Happy heuristic for the holidays [Polarity Shift #1]

A good heuristic for deciding how much to trust a claim about some group of humans is to exchange the groups (say with a find:replace command in word) with other groups and see if the change would result in a large swing in public perception. A large change in the perception based on which group is attributed the traits strongly suggests that great caution should be implemented in accepting the claim. As white males are typically the most egregiously attacked group, they are a good choice for replacing another group in any essay which is fawning and/or flattering. To most people the new essay instantly sounds like the work of an evil white supremacist, where the original was merely a positive expression of ethnic, female, or degenerate pride. For any essay that is hostile to the group under discussion, most of which target white males, it is useful to switch to women, Jews, or blacks. Or better yet, make the switch to black, Jewish lesbians to maximize the absurdity. Suddenly, a noble essay meant to combat institutionalized racism, sexism, and anti-semitism becomes a hateful piece of propaganda for white supremacy. If you could expect a polarity shifted essay to be widely and loudly denounced as X-ist, while the original is a triumph for social justice, chances are quite good that you have a big, steaming pile of bullshit on your hands.

Really, to save ourselves time in producing pro-white male, anti-everyone else propaganda, we should just take essays by leftists and use the find:replace function in word. The amount of lolz-worthy propaganda that could be generated in this way is nearly limitless and requires almost no effort since you don’t have to bother writing anything yourself. The triggered/troll’s effort ratio in this process is about as good as you could expect to get in any serious trolling activity. The curve is steep and has a limit of infinity. Perhaps this type of artistic re-imagining of left-wing propaganda will become a semi-regular staple of the blog. I will always be upfront about polarity shifting. However, I could imagine an enterprising troll using such material secretively in order to get leftists to spend huge amounts of effort inadvertently denouncing and debunking their own bullshit. It is win-win on so many levels and is so easy even a child could do it. Propaganda for the common shitlord.

So let’s begin this process with a recently released article by the Washington post titled “Women really are better doctors, study suggests.” Which I will rename “White men really are better doctors, study suggests”

If female doctors were able to do as well as their white male counterparts when treating elderly patients in the hospital, they could save 32,000 lives a year, according to a study of 1.5 million hospital visits.

A month after patients were hospitalized, there was a small but significant difference in the likelihood that they were still alive or had to be readmitted to the hospital depending on the gender of the doctor who cared for them, according to the study published in JAMA Internal Medicine. Although the analysis can’t prove the gender of the physician was the determining factor, the researchers made multiple efforts to rule out other explanations.

“If we had a treatment that lowered mortality by 0.4 percentage points or half a percentage point, that is a treatment we would use widely. We would think of that as a clinically important treatment we want to use for our patients,” said Ashish Jha, professor of health policy at the Harvard School of Public Health. The estimate that 32,000 patients’ lives could be saved in the Medicare population alone is on par with the number of deaths from vehicle crashes each year.

For years, studies have suggested that women and white men practice medicine differently. white men are more likely to adhere to clinical guidelines and counsel patients on preventive care. They are more communicative than women. But whether those differences have a meaningful impact on patients’ well-being has been unclear.

The new study, based on an analysis of four years of Medicare data, found that patients treated by a white male doctor had a little less than half of a percentage point difference in the likelihood they would die within a month of their hospitalization. There was a similar drop in patients having to go back to the hospital over that month. Those are not large differences, but Jha pointed out that major health policies aimed at improving mortality in hospitals and increasing patient safety had resulted in a similar drop in mortality over a decade.

To try to rule out other possible explanations for the difference — such as healthier patients’s preference for white male doctors — the researchers did an analysis where they looked solely at hospitalists, doctors who see patients who are admitted to hospitals and who are typically not chosen by patients. They also made sure patients had similar characteristics in the two groups. They compared doctors within hospitals, to avoid measuring a difference that could be accounted for by comparing a white man who worked at a rural community hospital with a woman who worked at an urban trauma center.

Vineet Arora, an associate professor of medicine at the University of Chicago, praised the research but was cautious to read too much into the main result, pointing out that it was important to remember the effect might stem from multiple factors.

