Tuesday, December 05, 2006

The Big and the Small of It All

Assemblywoman Bonnie Watson-Coleman (D-Mercer) is back in the news here in New Jersey. She had a bill passed back in March, 2005 (it was signed back then by Acting Governor Richard J. Codey) providing for mandatory classes for Doctors in medical schools on "cultural sensitivity." And a continuing education requirement for those who missed it in med school.

Here's a surprise: We are the only state requiring such classes for physicians. And, according to a report by Pete McAleer in the Atlantic City Press dated November 30, 2006, Watson-Coleman sent out a letter at the end of October to medical groups recommending a woman named Sharmila Ghosh, who assisted her in writing that legislation, to help develop the curriculum and perhaps teach the course in our medical schools, as well as the update courses.

All physicians will eventually be required to complete the coursework as a condition to renewing their licenses. According to the Press report:
Once the State Board of Medical Examiners completes its regulations, cultural competency training will be part of the curriculum in all New Jersey medical schools and will be a requirement for obtaining a medical license. Physicians already licensed in New Jersey will need to complete the training to renew their licenses.

In a moment of inexplicable candor, Bonnie's legislative spokesperson, one Nikki Graham, conceded that there might indeed be teeny-weeny conflict of interest involved in making the recommendation:

Nikki Graham, a spokesman for Watson Coleman, said the letters were not sent as a way to “jump ahead” of the state board of medical examiners. Asked if it might be considered a conflict of interest for a lawmaker to recommend someone for a position he or she essentially created, Graham said, "Now that you're asking this, I'm beginning to feel there is a conflict of interest."

Here is more from the Press story on the little lady who Bonnie wants to teach doctors cultural sensitivity (my emphasis added).

Ghosh, who was born in Bombay, India, holds a master's degree in intercultural relations from Lesley University in Massachusetts. She said she taught cultural sensitivity courses to police departments in Rhode Island after the terrorist attacks of Sept. 11, 2001 attacks and to companies throughout the United States and Europe. Courses generally require six hours of training and involve a combination of games and role-playing, she said. The goal is to explain how cultures interact and the impact cultural differences can have.

In the case of physicians, doctors might prescribe a medicine that is against a patient's religious or cultural beliefs, Ghosh said.

In an article posted on Ghosh's Web site, written by Rina Bisawas, Ghosh is said to have described a class session in which African-American participants were prompt but Latino participants arrived late and then held up the class as they took their time getting settled and socializing. According to the article, Ghosh explained to the writer that "the concept of time has a different value to the Latino culture, and that many Latinos feel the relationship-building that takes place in speaking and conversing with people is more important than promptness and the rigidity of maintaining schedules.

"The difference in how these two groups of people valued time was a nice example of one of the course's main objectives — how concepts of "space" and "time" differ between cultures, and that in trying to understand different cultural viewpoints, you can avoid hostility," the article stated.

Started almost 100 years ago, Lesley College was predominently a school for girls turning out kindergarten teachers over the years. Lesley joined forces with the Art Institute of Boston in 1998, and it became a University in 2001. The school just went co-educational in 2005, and has campuses located in Boston and Cambridge, MA.

Their motto is, "Let's Wake Up the World!"

There is no specific indication as to whether that motto is related to the following priceless, and slightly irreverent, quote about Lesley students, which can be found on Wikipedia, here (again, my emphasis). (See UPDATE, at bottom).

"Lesley to bed, Wellesley to wed." common knowledge amongst Harvard male students, as well as the few heterosexual males at Lesley.

One thing is for certain: The arrogance of Sharmila Ghosh is manifest. When asked about the apparent conflict of interest, she did not hesitate to immediately brush off the suggestion.

"She saw all the work I had done," Ghosh said. "When you make a law, people ask you, 'Do you know anybody that can deliver on it?' I think some physicians are upset because they feel physicians should deliver the course. But to teach this course, you need a degree in cultural training. You don't need a medical degree."

Hey! Here's a thought: How about having convicted armed robbers or other such felons as teachers for mandatory cultural competency classes on understanding the commission of violent street crimes?

It could go right along with street gang legislative proposals providing for the creation of "a certificate of rehabilitation courts would issue to show felons have been rehabilitated."

Those who pass could get a certificate of victimology! The statement accompanying the legislation could make the point that the concept of honesty and adherence to the law has a different value to felons, and that they could teach people to understand that feeling of the need for forcefully possessing something that doesn't belong to them, is a different value than it is to others. By understanding their point of view, you could avoid feelings of hostility, and perhaps even avoid getting shot in the process of being robbed. Through a combination of games and role-playing (i.e., having them jam a gun in your face and say, "Gimme yer dough!") you could learn to just cheerfully give up and promptly turn over all your possessions to any robber, whenever they brandish a weapon at you.

All we've got to figure out now is who will be required to take the mandatory course, and when.

Of course, continually cooking up and implementing idiotic ideas like required cultural competency courses for physicians does make it a wee bit difficult to get a handle on the cost of government, doesn't it? Like figuring out, as a recent headline read,

"Who is going to pay for the property tax reductions?"

Think about the logic of that for a moment . . . Here's the latest example of that kind of logic, from the middle of a Star-Ledger story by Dunstan McNichol, entitled, Property tax relief expansion in works: 70% of Jerseyans would get 20% cut. Before you get too worked up counting all that dough, head for the following paragraph in the middle of the story.

The legislative leaders would not say how much the property tax plan would cost or where all the money would come from, saying those are among the details to be ironed out. Ending the current property tax rebates for most homeowners would pay for part of the program, along with money from the recent increase in the state sales tax. (emphasis added)

These are instructive examples, one small and one large, why certain "law-makers" will never, ever act to really control, let alone actually reduce the spiraling cost of government.

Now, harken back to that little proposal of Assemblywoman Watson-Coleman described above. And just for starters, think about the folks sitting around drafting the regulations to implement that ridiculous cultural competency course proposal.

It's been a year and a half since Codey signed the bill!

UPDATE: 12/05/2006

Since piecing together the portion on Lesley, above, there have been a few edits at that site on Wikipedia. The Harvard quote has been removed! But here is the link to the earlier version (Revision as of 00:51, 1 December 2006), just in case you had any doubts! Scroll down to the bottom. Heh!


At 5:27 PM, February 12, 2007, Anonymous Anonymous said...

The dialogue taking place around this is interesting. I agree that the person doing the training in an area needs some experience in the content area. I also know that there are physicians who have designed training and contributed to the work of others who are doing the training. One on-line resource is www.qualityinteractions.org. It was designed by three docs out of Boston and NYC. It is worth checking out. My company Cook Ross www.cookross.com works with them and we work to meet the needs of docs who want to get data from docs as well as people who simply want the data to be relevant to their experience. Good luck to the docs in NJ, let us know if we can be of assistance.


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