19 May 2008

Doctors for America

Many of those in poverty in America really need better access to medical care.

"At Doctors For America, we are working with a great sense of urgency to build the movement to eliminate medical inequity by enlisting our nation's most promising future leaders in the effort. We recruit aggressively to attract outstanding recent college graduates of all majors and career interests to commit two years to serve as doctors in urban and rural communities, and we invest in the training and professional development necessary to ensure their success as doctors in our highest-poverty communities. Our doctors, also called corps members, go above and beyond traditional expectations to lead their patients to significant health improvement, overcoming the challenges of poverty despite the current capacity of the health care system."1

"We have found that the most successful doctors in our communities are those who operate as a successful leader would in any context. They set big goals for where patients will be physically at the end of the year, invest patients and others in working hard to realize that vision, plan purposefully and work relentlessly with a sense of urgency to maximize medical services in pursuit of the vision, and continuously increase effectiveness to reach the vision in spite of the multiple challenges and obstacles along the way. Knowing this, we carefully select those individuals who we believe have demonstrated strong leadership and therefore have potential for success in the examination room and the operating room."2

In order to create these new doctor/leaders: "We operate rigorous five-week summer preparation institutes in Atlanta, Houston, Los Angeles, New York City, Philadelphia, and Phoenix. Through opportunities for practice, observation, coaching, and study — as well as careful planning and thoughtful reflection — corps members develop the foundational knowledge, skills, and mindsets needed to be highly effective beginning doctors."3

"Corps members (during that five week summer program) provide medical services to patients for approximately two hours each day, under the supervision of experienced doctors. For the first hour, most corps members work directly with four to five patients with significant health issues, which also builds the doctor's skills for patient interaction. For the second hour, corps members take charge of an operating theater, which also builds the doctor's skills in delivering the highest levels of medical care."4

Are you excited now? Your child just got sick, are you ready to rush them to your nearest Doctors for America hospital?

Well, you might be, assuming that your choice is no medical care for your child. Assuming that the real doctors in your community won't take patients on Medicaid or won't take uninsured patients. When your choice is bad or nothing, people will often choose bad. But imagine that you run a hospital in the kind of neighborhood where people like this live and work:

Stephen Bollenbach Retired Co-Chairman & CEO Hilton Hotels Corporation Don Fisher Founder & Chair Emeritus Gap Inc. Lew Frankfort Chairman & CEO Coach, Inc. David Gergen Professor of Public Service Director of the Center for Public Leadership Harvard University Eddie S. Glaude, Jr. William S. Tod Professor of Religion and African American Studies Princeton University Leo J. Hindery, Jr. Managing Partner InterMedia Partners Walter Isaacson (Chair) President & CEO The Aspen Institute David W. Kenny Chairman & CEO Digitas Inc. Wendy Kopp Chief Executive Officer & Founder Teach For America Sherry Lansing CEO Sherry Lansing Foundation Sue Lehmann Management Consultant Michael L. Lomax, Ph.D. President & CEO United Negro College Fund Stephen F. Mandel, Jr. Managing Director Lone Pine Capital Anthony W. Marx President Amherst College James M. McCormick Founder, CEO & President First Manhattan Consulting Group Richard S. Pechter Alumnus, Teach For America Maxine Clark Retired Chairman, DLJ Financial Services Nancy Peretsman Managing Director Allen & Company, LLC Alma J. Powell Chair, America's Promise Alliance Paula A. Sneed (Vice Chair) Retired Executive Vice President Kraft Foods, Inc. Sir Howard Stringer Chairman & Group CEO Sony Corporation Lawrence H. Summers Charles W. Eliot University Professor Harvard University G. Kennedy (Ken) Thompson Chairman, President & CEO Wachovia Corporation John Thompson Chairman & CEO Symantec Corporation Gregory W. Wendt Retired Partner Goldman Sachs & Co. Lawrence J. Stupski Chairman Stupski Foundation Senior Vice President Capital Research Jide Zeitlin (Treasurer) Company Founder and Chief Executive Bear Build-A-Bear Workshop [the Teach for America Board] 5

In that case, your hospital probably hires people who have actually been to medical school, who actually have more than five weeks of training. (In World War II US Navy corpsman went through four months of training.6) In your neighborhood's hospital you probably wouldn't imagine that because, say, a person ran the Sony Corporation or was the grandchild of someone who ran the Sony Corporation and could thus get into a prestigious US university, that she or he could instantly be a great doctor due to leadership skills. You would expect more. You would demand more.

The value of great teachers

Who does more damage? The bad doctor or the bad teacher? Well, I'm not sure. I'm not sure in terms of individuals and I'm not sure in terms of society. I have seen great teachers save the lives of students, including, perhaps, mine. I have seen bad teachers destroy the lives of students - lots and lots of students.

