“Top Doctor” Company Castle Connolly Is Up To Their Same Old Racial Concordance Tricks

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Last year, Do No Harm reported how Castle Connolly—a New York City-based company that publishes top doctor rankings—jumped on the woke bandwagon by launching their DEI initiative that pushed for racial concordance.

Racial concordance is the false belief that patients have better health outcomes after seeing doctors of their own race. It is a thinly-veiled effort to push racial segregation in medicine under the guise of advancing equity. Yet companies like Castle Connolly are back at it again, pushing racial concordance despite all the evidence to the contrary. Recently the company published their “2024 Top Black Doctors” to allegedly “honor top clinicians and enable patients to find Castle Connolly Top Doctors who have shared backgrounds and experiences.”

Figure 1. From the Castle Connolly’s 2024 Top Black Doctors webpage.

Unfortunately, Castle Connolly is not the only entity pushing for racial concordance. For example, the Association of American Medical Colleges (AAMC)—which represents all accredited medical schools in the United States—has wholeheartedly endorsed the concept. Other medical organizations, such as the American Medical Association and American Academy of Pediatrics, have echoed this view.

But there’s more to come: in their press release, Castle Connolly also teased their plans to launch several other so-called “distinctions”, including “Exceptional Women in Medicine”, “Top Asian American and Pacific Islander Doctors”, “Top LGBTQ+ Doctors”, and “Top Hispanic and Latino Doctors”. Apparently, advocating de-facto racial segregation among one race is not enough for Castle Connolly—they are intent on pushing racial concordance in all racial groups equally. It bears a jarring resemblance to the “separate but equal” doctrine that has long been abandoned by American society.

However, just because an idea is increasingly popular among the medical establishment does not mean it is true.

In late 2023, Do No Harm published an exclusive report—entitled “Racial Concordance in Medicine: The Return of Segregation”—which evaluates several systematic reviews of racial concordance studies. Unsurprisingly, in nearly all of these reviews, racial concordance was not associated with any improvement in medical outcomes. And in the few instances in which a small number of academic articles suggested otherwise, these analyses typically suffered from fatally-flawed study designs.

Indeed, as Do No Harm researchers Ian Kingsbury and Jay Greene noted in their report, “the fashionable idea that doctors see patients as members of a racial group rather than as individuals fails to withstand scrutiny—and it promises a return of racial segregation.”

Make no mistake: Castle Connolly and the woke medical elite would rather side with the cherry-picked, flawed data of fringe activists pushing segregation in medicine than follow the actual evidence.

In addition, the Castle Connolly list of the Top Black Doctors is also, ironically, lacking geographical diversity. Their Top Black Doctors only hail from 30 different states, meaning doctors representing 40 percent of the nation’s states are entirely missing from the list. And among those states, there is a remarkable geographic concentration in just a few cities. For example, 20 percent of the list’s 240 doctors are from Atlanta, Georgia and Columbus, Ohio alone.

In other words, patients in need of finding a top doctor outside of a few population centers in less than two-thirds of states are completely out of luck. However, this could be interpreted as an encouraging sign that there are still many doctors that are resistant to the idea of nominating their peers to be on a racial concordance-based list.

Even more ironic, however, is that Castle Connolly’s primary search page for doctors offers no opportunity for users to filter potential medical providers on the basis of race. Distance, specialty, insurance, language, and other key factors are all optional search filters—but not race. It is almost as if race is not a relevant consideration for patients when finding a doctor!

Figure 2. Search categories for “top doctors” on Castle Connolly website.

Ultimately, patients deserve the right to choose the best doctor for them. Unfortunately, Castle Connolly and other organizations are perpetuating the myth that racial concordance should be a determining factor in finding the right doctor. Ultimately, the best doctors should be determined on the basis of their merits—not the color of their skin. The sooner that the misguided beliefs of racial concordance—which are rooted in medical segregation—are repudiated, the better.

Biracial Therapist Believes Focus on Race Hurts Patients

“Hello, I’m looking for a black therapist. I saw your profile. I’m looking for a black guy, I need someone who can relate to me.”

