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11 Dec, 2021 13:37

Diversity and inclusion are bad for people’s health

Diversity and inclusion are bad for people’s health

As a doctor, I am deeply concerned that the American medical profession is no longer a meritocracy and the desire to tick diversity boxes is considered more important. This ill-advised embrace of identity politics will cost lives.

American patients are in serious trouble.

Yes, poor patient behavior in the United States continues to drive chronic disease and healthcare expenses, as the obesity epidemic is only growing more dire and smokers and drunks keep killing themselves slowly with their self-abusive habits. But that isn’t why.

Yes, physician burnout remains pervasive and is increasing, especially in this exhausting age of Covid, as government bureaucracy and insurance companies and hospital administrations keep shoving burdensome paperwork, regulations, and requirements upon doctors’ weary shoulders, pulling their attention away from patient care. Yes, older doctors are selling out to corporations in droves, leaving their younger colleagues frustrated, overworked, and at the mercy of corporate suits who see medical professionals as costly assets, not caregivers. That isn’t why, either.

No, the American patient is in trouble because American medicine is embracing identity politics – “going woke,” as they say – and, as in every other sphere where neovirtues like “diversity” and “inclusion” have been crowned king, quality is going to suffer.

In this case, the patient will pay the price.

Medicine has always, until now, been a meritocracy, and for good reason: lives are literally on the line. It’s also perhaps the most naturally diverse field in existence, by every metric. Any operating room or hospital in the nation will find a comprehensive rainbow of ethnicities, males and females, liberals and conservatives, atheists and Christians and Muslims and Jews and Hindus, all working towards a common goal and for a common cause, and this diversity exists precisely because none of it matters. 

The sole consideration for determining who is allowed to deliver medical care, along with all the responsibilities and risks that entails, is: can you do the job? Medical training is a long and arduous gauntlet of hoops and hurdles, from high school until early thirties, designed to ensure that the answer to that question is “yes,” because every patient, every day, can’t afford for it to be otherwise.

That’s changing now, and it’s changing fast.

The American Medical Association is the most well-known professional physicians’ organization, wielding enormous influence nominally on behalf of all doctors (although fewer MDs belong to the AMA than might be assumed). In 2019, the AMA established the Center for Health Equity, whose mission statement reads, “The AMA Center for Health Equity works to embed health equity across the AMA organization so that health equity becomes part of the practice, process, action, innovation, and organizational performance and outcomes.”

Hey, the AMA heard you liked health equity, so they’re going to put more health equity in your health equity. What does this mean for patients? It’s hard to say, exactly, but it certainly sounds health equity.

The American Association of Medical Colleges is a nonprofit organization that represents academic medical institutions and oversees the Medical College Admissions Test as well as the application services for both medical schools and residency programs. In contrast to the AMA’s Center for Health Equity, the AAMC has a Center for Health Justice, but don’t worry: it, too, assures us that it’s working “to make progress towards health equity.” Together with the AMA, the AAMC sponsors the Liaison Committee on Medical Education, which accredits all programs that can grant a medical degree in the United States. In short, these organizations decide who will become a doctor. Historically, this process is extremely competitive, and only those students with the best grades and the highest MCAT scores were accepted.

But according to these organizations now, “merit” isn’t all it’s cracked up to be.

In October, the AMA and the AAMC released a document entitled Advancing Health Equity (health equity!), and anyone with an ear for buzzwords has already raised an eyebrow. It begins bizarrely with a “Land and Labor Acknowledgement,” a treacly, mewling apology for American “genocide and forced labor,” two historical phenomena in which certainly no physician alive today had any involvement. 

Soon after, we’re warned that “Narratives that uncritically center meritocracy and individualism render invisible the very real constraints generated and reinforced by poverty, discrimination and ultimately exclusion.” It’s difficult to glean any concrete meaning from such a muddied morass of verbiage, but “meritocracy” doesn’t seem to be very well liked. Reading on, every square in the social justice bingo card is filled: “critical race theory” is praised; “diabetic” is replaced with “person with diabetes,” as if this will lower any blood glucose levels; the biologically-nonsensical notion of “gender ideology” is affirmed; words like “blacklist” and “blackmail” are condemned as representative of “white privilege.” This sort of Orwellian silliness might be expected (but not encouraged) from a progressive college’s social studies department, but from medical organizations, it represents a serious concern for future patient safety.

Potential patients – that’s everyone – should be encouraged to read this baffling document for themselves. “Gender binary” is described, accurately to human biology, as “Classification of gender into...masculine and feminine,” then condemned as an “oppressive model.” It hopefully notes the “growing acceptance of the [hated by actual Latinos] term ‘Latinx’ in the US.” It’s like every pink-haired TikTok explainer video was strung together and transcribed.

This infection is spreading to every organ system, and symptoms abound. The American College of Obstetricians and Gynecologists released a brief about the Covid vaccine discussing “pregnant people” and “pregnant individuals” at length, yet never once use the term “pregnant women.” The American Board of Anesthesiology promises toweave diversity, equity, and inclusion into the ABA culture.” The American College of Surgeons invited open advocate for race-based discrimination Ibram X. Kendi to speak at its professional retreat. Pediatrics and psychiatry have long since capitulated to far-left politics, but now it seems as if no specialty is safe.

Fortunately, criticism for this philosophical shift away from the practice of evidence-based medicine towards nebulous Marxist identity-politics initiatives is mounting. Patient care must remain preeminent, and for that to happen the profession of physician must remain a meritocracy. Never mind that no doctor will appreciate the intimation that an MD was conferred primarily because she was female or his skin was a darker shade of brown, and not because of hard work, aptitude, and achievement. Imagine that this ideology does manage to redefine medicine in the view of the general public. Every woman and non-white physician will be viewed with an asterisk, and every white male will be assumed to be exemplary, else he would never have made it past the diversity quotas.

Ultimately, doctors can only do so much to push back against the press of progressivism into medicine. Patients themselves must demand that these organizations lose the politics and refocus on patient care. They must demand that the best and brightest, whether male or female or black or white, become the next generation of doctors, regardless of which or how many superficial “diversity” boxes those meritorious students might check.

Because in this case, “get woke, go broke” may actually kill people.

The statements, views and opinions expressed in this column are solely those of the author and do not necessarily represent those of RT.