California Physicians’ Group ‘Summit’ Urges Doctors to Promote the ‘Health Equity’ Ideology – But Dr. Marilyn Singleton Pushes Back

Physicians for a Healthy California (PHC) – the philanthropic arm of the California Medical Association (CMA) – recently called upon the state’s doctors to make “health equity,” a Critical Race Theory (CRT)-inspired doctrine, a priority in their practices.

PHC held its Health Equity Leadership Summit on September 14-15, 2023, in San Jose.

The concept of “health equity” claims that “systemic racism” and “oppression” create substantial barriers for minority individuals who encounter the healthcare system. According to this ideology, achieving “race concordance” between minority doctors and patients means more people from minority racial and ethnic groups would obtain better health care.

This claim has been translated into diversity, equity, and inclusion (DEI) policies and practices to admit more minority medical school applicants to the nation’s medical schools – even if merit and abilities take a back seat to race and ethnicity.

A “welcome” letter to summit attendees obtained by Do No Harm (DNH) announced PHC’s interpretation of health equity – one that seems to prefer politicized virtue-signaling to sound medical and scientific knowledge:

The pursuit of equity is one that requires humility, empathy, persistence and teamwork. As part of PHC’s Strategic Planning Initiative, which began in earnest last year, the PHC Board has been reflecting on our work in the space of advancing health equity and our role in the broader health equity ecosystem. We seek to expand beyond our historic work with the Network of Ethnic Physician Organizations (NEPO), and its cornerstone Annual Summit, while we consider innovative ways to discuss and advance equity in our health care system.

According to the organization, the summit event sought to train “physicians, executives, advocates, and allies” in how to promote the issue of health equity in California by caring for “underserved communities throughout the state.”

Workshops at the summit provided encouragement to attendees to embrace the health equity philosophy in their practices. Session titles included:

• Health Equity Leadership in Practice: A Discussion of Chief Health Equity Officers
• The Diversity Tax, Moral Injury and Career Satisfaction: How Medicine Can Attract and Retain Talent
• Showing Up as Your Authentic Self
• Incorporating Equity Practices throughout Your Career
• Developing and Advocating for Equitable Health Policy

Marilyn Singleton, M.D., a retired anesthesiologist and DNH senior fellow, attended the two-day summit.

“My overall impression of the conference was that the speakers were grim in their outlook on life,” Singleton, an accomplished black physician, told DNH during an interview. Dr. Singleton noted that some of the presenters at the summit were also competent minority women who nevertheless still feel the need to communicate “a sense of hopelessness and perpetual racism.”

“I find it curious that people who have made it, don’t speak from a place of ‘you can do it too,’” she explained, adding:

Yes, there are problems in health care. Yes, there are problems in America. But the fact that we’ve gotten where we are– I mean one of the panelists was an orthopedic surgeon, my goodness! There’s not that many women in ortho in the first place, and, now, she’s a black woman! Like how did you do it? And what does it take? And you must have had gumption and so many positive characteristics! But that’s not what they’re saying at all. It’s negative, negative. I think the same woman said there’s a diversity tax … to do more volunteer work and mentoring because of your gender and color.

Marilyn Singleton, M.D., Do No Harm senior fellow

“You should be proud that somebody’s asking you how you made it and not looking at everything from such a negative point of view,” Singleton responds to such complaints. She observes that embracing a positive perspective “doesn’t deny that there’s issues, but we’re looking for solutions, not a way to just drill down on problems.”

Singleton added another theme of the summit was the notion that “patients have no agency,” and no responsibility to take charge of their medical care.

“Everything is done to them” was the narrative of the presenters, one that, she said, amounts to “a racist view in itself.”

Groupthink pervaded the summit, Singleton continued, noting that questions for the presenters had to be submitted via an app that presumably sent them to someone who vetted them. She said she attempted to submit a question reflecting the lack of positive views of the accomplishments of some minority physicians, but it wasn’t selected for consideration.

Singleton also observed the irrationality of the agenda that insists such CRT-inspired “equity” programs will change decades of minority social circumstances.