Rodney Long Jr., MSSA, LISW-S, has lost track of how many times this voice message, or something similar, has been left on his work phone.

Rodney is a mental health therapist with a private practice in Ohio. He’s also biracial, and feels that is wholly irrelevant to the way he approaches his work.

“I grew up in poverty with parents in addiction,” Rodney explains. “I work with black doctors, lawyers, and teachers. A lot of times, our backgrounds don’t relate over anything except our skin color.”

In Ohio, the pressure to define and divide people based on race is coming from the top. The Counselor, Social Worker, and Marriage & Family Therapist Board — which oversees critical parts of the behavioral health field in Ohio — uses discriminatory practices to select who is eligible to join the Board. Specifically, it prioritizes race over levels of expertise.

“People are pushing for therapists to put more and more weight on identity and race, and less on individuality,” Rodney says. “We’re doing our clients, and the field, a disservice by doing so. Making assumptions about who people are should not be a core tenet of counseling. I don’t bring any of that stuff into the session.”

It wasn’t always this way. “When I started in 2013, the big worry was opiates. But in 2020, with Covid and George Floyd, there was a big push to get more black people into therapy,” he remembers. “Now there are entire practices opening up under the premise of being a black therapist that reinforce a belief that there is inherent trauma among black people that only other black people can understand.”

Rodney feels this is dangerous. He’s relieved nobody told him he was a “victim” when he was a young man because he may not have worked to overcome his difficult childhood and build the life he has today.

“The idea that you can tell me that I’m black, so I’m a victim, or I carry around something, is ridiculous to me,” Rodney says.

“If you told me when I was 10 years old that I was at a disadvantage, I would not be where I am today. And that’s what worries me. We’re telling kids, young children and young men, that they are at a disadvantage—and that if someone doesn’t look like they do, that person can’t help.”

Rodney knows from experience how powerful different perspectives can be. When he was a freshman in high school, his parents were in the depths of their addictions. Without the daily support and encouragement from a teacher and a guidance counselor at the school, Rodney might not have made it to graduation.

They also inspired Rodney to go into a helping profession. “These people were the reason I originally wanted to go into education,” he remembers. “I wanted to help someone else the way they helped me.”

Rodney had missed 100 days of school in the 8th grade and worked overtime to catch up in his academics. He made it to college, where he met a professor who became a mentor and convinced him to try social work. He cheered him on all the way to graduation and they are still close today.

“Everybody has somebody they can look to and rely on for guidance and support. The problem is that we start saying things like, ‘well, you’re not black, so you don’t understand.’ Or you didn’t grow up poor, so you don’t understand,” Rodney says. “Let me tell you, none of the people who helped me out the most were from where I was from. The most influential people in my life were people who were not like me.”

Nobody was telling Rodney that he couldn’t do it. They were only telling him that he could. Rodney’s mentors put him on the path toward the most rigorous education possible. And today, for so many students of medicine and mental health, that wouldn’t be the case.

Stories like Rodney’s are exactly why Do No Harm opened its doors.

America’s future practitioners get the best training—and patients get the best care—when we put education and grit over politics and ideology.

City of Hope’s New Thrust: ‘Infuse DEI Into Our DNA’

Employees at the renowned cancer center City of Hope in southern California can earn a $1,000 bonus for referring job candidates who are black or Hispanic Americans, American Indians, Alaskan Natives, Native Hawaiians or other Pacific Islanders if they are hired, an internal hospital email discloses.

The extra money offered through the hospital’s Employee Referral Program is part of City of Hope’s push to ensure that “we infuse DEI into our DNA,” says the Jan. 27, 2023, email marked “Dear Colleagues” and signed by Joline Treanor, System Chief Human Resources Officer, and Angela L. Talton, System Senior Vice President and Chief Diversity, Equity and Inclusion (DEI) Officer.

Since the start of last year, City of Hope has broadened the definition of its “underrepresented groups” beyond “Hispanic/Latinx and Black/African American.”