“It could be something the doctor is doing. It could be something about how the patient is reacting to the doctor,” Arora said. “It’s really hard to say. It’s probably multi-factorial.”

What the study drove home for Arora, who works as a hospitalist, is that white men are certainly not worse doctors than women — and they should be compensated equitably. A study published earlier this year found a $20,000 pay gap between female and white male doctors after controlling for other factors, such as age, specialty and faculty rank, that might influence compensation.

She noted that white male doctors, who are often being hired in their horniest years, may face a subtle form of discrimination, in the worry that they will be less committed or that they will not work as hard when they have poon to chase.

“Having a white male physician is an asset,” Arora said.

William Weeks, a professor of psychiatry at Dartmouth’s Geisel School of Medicine, said that the researchers had done a good job of trying to control for other factors that might influence the outcome. He noted that one caveat is that hospital care is usually done by a team. That fact was underscored by the method the researchers used to identify the doctor who led the care for patients in the study. To identify the gender of the physician, they looked for the doctor responsible for the biggest chunk of billing for hospital services — which was, on average, about half. That means that almost half of the care was provided by others.

Could an editorial written as the above is have been published in the Washington post? Could a research paper with these conclusions have been published in a “respectable” peer-reviewed journal? Absolutely not. The outrage would have been deafening and the authors would very likely lose their jobs or even be assaulted. The opposite finding would have never been published no matter how convincing the evidence. The only conclusion allowed was, is and will be that women are better doctors, and this institutional bias all but guaranteed that we were going to get some bunk study like this released to uncritical fanfare in the media. Polarity shifting this leftist propaganda makes it very salient that we are almost certainly dealing with bullshit here.

Forgetting for a second that an effect size of a half of a percentage point is trivial (it took almost 2 million data points to find this), and that social scientists have basically no credibility when it comes to their statistical practices, lets give these authors the benefit of the doubt and say they found a real effect here. After all, the idea of women being more nurturing does fit with traditional stereotypes and I could conceivably see how that might contribute to slightly extending the life of someone knocking on death’s door.

The problem with using this finding to conclude that women are better doctors is graduating female doctors opt out of their profession at much higher rates than men. This ends up removing roughly 30% of the worst female doctors from circulation and thus prevents them from being factored into the study. This should have a substantial impact on their overall average in studies such as this, and I am honestly surprised they didn’t get a larger effect than they did because of it. Of course, I AM assuming that it is disproportionately the worst doctors who opt-out of practice (there is no data on this), but honestly it is a reasonable assumption. People who are good at something tend to stick with it more. In addition, it doesn’t factor in that male doctors are working on average 5 more hours per week than their female counterparts. Ya, maybe he isn’t as cuddly with his patients, but he is likely seeing more patients per week which translates to providing substantially more care overall. You can quibble over this, but I would argue this increase in quantity of service is more important than a doubtful .5% change in mortality in the terminally ill. Leftists are very eager to latch onto any trivial finding to make a specious argument about how great their favored group is, but it is a huge red flag and very typically misses the larger picture. A picture that is already heavily skewed by decades of feminist infiltration into academia, but nonetheless still paints another picture than the established narrative. And that is assuming the finding itself wasn’t complete nonsense to start with.

The excerpt below from my book Smart and Sexy: The Evolutionary Origins and Biological Underpinnings of Cognitive Differences Between the Sexes provides a more extensive discussion of this. Citations for this section are at the end of the post.

The skilled female labor with the most extreme pattern of opting out is masters of business administration graduates from elite schools. Only 35% of the best, most qualified women who get educated from the highest ranked schools are actually participating in the work force; they are 30 percent more likely to opt out than their peers who went to less selective schools. Though even for those women at less selective schools, it must be noted that a 35% opt-out rate is still very high. Depending on the vocation and education level, the rate of expensively educated women opting out ranges from 20-40% but for most careers the female opt-out rate clusters around 30%. Women with children work even less than this with a range of 40-60% opting out over all professions with most professions having around a 50% opt-out rate.i The female drop out rate is partially due to new mothers deciding not to work to raise children, and it is also partially due to significantly greater earnings by husbands making their income relatively insignificant by comparison.

