Framing, context, asking (not answering) questions

It was one of those little stories that seemed to take on a life of its own: The New York Times1 Last week there were reports of an assistant professor of organic chemistry at NYU who was fired after students complained that his tests were too difficult. I would have missed it, but was discussing The Bulwark last time for JV.2

Both discussions touched on what constitutes an intestinal course organ; How many aspiring doctors see their career hopes shattered by class? Debates have erupted over whether colleges are credential factories, public utilities, or simply a business selling a product trying to satisfy their consumers. JVL writes, “The course exists for two purposes only: (1) to reduce the number of attractive medical school applicants and (2) to prepare a handful of students for a future in biochemical research.”


Since this story is obviously about education, let’s turn briefly to an unfortunate side effect of modern American education. The focus is not on teaching students how to think, but on successfully answering questions on tests. An unfortunate side effect of this misfocus is that it forces students to answer questions with specific answers, ignoring the effect of question framing.

Law school teaches you how to think. You will learn that framing is extremely important; The attorney who can get a judge or jury to focus on the relevant questions is halfway to victory.

“Is this organic chemistry class too hard?” When faced with questions like this? Perhaps we are better served by asking some different questions:

1. Why do we want to exclude future doctors from the ranks of students? (And who made this decision?)

2. Why does the United States lag behind our peers in doctors per capita?

3. What is the purpose of limiting the number of medical students (and therefore physicians)? What role does the American Medical Association (AMA) play in this?

4. What does this mean in terms of cost, availability, and wait times for health care services in the United States?

5. To ask the above question more precisely, why is US medical care so expensive compared to comparable countries?

6. Worse, why does the United States perform so poorly in terms of longevity and general health compared to comparable countries?

That change of frame leads to some amazing places. We discovered that health care in the United States lags behind most of the industrialized world. Our longevity is short, our costs are high, healthcare is rationed for profit 3rd Party insurers.

Derek Thompson observes that “the United States has the longest, most expensive medical education system in the developed world and the fewest doctors per capita.” We have to question why we are not producing enough doctors despite the growing population. The number of new medical schools was strongly limited; Foreign-educated doctors are often restricted from practicing in the United States.

My preference is to see the big picture, to see the world from a 30,000-foot view. No wonder no one talks about the big picture: health care in the United States and why it’s so expensive and so many people are so underserved by the profession.

In 1960, the United States had more doctors per capita than any other country. What happened since then?

see more:
Why America Has So Few Doctors By Derek Thompson The Atlantic, February 14, 2022

US Physician Shortage Plans (Niskanen Center, September 8, 2020)

in the past:
Change Your Perspective (July 22, 2022)


1. At NYU, students were failing biochemistry. Whose fault was it? By Stephanie Saul on October 3, 2022

2. About the organic chemistry professor who was fired for giving bad grades, Jonathan V. Last, The Triad, 4 October 2022

In 1960, the United States had more doctors per capita than any other country. What has happened since then:

Source: Our World in Data

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