But because I am not sure I am demonstrating how much I value the role of teacher. How much I respect that as a profession. I know that being a great teacher, even a good teacher, is incredibly difficult. It takes massive commitment, a tremendous knowledge base regarding how humans learn and develop, significant content knowledge, a lot of observation, and, in almost every case, substantial experience. (I've had a number of jobs in my life. In every case I might have thought I was doing a great job in my first year, but by my third year I realized that had not actually been true.)

There is the fact that in Cuba teachers are among the highest paid people in society. That suggests something about the value that nation puts on education. In the US we value bookies above all others. No profession earns more than those who place bets on the stock markets and other exchanges for others. Those in charge of preparing the next generation for our collective future? Even when we pay then decently, we complain about it, and whine about their amount of "time off."

We don't value teachers. And Teach for America's people - well, they despise teachers. Hell, anyone born rich can be a teacher the way they see it, or at least anyone who can get through Harvard or the University of Michigan. Teaching requires no particular skill set, at least no more of one than it might take to learn a hobby. It is easier (and faster) according to TFA, to learn to teach than to drive, or become the grill person at McDonald's.

This hatred of teaching is rooted in a belief in American education as missionary work. Skills, individual capabilities built from experiences, knowledge base, none of that matters. The best missionaries are the truest believers, and TFA people? They are true believers. "Just behold us, for God loves us, and we are blessed," they say, followed by, "Just act like us, and you too might be eligible for (at least a tiny bit of) God's love." An understanding of who they are teaching? Not important. An understanding of pedagogy? Equally ridiculous. Attention to special needs? Who cares. We believe and we offer them the word. And when we measure them our way we find that they are "improved" above the jungle condition we have otherwise consigned them to.

While poor kids in America's poorest communities get Teach for America, these leaders of society have something different in mind for their own children. the same weekend that The New York Times praised Teach for America, the paper's Real Estate section said this about Scarsdale, New York's schools, "The school system remains tough to beat and is clearly doing all it can to stay that way. SAT averages run more than 100 points higher than the nation’s, and the level of the high school curriculum is such that this year the faculty has begun phasing out Advanced Placement classes and replacing them with a more demanding homegrown version."7

I wondered if the students of TFA teachers outperformed the students of Scarsdale teachers - where teacher pay averages six figures, or 40% higher than even the communities which surround it in Westchester County. The Times called teacher preparation programs "diploma mills," but I guess somehow those "mills" are working - according to the same newspaper - for the children of the Times's editors and their friends and anyone else who can afford a school district with an average house price around $1.4 million (US).

Of course, as you'd expect with the medical analogy I began with, the higher the needs of the students involved, the worse Teach for America hurts: Linda Darling-Hammond: "It is common for these teachers to create a setting in which the kids are under very, very tight control. Special education students and non-native English speakers had the lowest academic growth rates when taught by under-qualified teachers."8

Maybe every 22 or 23-year-old university graduate I've met is a moron compared to the geniuses chosen for TFA, but perhaps, just perhaps, five weeks isn't enough for anyone to learn everything one might need to know about second language acquisition, about the range of cultures in American classrooms (a range not likely to be encountered on the campuses most TFA recruits come from), plus Aspergers, plus ADHD, plus dyslexia, plus dyscalculia, plus CAPD, plus Autism, plus EBD, plus the spectrums of all of these "issues" and the deep variety within each... well, we can't really expect these five-week wonders to do positive things for every student. I think it is a crime that many teacher preparation programs devote only one or two semester courses to the kinds of special needs students who will make up between 25% and 50% of many classrooms. And TFA with just five weeks for the entire study of education? I'm guessing those "teachers" might be missing a few facts about human difference and how those differences mesh with learning needs.

Lowering that bar

I had an email debate about 18 months ago with a dean at an Ivy League university. He's a big TFA fan. Many of the Ivy League elite are. He's not a fan of teacher preparation programs. But then, his university doesn't offer one. They don't really want to think about what teachers need as they enter the classroom, or about how students learn. They don't want to do the work of preparing better, or better equipped teachers. They, like Teach for America, want to create "leaders." Oh good.

I said to the dean, "It seems to me that an MSU teacher ed student spends almost as much time in high needs schools before certification - before beginning to teach - than TFA teachers spend in total." And he told me that was, "probably true," but MSU wasn't 'the norm.' "Wouldn't that make them at least somewhat better prepared?" I asked. He said, "TFA teachers do better than other badly trained or unqualified teachers." Yup. You can't possibly set the bar much lower than that.

Outside of the Republican Party ("You can't expect government to work!" "You can't expect leadership to be competent!") and the TFA-related KIPP Foundation, no one in America sets the bar for success lower than Teach for America.

