Annals of Academic Warfare: The Physician Gender Pay Gap Myth


There are a few truths that seem to be glaringly ever more important in contemporary society.  One is that the feelings of the elite trump facts. Another is that the capture of venerated institutions is so complete that they are frequently used to present feelings as fact. 

No better example of this relates to the always contentious physician gender pay gap problem that is examined in a recent study published in the esteemed New England Journal of Medicine.  The study seeks to examine the different practice patterns of men and women physicians to understand why men in medicine seem to always make more than women in medicine.  Most questions have multiple potential answers, but the answer to this particular question is already known by the IYI class of physicians and researchers that torture data to create the type of glossy PR that would make tobacco executives jealous.  The researchers use a mediocre study to spin a tale of woe for women physicians despite the fact the results of the study should leave anyone with more than an ounce of objectivity to quite different conclusions. I must also pause to say that the fact that this weak study gets published in the NEJM with an accompanying editorial confirms the journal’s place on the vanguard of the feelings>facts social justice movement. 

The job description for those writing these studies that specialize in confabulation is simple.  First, find some dataset of men and women physicians, and then manipulate the findings to spin some tale of societal systemic discrimination that oppresses women.   Ganguly et. al. are professionals, and don’t disappoint.  

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COVID-19 Converts Elective Clinical Interventions Into Discretionary


In an editorial in the Journal of the American Medical Association last October, two of Harvard’s more influential economists, David Cutler and Lawrence Summers, called COVID-19 the “$16 Trillion Virus”. This is their estimate of health expenditures and lost income through the summer of 2021 barring important mitigating medical and/or policy interventions. That astronomical sum represents 90% of the annual gross domestic product, which translates into a loss of $200,000 for a family of 4. Approximately half represents diminished income consequent to job loss and the COVID-19 induced recession. The other half is in expenditures related to premature death and long-term physical and mental health impairments. 

Cutler and Summers do not focus on the costliness of treating acute SARS-CoV-2 infections. These are economists who are keen on following the money. It turns out that during the early months of the COVID-19 pandemic when Intensive Care Units in many cities were overrun with patients requiring costly and labor-intensive care, health care expenditures in the country plummeted, as much as 50%! The decrease in healthcare expenditures reflects decreases in outpatient and inpatient utilization across the age spectrum and was particularly dramatic for those with private health insurance. Obviously, many found the need to seek medical care more discretionary than they had prior to the pandemic. Some of this behavior represents avoidance resulting from concerns that healthcare facilities were sources of infectivity. Much of it represents reframing the notion of “elective” procedures. 

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The Apocalypse Will Be Streamed


After 9 months of taking every reasonable precaution and then some  (masks, social distancing, extreme hand washing, crossing the street to avoid people who looked like idiots) I tested positive for COVID-19 a week before Christmas.

Fourteen days later, I found myself climbing out of my bunker. Coughing, blinking, and surveying the New World. 

My case was “moderate.” 

Trust me, in this case, the word “moderate” does not mean what you think it does.

A few observations follow.

(And no, this is *definitely* not what I asked for for Christmas.)

In my case, “moderate” meant 7 days of 101 plus degree fevers, shortness of breath, plunging O2 Sat levels and a bunch of weird ass symptoms. Including – but not limited to – coughing up blood, circulation issues, acid-like changes in taste + perception.

I live in Los Angeles, which turns out to be the not very well made but impossible to escape sequel to COVID in the spring in New York.

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