“With this more inclusive definition, referrals of American Indians/Alaskan Natives and Native

Hawaiians/Other Pacific Islanders when hired will result in a higher payout to you,” Treanor and Talton write. “Successful referrals that fall within these categories who are hired into eligible positions will receive the approved employee referral bonus ranging from $500 to $5,000 PLUS an additional $1,000.”

Figure 1. Email from City of Hope Chief HR and DEI Officers (January 2023).

City of Hope launched its Employee Referral Program in January 2022 “with additional incentives to help build our diverse workforce,” the two officers explain. And involving employees in the effort appears to be paying off.

“To date, your active participation in the program has generated an increase in diverse referrals of 63%. By sharing our open jobs with your network, you have made a difference that truly matters,” they write in the January 2023 email.

Broadening the group to include Native Americans, Alaskans, Hawaiians and other Pacific Islanders means employees potentially can earn the extra $1,000 for helping to recruit a new employee of any race or ethnicity except Asian or white — even though census data for 2021 showed whites, Hispanics and Asians as the three most common ethnic groups among the 21,700 residents of Duarte, California, where the main medical center is located.

City of Hope also has locations in Orange County (Irvine), California, and the Atlanta, Chicago and Phoenix areas.

“We are making this change in support of our Indigenous Peoples Alliance employee resource group (ERG) and to align our City of Hope definition to that of the National Institutes of Health,” the email concludes. “We believe, in addition to this being the right thing to do at City of Hope, it demonstrates the integral role our ERGs play in ensuring we infuse DEI into our DNA.”

The City of Hope location in the Los Angeles area is a National Cancer Institute-designated comprehensive cancer center. Having pioneered research and treatments for cancer, the medical center has been ranked for more than a decade as one of America’s best cancer hospitals by U.S. News & World Report.

The slogan “Infusing DEI into our DNA” is a recurring theme at City of Hope. The phrase was central to its Diversity Week celebration from Oct. 2-6, 2023, according to emails sent to employees on Sept. 29 and Oct. 6, which were also shared with us. The week’s activities kicked off with two half-hour sessions on City of Hope’s “leadership commitment” to DEI efforts with CEO Robert Stone, Executive Vice President and Chief Transformation Officer Debra Fields, and Talton, the chief DEI officer.

“Hear our leaders speak to the importance of diversity, equity and inclusion (DEI),” said the first email encouraging employees to register for events. The second email, outlining activities to wrap up the celebration, noted that daily videos throughout Diversity Week included some by “leaders across the system” on the topic of “DEI accountability.”

Healthcare organizations must base their hiring decisions on the qualifications of applicants, not on racial characteristics. In the same way that individuals shouldn’t be denied a job because of the way they look, they shouldn’t be given one based on their appearance. With more than 11,000 employees systemwide, City of Hope would do well to concentrate less on ideologically-driven DEI initiatives and more on its mission to provide “exquisite care, innovative research and vital education focused on eliminating cancer and diabetes.” Rather than offering employees extra money to recruit colleagues from minority ethnic groups, City of Hope’s leaders should be reminding them of the pledge on its website: “All of us are united by our desire to find cures and save lives.”

S2E6: Lindsay Bednar, the Mom Who Took on the Local School Board over DEI Initiatives and Won

Lindsay Bednar is a former teacher and a mom of two young students in one of the largest school districts in Minnesota. Over the past year, Lindsay started hearing that schools in the district were pushing unwanted ideologies onto students at all levels, from elementary to high school. All of them traced back to DEI initiatives that were overstepping boundaries and breaking trust with parents. Lindsay knew she had to speak up.

Listen in via YouTube, Spotify, or Amazon Music.

Key States Gear Up to Advance Detransitioning Protections

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In an attempt to assist individuals seeking to detransition, state lawmakers across the country are advancing legislation that would provide critical insurance-related protections.

HB1639, introduced by Rep. Doug Bankson (R-Apopka) and Rep. Dean Black (R-Jacksonville) of Florida, would require insurance companies that cover gender reassignment procedures to also provide coverage for any treatment to detransition, in addition to several other provisions of the bill. The legislation is currently moving through the legislature and has passed out of both the Select Committee on Health Innovation and the Insurance and Banking Subcommittee. Opponents of the legislation include Democratic legislators and activists, as well as insurance companies that would potentially bear responsibility for providing coverage.