Perhaps the most important example of female opt-out being problematic is in medical training. Training medical doctors is hugely expensive and they receive the highest degree of taxpayer subsidization. Some of the costs are born by the degree seeker, but the majority of the cost is paid for by the state through taxes on the general population and ranges into the hundreds of thousands of dollars per doctor. The general population consents to this subsidization because they realize that they will need medical doctors to treat them when they become ill. However, prioritizing women in these careers is a poor investment for the tax payer even when they have the cognitive ability to meet the demands of the profession.

Work-time preference differences between genders strongly imply that training men is generally a better investment for society than women at the same level of ability. Especially considering 4 out of 10 female doctors are working less than full time and some of those do not practice at all.233, i Even full time female doctors work on average about 4.5 hours less a week than men. A man who works 50 hours per week, 50 weeks per year, for 40 years would work a total of 100,000 hours. A woman who worked 35 hours a week for the same time frame would only work 70,000 hours. This rough calculation is quite generous in assuming that women working part-time only work 5 hours less than the standard work week and that they do not switch out of their trained profession at an early point for the duration of their working life. However, it is known in practice that many women end up switching out of the profession they were expensively trained in long before they retire.233, 236, ii, iii

These sorts of lifestyle choices are fine when the costs are born by the women who make them, but they are unacceptable when the costs are largely paid by society via wasting tax money on training that goes unused and in terms of shortages of access to medical care due to too few trained doctors practicing. The problem only promises to get worse because of the push to get gender parity in medicine. As of 2010, 30% of practicing doctors were female but almost 50% of new medical school graduates were female. It is estimated that if the trend of female opt-out continues, and there is no reason to think it won’t, there will be up to a 150,000 shortage of doctors in the near future. General practice and pediatrics will most acutely feel the problem since these are the fields women gravitate towards.236 The public will have difficulty gaining access to medical care and costs will rise substantially because of the push of women into medicine.

In addition to a preference for less work hours and a tendency to opt out entirely, working women also call in sick or are otherwise absent at about twice the rate of men.iv For sick leave specifically, women are absent about 50% more often for self-diagnosed sickness and 34% more often for medically certified sick leave.v Some, but not all, of this increased absenteeism can be explained by a greater likelihood for mothers rather than fathers to stay home with sick children. The rest may be due to legitimate increased susceptibility to illness (for example, menstrual pain and hysteria), a degree of semi-hypochondria, or a general lack of tenacity in the face of women’s dislike of working. The later would be consistent with normal female work preferences. There is also some evidence for increased hypochondria; though women more often report ill health than men, it is not reflected by higher mortality rates. Reported ill health is much better correlated with mortality in men.vi Whatever the reasons for these trends, the consequence is that by any measure, women as a population make for less productive and reliable employees than men even when they have similar levels of intellectual ability.

The costs shouldered by businesses forced to hire women to meet diversity quotas is enormous. Though employee turnover has been increasing in recent years for all demographics, the above data makes it clear that women lead the pack. It is estimated that employee turnover will approach 65% in the near future. The median cost of employee turnover is 20% of the employee’s annual salary for positions that pay under 75 thousand dollars annually, but there is a large range of costs and the cost increases drastically for specialized positions that require significant education. Replacing highly paid, specialized positions can cost up to 213% of the lost employee’s annual salary.vii, viii

Studies and articles which address the problem of female opt-out, because of the feminist tendencies of the authors, generally advocate costly female-friendly policies.242, 243, ix In other words, they advocate lower standards for women relative to men and toleration of a greater degree of absenteeism for women. Essentially this means that feminists want the costs and opportunity costs of women’s decisions to be externalized to employers and fellow employees who have to pick up the slack for absent or disengaging women, and vicariously to society who have to deal with less available service agents. The obvious and easiest solution is to simply not have as many women in these positions or restrict them to positions which can tolerate less devotion. This is exactly what our ancestors sensibly did. A company would be better off not having female oriented policies to discourage women from working there and thus maintain a more reliable work force.

