By Ian Kingsbury
Sunday, May 26, 2024
Medical schools have eagerly embraced the DEI
(diversity, equity, and inclusion) agenda, which has supplanted merit and
excellence. Common sense says that’s a mistake, and a new study makes the folly
of that decision clearer than ever.
The study, published in the Journal of the American
Medical Association on May 6, observes that among newly trained
hospitalists, scores on the certification exam of the American Board of
Internal Medicine certification are positively associated with better outcomes
among hospitalized Medicare beneficiaries. Specifically, patients assigned to
internists who scored in the top quartile on the exam were 8 percent less
likely to die within one week of hospital admission than were patients assigned
to internists who scored in the bottom quartile. Patients assigned to the highest-scoring
internists were also 9.3 percent less likely to be readmitted within one week
of discharge than were patients assigned to the lowest-performing internists.
Together with past research indicating that students who score higher on
the MCAT (the medical-school entrance exam) tend to score higher on licensure
exams, the study in JAMA is a clear and unsurprising
indication that brighter doctors make for better doctors. If logic and wisdom
reigned, the findings would be heard as a clarion call for medical schools to
abandon the DEI agenda and redirect medical-school admissions to a central
focus on merit and excellence.
Unfortunately, however, DEI stalwarts have captured most medical schools and medical
institutions, so the findings are almost sure to be ignored. Flagrant and recurrent dishonesty and factual sloppiness among identity-obsessed zealots expose
that DEI is, rather than a mission to advance standards of patient care through
reason and evidence, a political crusade seeking to exact “justice” against
perceived systemic problems in American society, consequences be damned.
A tragic irony in the dismissal of reason, evidence, and
excellence among DEI acolytes is that it’s almost certain to inflict the
highest toll on the patients whom DEI ostensibly seeks to help. Consider, for
example, the case of the UCLA David Geffen School of Medicine. The school has
gone so far in abandoning merit in favor of racial considerations that “up to
half of UCLA medical students now fail tests of basic competence.”
Prestigious, resource-rich hospitals and clinics would
have good reason to steer clear of UCLA graduates. Likely, they will
disproportionately work in clinics and hospitals that treat economically
disadvantaged patients. In light of the findings of the JAMA study,
it’s a recipe for exacerbating health disparities.
Similarly bad logic was displayed in a recent hearing
that the Senate Health, Education, Labor, and Pensions Committee held on
“minority health care professionals and the maternal mortality crisis.”
Committee chairman Bernie Sanders (I., Vt.) emphatically asserted
that racial disparities in health are explained by the demographic composition
of the physician workforce and that more doctors from “underrepresented” groups
are needed. The solution, according to Sanders, is “to substantially increase the class sizes of Historically Black Colleges and
Universities (HBCUs).”
Sanders is wrong in both his diagnosis of the problem and
his solution for fixing it. The idea that patients benefit from racially
concordant care is a myth. Patients do best with highly capable doctors, not
ones who happen to share the same race. To that end, expanding enrollment in
HBCU medical schools is a remarkably foolish solution for addressing health
disparities. The four HBCU medical schools (Howard, Morehouse, Meharry, and
Charles Drew University School of Medicine) feature some of the lowest admissions standards among all medical schools in
the country. The results of expanding their enrollment to address health
disparities are all too predictable.
In medical-school admissions, the case for excellence
over identity couldn’t be more obvious. When DEI wins, everyone loses.
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