Several individuals have testified in favor of the bill. For example, Aaron DiPietro, Legislative Affairs Director of the Florida Family Policy Council, noted that “Detransitioners are real and deserve protections and empowerment. And as more of these patients share their stories nationwide, the public is increasingly aware of the lifelong risks of gender medicalization. Detransitioners have often been neglected by health insurance companies and the medical establishment, despite often suffering severe and irreversible complications from treatment. Health insurance companies must be held accountable and provide at least some relief and coverage to help these hurting people find some measure of healing. After all, the insurance companies were the ones funding the original procedures that are being regretted.”

In Arizona, SB1511, introduced by Sen. Janae Shamp (R-Phoenix) would similarly mandate that insurance companies covering gender transitioning procedures also be required to cover detransitioning procedures. As Senator Shamp noted “There are dozens of medical billing codes for gender-affirming care. But there’s not one single for patients seeking to cease gender-transition therapies and reclaim their God-given gender.”

SB1511 has had over 75 individuals file in support of the bill, where it is currently pending before the Arizona Senate Health and Human Services Committee. While there has also been turnout against the bill, those filing in opposition to the legislation are more likely to be registered lobbyists compared to those filing in support of the bill. Additionally, among these registered lobbyists, several filed in opposite to the bill for multiple clients, inflating the number of those carding against the legislation.

Similarly, in Tennessee, HB2816 introduced by Rep. Jeremy Faison (R-Cosby), and companion legislation SB2396 introduced by Sen. Richard Briggs (R-Knoxville), would also require insurance entities that cover transition procedures to additionally require detransitioning procedures. The legislation imposes a similar requirement on state funded gender clinics that perform gender transition procedures to also perform detransition procedures. Both companion bills are currently being considered in committee.

And finally, while not precisely identical to the other measures, SB304 (introduced by five Senators in New Hampshire) would create a legal cause of action for medical injuries that result from certain gender reassignment procedures, while providing protections for those who pursue medical detransitioning.

These legislative efforts—and others throughout the country—are crucial attempts to both provide necessary services for individuals seeking to detransition and to hold insurance companies accountable for their actions in covering transitioning procedures that may cause irreparable and lasting damage on a patient.

In fact, several of these bills contain provisions that resemble the key tenants of the protections contained in Do No Harm’s “Detransitioner Bill of Rights”. Section 6 of the bill of rights model legislation calls for a “right to insurance coverage” that includes, among other provisions, coverage for detransitioning procedures.

Policymakers across the country can consider critical insurance protections—such as those contained in the legislation being considered in Florida, Arizona, Tennessee, and elsewhere—to help protect individuals seeking to detransition.

Wanted: Black Interns Only?

The incorporation of racial bias and race-based admissions into medical internships is, unfortunately, alive and well. A perfect example of these types of woke initiatives can be gleaned from the “GROW RegenMed Internship Program” sponsored by the Alliance for Regenerative Medicine (ARM).

This internship program allegedly provides “crucial, early-career paid opportunities in the regenerative medicine sector for Black undergraduate and graduate students.” In fact, the very first eligibility requirement listed on the internship application is that “Interns must identify as Black/African American.”

Figure 1. Eligibility requirements of the ARM’s GROW Student Intern Application.

ARM’s GROW RegenMed Internship Program was originally launched in 2021 with 17 inaugural interns. According to a press release at the time, the internship program was the product of ARM’s “Action for Equity Task Force” formed “in the wake of the murder of George Floyd.”

ARM claims to be the “leading international advocacy organization championing the benefits of engineered cell therapies and genetic medicines for patients, healthcare systems, and society” representing “more than 400 members across 25 countries”. The organization is structured as a 501(c)4 organization, meaning it is designated as tax-exempt by the IRS. In 2022, the organization generated more than $15 million in revenue and recorded nearly $14.5 million in expenses, including roughly $620,000 in compensation to its outgoing CEO.

