Harvard Professor Mourns Death of Racially Discriminatory Admissions in CME Course

Earlier this month, Stanford University offered a continuing medical education course in the form of a webinar titled “The Supreme Court’s 2023 Affirmative Action Ruling: What Does it Mean for Health Equity and Public Health?”

Speaking at the course was Dr. Michelle A. Williams, the former Dean of the Faculty at the Harvard T.H. Chan School of Public Health.

Williams offered a full-throated defense of racially discriminatory policies and criticized the Supreme Court’s decision in Students for Fair Admissions v. Harvard (which found racially conscious admissions illegal), justifying her arguments in the name of diversity and equity.

Particularly revealing was the language used by Williams to characterize the impact of this decision, and the regime she instead wished remained in place.

“Our conclusion was that the focus on racial neutrality was flawed,” Williams said.

Additionally, Williams mourned the ostensible negative effects of the Supreme Court’s decision, arguing that the lack of an ability to racially discriminate will impair healthcare.

“Medically underserved areas are going to be even less well served as a result of the workforce shortages,” Williams said. “There will continue to be a reduced ability to provide culturally competent care, affecting the quality of healthcare across diverse communities.”

Williams then proceeded to make several seemingly incorrect claims.

“We also know from emerging literature and well done studies concordant care, meaning the aligning of care with social and cultural status, leads to better health outcomes for marginalized populations and that concordant care can increase patient experience, can improve screening, which will improve preventive measures…and we’ve seen that mortality rates for black newborns for example, dropping by half when black physicians care for the patients,” Williams said.

It’s not clear what study exactly Williams is referring to, but her claim does bear a striking similarity to a false claim by Supreme Court Justice Ketanji Brown Jackson, which stated that “for high-risk black newborns, having a black physician more than doubles the likelihood that the baby will live.”

Justice Jackson’s claim is incorrect for a number of statistical reasons; but beyond that, the famous study often used to support racial concordance on the basis of improving black infant mortality is methodologically flawed.

Proponents of DEI and race-conscious admissions in medical schools have frequently cited the 2020 study, “Physician–patient racial concordance and disparities in birthing mortality for newborns,” to argue that medical schools should prioritize race in admissions in order to increase diversity among physicians and thereby improve care for minority patients. The 2020 study examined Florida infant mortality data and purported to show that the elevated infant mortality rate among black babies was partially reduced when black babies had black doctors rather than white doctors.

But a 2024 commentary published in the same journal, examined the same data and found that, when controlling for very low birth weights, the racial concordance effect becomes statistically insignificant in the most comprehensive statistical models that include hospital and physician fixed effects. 

Moreover, Williams’ general point about the positive effects of racial concordance are similarly incorrect.

Do No Harm’s report on racial concordance highlighted the fact that four out of five systematic reviews found no evidence to support the claim that racial concordance improves health outcomes. Moreover, the fifth systematic review suffered from methodological flaws, such as the unexplained omission of studies that contradicted its conclusion.

Williams then went on to provide recommendations for how schools can continue to pursue these diversity and equity goals.

“Staying within…the framework of our laws, the strategic acts that would be necessarily [sic] to counteract the decline in our healthcare workforce that is represented in our population would require us to continue to look for ways to expand how we do our admissions processes to be holistic,” Williams said. “Holistic means looking at socioeconomic factors, as well as the life experiences, along with the academic metrics of applicants.”

Although it’s not clear what decision-making process Williams has in mind, as Do No Harm has shown holistic admissions is often a proxy for racially conscious admissions; it provides a veneer of plausible deniability for medical schools to continue to consider race in their admissions decisions while devaluing objective metrics like MCAT scores and GPAs.

Williams then suggested scholarships for “diverse” students as a way to continue addressing health equity.

“Financial support is going to be important, particularly providing scholarships for…students of diverse backgrounds, particularly of low socioeconomic strata,” Williams said.

It’s worth noting that restricting access to scholarships on the basis of race is illegal; Do No Harm has filed numerous complaints against medical schools that offer racially discriminatory scholarships.

In sum, this course amounts to a defense of racially discriminatory admissions policies and a eulogy for racial discrimination. 

Needless to say, these ideas have no place in medical education, and are antithetical to the principles of merit and excellence that serve as the foundation of medical practice.

And in light of the Supreme Court’s decision, such ideas are illegal and should be confined to the dustbin of history.