Here is the key phrase in Teach for America's Mission Statement: "...the training and professional development necessary to ensure their success as teachers in our highest-poverty communities."9 Obviously that is not the "the training and professional development necessary to ensure their success as teachers" in the schools of those who run Teach for America. Those schools, those students, require something more. Of course those schools are filled with wealthy white kids.

Because here's the other key phrase: "The most rigorous study on Teach For America shows that corps members are having a greater impact on students than typically would be expected in a year."10 Than typically would be expected. Yes, they're doing better than a bunch of rich white elitists might expect from a bunch of stupid minority kids. Not - of course - what they'd expect from their kids, but, remember, we're devoted to the idea of "good enough for these types of children."

Let's go back to the hometowns of that TFA Board. Want to become a teacher in Cambridge, Massachusetts? "Teachers are required to have a Bachelor’s degree and to hold appropriate Massachusetts teacher licensure/certification."11 Stamford, Connecticut has certification requirements and approved course lists. Tom's River, New Jersey says, "All applicants must possess a NJ LDTC Certification."12 Funny, rich white kids deserve trained, certified teachers. Of course, because rich white districts want to compare their student successes with those of the best districts in the nation. TFA and KIPP don't need trained, certified teachers. Of course they only compare themselves to the worst schools they can find.

This is colonialism at its worst. Imperial reductionism. Just as Iraqis should shut up about conditions created there by American idiocy because, "Saddam was worse!" and Black Rhodesians in the old British Empire were told to shut up because life was, "worse in the Belgian Congo," the students (and parents) offered TFA and KIPP are told to shut up because, "otherwise you get nothing at all."

Social Reproduction

TFA and KIPP embrace these very low expectations because those behind these organizations believe in elite divinity. As inheritors of wealth and privilege in America's Protestant mindset they believe that they must colonize and convert America's poor communities. Scratch the surface of the TFA and KIPP argument and you'll find these assumptions: (1) In order to become truly useful in America minority groups must become as much like white Protestant Americans as possible. (2) There are two ways to speed this conversion, through the forced compliance of repeated ritual (the KIPP school), and through appearing before these poor folks as magnificent white leaders who the poor can emulate (Teach for America).

We shouldn't be surprised. Both these efforts are standard colonial liberalism. Yes, the kind of liberalism associated with Ted Kennedy and Hillary Clinton and Lawrence Summers. Those born rich and powerful who will come down from their summer places to toil and sweat on behalf of the poor, who will give them the gifts of white culture, who will teach them to dress and speak and act in ways unthreatening to those in power. These people could put their efforts into the struggle to alter the circumstances of poverty - re-writing the tax code or equalizing education funding or eliminating the affirmative-action-for-the-rich which dominates Ivy League admissions and corporate hiring - but those are tough things to sell. It is so much easier to givet charity to the poor than to grant them rights.


None of this is to imply that I think America's teacher preparation programs are good. In most cases, they are not. Nor is it to imply that I do not believe in alternative certification programs, I do.

Teacher preparation programs must get much better. They must begin by revolting against the tyranny of a political system that destroys their ability to individually support learners. They must also revolt against a research funding system which defines success by measurements of industrial processing. Then they must help their future teachers to understand the vast, individually-variable world of cognition and child development. They must help them know the fullest range of possible learning routes. And they must help them to know how to fight against the ways in which schools demean and limit children.

And then they must demonstrate it. Every teacher preparation course needs to operate via universal design and differentiated instruction techniques. You can't not model these structures in every course and think that you'll ever change perceptions and practice. And every teacher preparation institution should be running at least one school which demonstrates what is possible, and must stop relying on student teaching apprenticeships which reproduce the system that we know does not work.

And every teacher preparation program must also reach out. If Teach for America actually wanted to improve the schools it is involved in, it would offer alternative routes to certification via community-located teacher training to those from those communities who have proved their commitment, but because of opportunity limitations are now working in the schools driving busses, or serving lunches, or working as classroom para-pros. Yes, I know, if they did that, Gregory's grandson wouldn't have this great line on his resume that proved how much he cared about the poor. But then, the school might have a twenty or twenty-five year teacher, a teacher who would get better and better with support and experience. And a teacher who would actually prove possibility to the children of that community.

It might also be important to note that if 5% of the endowments of the universities at the top of the contributors to the TFA corps was spent annually on actually trained, certified teachers, about 25,000 teachers costing about $150,000 per year could be added to America's schools (in other words, they could do it with a bit of their investment income). And they might be able to pay off the student loans of those teachers as well. In other words, the same people most in love with the TFA idea could solve the problem instantly, if they were willing to make a sacrifice. But that would be, a sacrifice. Instead, they choose the minimalism of charity.