ARM is not the only organization incorporating racially-based admissions or hiring programs in recent years.  Do No Harm previously published an exclusive report highlighting how racial, ethnic, and gender-based factors were growing in prevalence at medical schools, such as the University of North Carolina School of Medicine. Similarly, a Do No Harm analysis of the 2024 American Medical College Application Services (AMCAS) reported how identity politics were seeping their way into decisions related to the acceptance of candidates. And, perhaps most notably, earlier in 2024 Do No Harm agreed to settle its lawsuit brought against Vituity’s Bridge to Brilliance Program­–an initiative that incentivized black doctors, including through $100,000 sign-on-bonuses—after the company ended its incentive program.

Additionally, Do No Harm has filed multiple complaints with the U.S. Department of Education (DOE) and the U.S. Department of Health and Human Service (HHS) Offices of Civil Rights (OCR) regarding similar discriminatory practices in the medical field. In 2023 alone, Do No Harm filed 150 federal civil rights complaints with the DOE and HHS OCRs, resulting in 40 federal civil rights investigations. Several of these investigations resulted in favorable decisions to remove discriminatory practices, whereas others led to the institutions of higher education quietly scrubbing their websites of the questionable programs. As was the case with Vituity and these OCR complaints, ARM’s internship program raises serious questions about compliance with federal civil rights laws, equal protection, and even the Affordable Care Act. At best, however, the program is a case-in-point example of how woke ideology has deeply infiltrated the medical field. Other medical organizations would do well to avoid following ARM’s lead. Instead, candidates for internships should be selected on the basis of their merits, not their racial or ethnic background. Do No Farm Founder Dr. Goldfarb put it best: “Patients want and deserve the best doctors and the best medical care regardless of skin color or the racial makeup of their physician.”

Johns Hopkins DEI Officer and AAMC Are Aligned on the Definition of “Privilege”

The Johns Hopkins University Chief Diversity Officer Dr. Sherita Hill Golden is under fire for sending an email that labels all white people, males, and Christians (among others) as beneficiaries of “privilege.”  Turns out, she was simply taking cues from the Association of American Medical Colleges.

The definition used by Golden almost perfectly mimics the AAMC’s definition of privilege. Screenshots indicate that the language was lifted without attribution, though it is possible that it appears somewhere else in the email.

From AAMC’s “Power & Privilege Definitions.”
From January 2024 email by Johns Hopkins University Chief Diversity Officer Dr. Sherita Hill.

Golden’s definition adds “cisgender people” (i.e., anyone who is not transgender) to the list of “privileged classes” and changes a few words in the first paragraph, but otherwise lifts language directly from the AAMC. The AAMC’s definition tracks with their commitment to identity politics and woke radicalism. For example, the organization—which oversees the Medical College Admissions Test (MCAT) and cosponsors the organization that accredits all medical schools in the United States— encourages medical schools to implement DEI policies and surveys them about their adherence to such policies. Indeed, it’s no coincidence that the same definition of “privilege” is also peddled by the Emory University School of Medicine.

From “Diversity Terms and Definitions for Orientation,” Emory University School of Medicine.

Fish rots from the head down. Restoring medical education to focus on rigor and excellence instead of identity and activism requires dramatic changes at the AAMC and other important gatekeeping institutions.

S2E5: Dr. Roy Eappen on How “Gender-Affirming” Care is Hurting American Children

While Europe pulls back from so-called “gender-affirming care,” the United States keeps pushing the ideology on its citizens. Dr. Roy Eappen, an endocrinologist certified by the Royal College of Physicians of Canada, wants to know why America is moving in the wrong direction and ignoring the science. He believes the “mental and physical health of American children are now at risk.”

Listen in via YouTube, Spotify, or Amazon Music.

Do No Harm Physician Member Pens Letter to the Editor in Naples’ News-Press

In a letter to the editor titled “Unwarranted charge of systemic racism,” Do No Harm member Dr. James Lally responded to claims of bias causing health disparities in a regional publication’s article.

