that is my view. 

In that sense there is no way white privileges does not exist in the US. 

Stop being a dick. 

That's an unprofessional comment for a moderator to make.

...a recent PNAS paper titled “Physician–patient racial concordance and disparities in birthing mortality for newborns”...

The authors use the State of Florida’s Agency for Healthcare Administration data on births between 1992 and 2015. This data, notably, contains details about the race of patients but not of doctors. This seems like a pretty big deal! If the paper is meant to test the effect of racial concordance, I’d hope the authors knew what the race of the doctor was.

Here’s how the authors got around this problem: They used the doctors’ names and searched them up on various health websites like vitals.com and healthgrades.com. We can be pretty sure these really are the doctors in the dataset, because the researchers matched doctors’ license numbers, and affiliations. They then downloaded photos of every doctor. Here’s where bias may start to creep in: of the 9,992 doctors in their sample, only 8,045 had readily available photos....

The researchers assume physician-patient pairing is quasi-randomized — or that which doctors patients get are not “chosen”, but dictated by the doctor who happens to be on call. Is this justified? The authors don’t get into it. It could be the case, for example, that wealthier black mothers choose black doctors at higher rates — and their wealth is a predictor of mortality in and of itself. 

Mortality of infants is linked to their attending physician. Medicine is a team sport, and there are teams of nurses, other physicians, and administrators who all play a role in the outcome of a patient. Do we have good evidence that an individual physician has such an outsize impact on their team?

Do we trust that the physician listed is even the person with primary responsibility for patient care? One doctor in Vinay’s thread says that “one hospital where I worked all infants had the medical director listed. Another it was the admitting doc. Could be paediatrician after discharge.” In other words, we have no guarantee that the patient of record the authors used was even the person who looked after the birth.

Finally, the biggest critique: are there systemic differences in which doctors look after infants with higher mortality risk? Is it the case, for example, that ICU pediatricians are disproportionately white? In this case, we’d expect white doctors to on average have higher mortality, because they’re on average looking at tougher cases. Selection bias matters!

Additionally, I’d like the point out that the researchers didn’t use their data to look at disparities across other racial groups. As far as I can tell, the only thing they looked at was black patients and black infants. Suppose we found that black infants had worse outcomes with middle eastern or east asian doctors as well? Would we be as quick as to leap towards a racial bias narrative? What if we found that white infants had worse outcomes when treated by south asian doctors?

I have had but one answer from the beginning. Do nothing with us! Your doing with us has already played the mischief with us. Do nothing with us! If the apples will not remain on the tree of their own strength, if they are worm-eaten at the core, if they are early ripe and disposed to fall, let them fall! I am not for tying or fastening them on the tree in any way, except by nature's plan, and if they will not stay there, let them fall. And if the negro cannot stand on his own legs, let him fall also. All I ask is, give him a chance to stand on his own legs! Let him alone! If you see him on his way to school, let him alone, -- don't disturb him! If you see him going to the dinner-table at a hotel, let him go! If you see him going to the ballot-box, let him alone, -- don't disturb him! (Applause.) If you see him going into a work-shop, just let him alone, -- your interference is doing him a positive injury. 

"Let politicians, schoolteachers and administrators, community leaders, ministers and parents drill into children the message that in a free society, they enter adulthood with three major responsibilities: at least finish high school, get a full-time job and wait until age 21 to get married and have children.

Our research shows that of American adults who followed these three simple rules, only about 2 percent are in poverty and nearly 75 percent have joined the middle class (defined as earning around $55,000 or more per year). There are surely influences other than these principles at play, but following them guides a young adult away from poverty and toward the middle class.

Consider an example. Today, more than 40 percent of American children, including more than 70 percent of black children and 50 percent of Hispanic children, are born outside marriage. This unprecedented rate of nonmarital births, combined with the nation’s high divorce rate, means that around half of children will spend part of their childhood—and for a considerable number of these all of their childhood — in a single-parent family. As hard as single parents try to give their children a healthy home environment, children in female-headed families are four or more times as likely as children from married-couple families to live in poverty. In turn, poverty is associated with a wide range of negative outcomes in children, including school dropout and out-of-wedlock births."