Washington State Medical Association Undermines Law to Fund Racial Concordance

WSMA’s misguided policy is disrespectful to patients, physicians, and may be illegal

Why is the Washington State Medical Association raising money for a project that may be illegal? WSMA, the state chapter of the American Medical Association, appears to be offering racially discriminatory funding, via its foundation, with its new Scholarship and Diversity Advancement Fund.

The foundation says its intent is “to build a more diverse physician population in Washington state by supporting students who are underrepresented in medicine.” Its website notes that racial and ethnic minorities comprise 30 percent of the U.S. population but “only about 10 percent of practicing physicians are Latino, African American, Native American or Alaska Natives combined.”

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In its push to increase the number of racial and ethnic minorities in the medical field, the WSMA Foundation is establishing a scholarship fund based on “racial concordance” – a deeply flawed and misguided theory that suggests patients receive better care when treated by practitioners of the same race.

Its website claims: “Physician and patient racial concordance contributes to a more effective therapeutic relationship and improved health care. When the physician is the same race as the patient, patients report higher levels of trust and satisfaction and demonstrate greater treatment compliance. At the same time, medical students trained at diverse schools are more comfortable treating patients from a wide range of racial and ethnic backgrounds.”

Yet, medical research does not support these claims.

Certainly, disparate health outcomes are real challenges facing the American healthcare system, but racial concordance mandates in our hospitals and clinics often fail to account for the severities of patient illnesses and risks of mortality – among other factors – and are not meaningful solutions, as our December 2023 report –“Racial Concordance in Medicine: The Return of Segregation” found.

“The implications for racial concordance should be clear. First, attempts to match patients to doctors on the basis of race hold no promise for producing better care or better outcomes. Instead, as common-sense dictates, patient-provider pairings should be determined by convenience, practicality, and expertise. Second, efforts to increase the number of doctors from any particular racial group will not result in better patient care,” the Do No Harm research discovered.

Further, prioritizing diversity in student admissions at medical schools by offering scholarships to members of underrepresented racial and ethnic groups gives unfair preferential treatment to certain students. Indeed, this practice also circumvents the Supreme Court’s June 2023 ruling against affirmative action in education.

The WSMA seems undeterred.

In May, the WSMA and Washington’s three medical schools — the University of Washington School of Medicine, the Pacific Northwest University of Health Sciences College of Osteopathic Medicine, and the Elson S. Floyd College of Medicine — issued a joint statement expressing support for diversity, equity and inclusion (DEI) efforts in medicine. “These efforts are foundational to increasing health care access, quality of life, and the experience of belonging in our communities, along with striving for the highest attainable standard of health for all,” their statement professed.

However, even they acknowledge that there is growing momentum to push back against these and other similar efforts— now including a bill in Congress that proposes to end federal funding for U.S. medical schools with DEI programs — which “may have consequences for the work we’re doing here in our state.” In the field of medicine, where a health care provider’s competency can make a life-or-death difference, a smarter approach to qualifying medical school admissions is to emphasize strong academic readiness, as our report suggests.

Yet, with its Scholarship and Diversity Advancement Fund, the WSMA Foundation has set a goal of awarding full-tuition scholarships for four years to three students annually, one at each of Washington’s medical schools. It aims to initially secure $2 million to $3 million to endow the fund, and then to increase that fundraising goal to $5 million (in mid-May, it had raised just over $780,000). Criteria for a scholarship is based on obtaining admission to a Washington medical school, meeting the Association of American Medical Colleges’ definition of “underrepresented”. and having a “commitment to advancing health equity.”

According to the foundation, 15 percent of students overall at the three medical schools in Washington are Black/African American/African, Hispanic/Latinx, Pacific Islander/Hawaiian Native, and American Indian/Alaska Native (using data from 2022-2024). Two of the universities offer no full-tuition scholarships; the other offers a few, the foundation says, though it does not explain the demographics of scholarship award recipients.

To emphasize the importance it places on diverse racial representations, the foundation cites a 2022 working paper by the National Bureau of Economic Research, claiming that “patients who share racial characteristics with the physicians treating them demonstrate higher rates of both treatment compliance and personal satisfaction” and that “newborn/physician racial concordance is associated with a significant improvement in mortality for black infants.” 

These claims simply do not align with the preponderance of evidentiary scholarship, including the research conducted by fellows at Do No Harm.

While identifying the causes and potential solutions to meaningfully address racial health disparities is a worthy cause, restructuring the provision of healthcare in America along racial lines – based on faulty and misguided information – isn’t the answer. Pursuing this agenda fosters distrust between physicians and patients of different races and doubt among patients and physicians about the qualifications of providers.

We can chart an alternate path – one that promotes wellbeing, confidence in the capacities and preparedness of our medical professionals, and protects patients from profiling that leads to diminished outcomes and increased sociopolitical divide.