The recent article in the Naples Daily News from the Center for Public Integrity that contends: “documented and widespread biases and racism contributing to disparate health outcomes for certain populations” is a seriously flawed and cynical attempt to infect medicine with the unwarranted charge of systemic racism. Just one example shows how controversial data has been cherry-picked. The authors reference the landmark study from the Institute of Medicine, Unequal Medicine, and report that: “bias, stereotyping and prejudice could be playing a contributing role.” A role in disparate health care outcomes. A close reading of that extensive report in the summary of part 4 has quite a different statement: “In summary, the committee found no direct evidence that racism, bias, or prejudice among health care professionals affects the quality of care for minority patients.” Do No Harm is an advocacy group of health care professionals that seeks to treat patients with dignity without the cloud of racism and prejudice marring that encounter. In their mission statement they aim to: “protect patients, physicians, and health care itself from radical, divisive ideology.”

James F. Lally MD, Naples, member, Do No Harm

We thank Dr. Lally for his support, and for highlighting the facts surrounding the oft-repeated narrative related to so-called “implicit bias” in healthcare.

Hospice and Palliative Care Credentialing Center Prioritizes DEI and Belonging over Merit and Competency

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Hospice and palliative nurses care for some of the most complex patients and their families during a time when they are at their most vulnerable. Because of the multifaceted nature of their medical conditions, these patients depend on the clinical knowledge and skills of their nurses. But “the premier national credentialing organization” that certifies these nurses aims to prioritize identity politics over merit with a new strategy.

The Hospice and Palliative Care Credentialing Center (HPCC), which offers specialty certification exams for advanced practice nurses, registered nurses, pediatric hospice and palliative nurses, licensed practical/vocational nurses, and nursing assistants, prides itself on “advancing expert care in serious illness through state-of-the art certification procedures.  HPCC recently announced its “Multiyear Diversity, Equity, Inclusion, and Belonging (DEIB) Strategic Initiatives,” which aims to enshrine DEIB within its organization by “identifying internal and external barriers to achieving certification and providing opportunities to alleviate disparities and remove systematic biases.”

Figure 1. HPCC DEIB Strategic Initiatives.

Those initiatives included the formation of a DEIB task force in 2023, made up of individuals “passionate about a culture and processes prioritizing DEIB.” In a recent letter to certification holders, HPCC board president Larry Fabrey, PhD wrote, “The [DEIB] task force is making recommendations to the board that will impact the appropriateness of all aspects of HPCC certification, from initial contact with prospective applicants through recertification.”

The inspiration for this initiative came from a 2022 article in Nursing Outlook, which hypothesizes standardized testing historically impeded education and career attainment for members of underrepresented minority groups. They specifically looked at the National Council Licensure Exam (NCLEX) – an exam all new graduates in the United States must take to determine if they are deemed safe to practice as a nursing professional. The article indicates nursing organizations have not published data needed to “evaluate/refine the NCLEX-RN from a DEI perspective.” “Preliminary nursing studies and data from other professions indicated disparities in testing outcomes,” the authors lament. Noticeably missing is a concern for a merit-based licensure process.

In response, HPCC launched a performance analysis of its certification exams with a review of disparities in pass rates based on race, ethnicity, and gender over a 3-year period. To date, the full report of these findings is not available. However, HPCC asserts their initial findings indicate a racial, gender, and ethnic gap in exam pass rates, with a commitment to reduce pass rate disparities among these groups.

The HPCC outlined other strategies in their notice to certificate holders and members, including:

  • Performing a differential item functioning (DIF) analysis of its Certified Hospice and Palliative Nurse (CHPN®) program, which is its largest certification exam. The aim is to identify bias in exam questions and how different demographic groups answer exam questions correctly.
  • Increase diversity in HPCC committees with member and certificate holder volunteers. Applicants are considered based on their demographic and geographic background, with the goal to reach “underrepresented” certification holders.
  • A review of current exams, by the HPCC Examination Development Committees (EDCs), to “ensure they are free from stereotypes, overt and subtle discrimination, and negative messages.”
  • Creation of a “DEIB Style Guide” to ensure exam questions are written with “inclusive language and are culturally aware”, including “avoiding the use of gender-specific pronouns and other non-inclusive language.”

