Hmm. I have been substantially exposed to the health care systems in the United States, Australia, and The Bahamas. Some of Dr. Satel's points ring true, but she seems to draw a boundary that is too tight. I expect we would agree that, for example, when Sydney emergency room doctors took a strong stand on closing hours for nightclubs, having seen the drunken carnage spill into their ERs for far too long, that was an appropriate extension of their professional expertise into the political arena. There are many similar examples.

But what about issues such as universal health insurance? Does it not make sense that a doctor with years of experience in the grotesque world of American health insurance, particularly if that doctor understands how every other developed country does it better, would have a considerably more informed view than most other participants in the debate? Having seen patients denied treatment due to insurance coverage problems? Having seen patients, collectively in their millions, bankrupted due to medical bills? Having to treat patients far too late, because the patients were afraid of the costs of coming to the doctor? Obamacare, medical insurance, single payer, and the like are well within the professional competence of many U.S. medical practitioners.

Regarding anti-racism training and the like: there is a substantial literature of research-validated findings that doctors vary their treatment based upon the race (and sex and class and age...) of their patients. Reducing these biases is clearly a fit topic for med school training and for the professional colleges in continuing professional development.

On the other hand, much of what passes for anti-racism training now seems to be cant and bluster, so Dr. Satel has some good points to make there. One point that seems unduly contentious is that, while race may be a social construct, ethnicity is not, and difference ethnic groups sometimes vary in their disease concentration, response to medicines, etc. It would be a great tragedy if knowledge of these variances was suppressed to to misguided anti-racism training. Similarly, doctors are also attuned to differences in patient compliance across various groups, and that knowledge needs to be incorporated into training and development.