“All this stuff to me is missing the whole problem,” she said, elaborating:

You need to go back to when these kids are in kindergarten. Don’t sit here and try to make some sort of program when somebody’s graduated from college already. Education-wise, it’s already too late. Unless you start way back when you can get the kids on an even keel and out here in California, my goodness, what is the new stat? Only 34% of kids are at grade level in English and maybe 40-something in math. So that’s what you have to change. And to have this over-focus on finding black residents or finding black people for medical school. Maybe they’re putting the cart before the horse in that particular arena that we’ve got to get back to basics, but nobody wants to do that because you’d actually have to sit down and quit sort of flapping your gums and do something, and pick up some policies that might be helpful, like school choice and all these things that have been fought for years. So, until we change all that, I don’t think anything’s going to change by the time you get up to medical school and residency.

A summit session panel, for example, featured Manisha Sharma, M.D., senior medical director at Blue Shield of California, referring to doctors who work with patients to encourage them to change their behaviors in order to improve their health as physicians who are “trained to blame and shame.”

“You’re the problem, you don’t eat right, that’s why you’re obese,” Sharma characterized an attempt to teach a patient how to take responsibility for her health.

“The entire time there was absolutely no focus on personal agency,” Diana Blum, M.D., a California neurologist who also attended the CMA/PHC health equity summit, told DNH:

There’s no sense that physicians are supposed to help empower patients to take ownership of their health. There was none of that. And what I found fascinating is here you have these big healthcare organizations that are supposed to really care for you from cradle to death, right? So, you should care about empowering patients to make healthy choices. But it was all about blaming the system. It’s not your fault. It’s the system that’s scapegoating you.

Diana Blum, M.D., California neurologist

Sharma, who identified herself as a “physician-activist” who views everything through the lens of “equity,” also told physician attendees they should all ensure their patients register to vote.

“That means everybody who comes through our doors, every person that you see in the gas station, everybody that you have on the street that you’re taking care of” should be registered to vote, she said.

LGBTQ-activist speakers reportedly schooled physicians attending the health equity summit on pronoun usage and provided a “resource” containing an LGBTQ glossary of terms.

“It was really bizarre,” Blum said. “How is it that we’re being lectured by folks on something that is not even scientific? What I read was anti-science, and they’re lecturing to physicians? I didn’t feel like these people were even educated on what they were saying – they couldn’t answer any of the questions about the pronouns that were asked of them.”

“Why are we wasting our time learning this and how is it going to actually improve patient care?” Blum asked. “None of that made sense to me.”

Both physicians walked away from the CMA/PHC health equity summit experiencing a sense of “lost opportunity” that doctors’ time could have been spent strategizing for real solutions for patient health problems, instead of blaming “the system” and allowing a radical political ideology to snatch power away from individual patients.

“I just felt like it was a lost opportunity, to be honest, because there are major issues that I face every day in my practice,” said Blum, elaborating:

For example, not being able to get the medication my patients need, because of, in my opinion, all the conflicts of interest. Given the stakeholders involved, this was an opportunity to actually discuss how do we make care more affordable, how do we actually increase access and not scapegoat so-called “white supremacy” culture, but actually improve the quality of the care that we’re getting.

“That’s what frustrated me,” she said. “Doctors don’t have much time. So, we’re taking time out of our busy schedule and making an effort to learn and to improve our practice. This was just a total waste on all fronts.”

While Singleton acknowledged some physicians may not be aware of what some minority or LGBTQ patients experience, her overall view of the “grimness” of the presenters, and the extent to which they blamed “the system,” gave her the sense “they were more wanting to create drones than educating people about things they may not know something about – like an army of social justice drones.”

“But there’s a difference between getting informed versus getting indoctrinated,” she said.

Despite the great effort by woke medical schools and associations to create a need for “racial concordance” between doctors and patients, DNH has already shown there is no evidence to support patients benefit from it with improved healthcare outcomes. As noted in the December 2023 report, overwhelming evidence suggests “it is irresponsible for medical organizations and political actors to push, in practice or policy, for racial concordance in medicine.”

 The “attendant radical restructuring of healthcare along racial lines,” the authors added, “amounts to the return of segregation of medicine, sowing seeds of distrust between physicians and patients of different races.”

“The idea of separating the races should be relegated to the ash heap of history,” the authors concluded, “not revived by the false and dangerous claim that they are needed to improve health outcomes.”