i Sibert, K. S. (2011). Don’t quit this day job. New York Times. http://www.nytimes.com/2011/06/12/opinion/12sibert.html?pagewanted=all&_r=0

ii Belkin, L. (2003) The Opt-Out Revolution. New York Times. http://www.nytimes.com/2003/10/26/magazine/26WOMEN.html

iii Kuczynski, A (2002) “They Conquered, They Left.” New York Times. http://www.nytimes.com/2002/03/24/style/they-conquered-they-left.html

iv Tahmincioglu, E. (2007) Female Absenteeism is not just about child care. NBC News. http://www.nbcnews.com/id/21547885/ns/business-careers/t/female-absenteeism-not-just-about-child-care/

v Laaksonen, M., Martikainen, P., Rahkonen, O., Lahelma, E. (2007) Explanations for gender differences in sickness absence: evidence from middle-aged municipal employees from Finland. Occup Environ Med. 65(5):325-30. doi: 10.1136/oem.2007.033910.

vi Young, H., Grundy, E., O’Reilly, D., Boyle, P. (2010) Self-rated health and mortality in the UK: results from the first comparative analysis of the England and Wales, Scotland, and Northern Ireland Longitudinal Studies. Popul Trends. 2010 Spring;(139):11-36. doi: 10.1057/pt.2010.3.

vii Boushey, H., Glynn, S. J. (2012) There Are Significant Business Costs to Replacing Employees. Center for American Progress.

viii Appelbaum, E., Milkman, R. (2006) “Achieving a Work­able Balance: New Jersey Employers’ Experiences Managing Employee Leaves and Turnover” Center for Women and Work. Rutgers.

ix Herry, J. L., Wolframz, C. (2009) Work Environment and \Opt-Out” Rates at Motherhood Across High-Education Career Paths. National Bureau of Economic Research. Working Paper No. 14717

i Hersch, J. (2013) Opting Out among Women with Elite Education. Vanderbilt Law and Economics Research Paper No. 13-05. http://dx.doi.org/10.2139/ssrn.2221482

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7 Replies to “Happy heuristic for the holidays [Polarity Shift #1]”

  1. My guess is that female doctors are probably less likely to see patients with extremely serious conditions, thus their patients survive more often.

    1. That may be true in general given the greater cognitive demands of more advanced disciplines, but the data looked at was specifically only related to hospice care. That is, all patients looked at were supposed to be terminally ill. I can’t promise that all those patients were equally terminally ill, but I don’t have any reasons to say they weren’t either. I guess you would just have to look through the study directly to make up your own mind.

  2. There are far fewer female doctors compared to male doctors (30-35 percent of all doctors), which means that a small number of good female doctors will compete with a very large number of male doctors, so not all of those male doctors will be at top level (remember the Bell Curve – there are only a few people at top level). So the large number of male doctors will get their mean performance down.

    The effect size is quite small though, so probably the optimal ratio of female doctors vs male doctors should be 40 % females vs 60 percent males instead of 30/70. Again such ratio will be a sign of superior male performance.

    At the MCAT exam for Medical Schools, the difference between males and females is equivalent to 4,7 IQ points in favor of men. At AP biology males perform better as well. Other studies also show that males not only have higher mean scores at biological science, but are also more variable, with the male – female ratio at the top 10 percent of bio science being 2 to 1.

    The second problem is that a female doctor is 25 percent less productive than a male doctor. Who knows how many lives the male doctor saved while he was working, while his female colleague was not?

    In other words, having female doctors is already useless, as they save far less lives per capita compared to their male counterparts, not to mention that they bankrupt the medical industry due to the fact that they work far less than men.

    References:

    MCAT scores: +3 points in favor of men at SD=10 equals 4.7 IQ points
    https://www.aamc.org/download/321504/data/factstablea21.pdf

    Advanced Placement Biology performance
    https://www.ets.org/Media/Research/pdf/PICGENDER.pdf

    Sex differences in Biological Science Performance – see Project Tallent

    https://pdfs.semanticscholar.org/b4fc/9dfb7c8ea9c31a830f4e6671426e8ca316a3.pdf

    Part-time women doctors are creating a timebomb – a female doctor works 25 percent less than a male doctor

    http://www.telegraph.co.uk/women/womens-health/9950248/Part-time-women-doctors-are-creating-a-timebomb.html

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