So, the kind of people who now think Teach for America is "good enough for those kids," could be giving all kids the same things they want for their own rich kids. They could. But if you try to point that out they will scream at you, "This is all that's possible right now! And you want to take it away and leave the kids with nothing!" They will never actually start to discuss other ways of using the money which they control. This is important: Teach for America builds dependence - as all charity does. Re-directing resources can, on the other hand, alter the social order, and that has damn little appeal for those who currently sit at the top.

If it is a problem, it demands an actual solution

Teacher training in the United States is not good. It is almost universally conducted in ways that reinforce traditional practice - the kind that doesn't work. In-service teacher education in the United States is not good. There is not the time allotted, nor the money, nor is it situated in place and adapted for each teacher. Teacher pay - and thus teacher recruitment - in the United States is not good. If you want to attract and hold the best you must combine great pay (at least in capitalism-worshiping America) and good working conditions and a bit of status, and we rarely offer any of that. School funding in the United States is awful. The schools with the highest needs consistently have the least money, a system which guarantees a lack of social mobility.

With all those problems, Teach for America and its cheerleaders will tell you that the best solution all of their money and power can deliver is a bunch of untrained bright college graduates sent to be teachers of poor kids for two or three years.

"They" could do different things. "They" - those who fund and run TFA - could fight for real change, or they could use their own wealth and the wealth of the endowments of their favorite universities to fund real change. "They" - those young academic stars who join TFA - could volunteer or accept VISTA-like positions in schools across America, working in classrooms with small student groups, serving as one-to-one student support, providing curriculum extensions in schools which do not have a variety of extra programs, painting and repairing the buildings, driving students without dependable parental transportation to charter schools which might be better individual fits, watching playgrounds, supporting teacher and classroom technology use. But none of that would fit the political or social needs of those involved in TFA. Those actions might not be proof of their inherent superiority, and those actions might not look the same on a resume.

But I think there are better solutions. Just as I know that KIPP is "just good enough for the poor" because Greenwich, Connecticut's schools don't operate that way, I know that TFA is "just good enough for the poor" because Scarsdale, New York doesn't pick teachers that way. And I just don't believe anything that actually encourages the gap between rich and poor in America to be any sort of solution at all.

I think that Teach for America hurts the most vulnerable students in America, not just because it asserts that untrained short-term teachers are "good enough," but because it pretends the easy solution. A solution without sacrifice for the haves in the United States.

But if you feel differently, I'll happily sign you up for the nearest Doctors for America hospital. Trust us. We're bright, we're committed, we've got a bachelors degree in economics - I'm sure your operation will go just fine. Or if not that, perhaps you'd like to drive across the bridge built by our new Engineers for America. You could get there by flying with Pilots for America.

If it's good enough for you to recommend it, shouldn't you risk your life, our your child's life, to prove your point?

- Ira Socol

1 - http://www.teachforamerica.org/mission/mission_and_approach.htm with a few words changed.
2 - http://www.teachforamerica.org/corps/teaching/becoming_exceptional_teacher.htm with a few words changed.
3 - http://www.teachforamerica.org/corps/training.htm#institute_overview with a few words changed.
4 - http://www.teachforamerica.org/corps/training.htm#institute_overview with a few words changed.
5 - http://www.teachforamerica.org/about/our_boards.htm
6 - http://en.wikipedia.org/wiki/Hospital_Corpsman
7 - http://www.nytimes.com/2008/05/18/realestate/18livi.html
8 - http://daily.stanford.edu/article/2005/4/15/studyRaisesQuestionsAboutTeachForAmerica
9 - http://www.teachforamerica.org/mission/mission_and_approach.htm without changes.
10 - http://www.teachforamerica.org/corps/teaching/becoming_exceptional_teacher.htm without changes.
11 - http://www.cpsd.us/HR/Emp_Overview.cfm
12 - http://www.trschools.com/administration/employmentops.asp

Blog Alert! On BBC-Ouch! Goldfish sums up this year's Blogging Against Disabilism Day.
at Schooling Inequality there's a look at some of the recent blogosphere Social Justice debates.
Paul Hamilton on Flypaper. Lon Thornburg on the new text-to-speech phone from Kurzweil.
Karen Janowski's essential Thought for the Day. James Hollis has a great new IWB application.

The Drool Room by Ira David Socol, a novel in stories that has - as at least one focus - life within "Special Education in America" - is now available from the River Foyle Press through lulu.com

US $16.00 on Amazon

New! Digital version available through lulu.com

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HomerTheBrave said...

At the end of reading this excellent criticism, I'm stuck with the image at the end of 'If...' You know the one.

I think the upper-class education is failing, too, because it graduates people who think that the poor are stepping stones to be put in their résumé. The knife cuts both ways, in other words. Everyone misses out on something, and these mutually missing parts drive the momentum of inequity.

irasocol said...


No doubt. Boxes are boxes, even when some are far more comfortable than others.

-Ira Socol