The hospice and palliative nursing certifications are some of the most challenging and rigorous credentialing exams in the profession. They require knowledge of multiple disease states, extensive pathophysiology, and caring for a patient at the end of life. It has traditionally been a prestigious, merit-based certification that palliative and hospice nurses are proud to display. The initiatives proposed by HPCC beg the question: How will they ensure excellence remains the top priority in the certification process?

This is a disheartening trend among nursing organizations that prioritizes DEI over merit, activism over healing, and appeasement over fidelity to the profession. For current HPN certification holders, it is insulting to realize that the work done to reach this accomplishment is minimized by ideologically motivated initiatives that have no credible evidence to support them. Even worse, it is heartbreaking for patients and families, who need the best, most qualified nurses at the most vulnerable times of their lives. Nurses – who are repeatedly ranked as members of the most trusted profession in the country – must act to return their professional organizations to its main purpose: Providing the best possible care to all patients.

APA Journal Denounces Parents Who Don’t Gush About BLM to Their Children

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Black Lives Matter leaders have absconded with millions in donations while the organization languishes in debt. Meanwhile, the organization regularly traffics in hateful and radical ideology which includes a demand to defund the police, opposition to the nuclear family, and support for the perpetrators of Hamas’ October 7th attack against Israel.

Apparently, none of it matters to the American Psychological Association. In a recent “study” that appears in Developmental Psychology—a journal published by the APA—researchers explore differences in whether and how black parents and white parents discuss BLM with their children. The findings are not especially interesting, but the framing of their inquiry is alarming. “The BLM movement is explicitly about racial injustice,” the authors claim. Parents who engage in “delegitimatizing narratives” about BLM are “actively upholding racial injustice through harmful racial ideologies that perpetuate racism.”

Behind the comically tedious repetition of the word racism is a thinly veiled proposition: That BLM is a righteous organization, and that public support for it should be treated as a normatively desirable goal among health professionals.

There is no indication that talking about BLM would facilitate improved mental or physical health. There are however indications that BLM objectives endanger both. BLM-inspired protests in 2020 resulted in 19 deaths and billions in property damage, while the “defund the police” movement ushered in a historic spike in violent crime.

Nevertheless, the APA offers their staunch support. In 2016, the APA website offered glowing coverage of the “hundreds of students and psychologists” who marched in solidarity with BLM while at the APA annual convention. Another article published by the APA that year cribs fictional narratives about the U.S. justice system promoted by BLM to probe how “psychological research findings offer ways to foster justice.” In 2020, APA President Sandra Shullman called for “systemic change” in response to what she labeled a “racism pandemic” in the United States.

The corruption of medicine as a vehicle for woke political activism is a pandemic that should truly concern the APA. Instead, they’re fueling it.   

Do You Care About Your Doctor’s Race? The Joint Commission Does

Hospitals and healthcare organizations must provide race and ethnicity information about their staff and leaders if they hope to secure a new Health Care Equity Certification offered by The Joint Commission (TJC), even though there’s no evidence that doctors, nurses and other providers will treat patients differently according to these metrics.

In its explanation to healthcare providers about data collection for this new, advanced certification, TJC unbelievably acknowledges outright that racial concordance factors into it:

“It is essential for an organization to collect data and conduct analyses to understand the specific healthcare disparities that may exist at the organization and within the community it serves,” TJC states. “The organization should collect data to understand the sociodemographic characteristics and health-related social needs of the individuals in its community. In addition, data from the organization’s staff and leaders should be collected to identify opportunities to increase diversity and racial, ethnic, and language concordance.”

But do patients and their families truly care about the race or ethnicity of medical providers and staff who attend to them, or do they simply want the best clinical, ambulatory, and other types of care possible without the intrusion of political correctness and diversity, equity and inclusion (DEI) ideology? Requiring this information adds to the burden of staff members at organizations seeking certification or accreditation who spend time and resources collecting data and readying their departments to satisfy TJC’s numerous requirements — especially with its new emphasis on “healthcare equity.”

We cautioned recently that the DEI healthcare equity creep was deepening with TJC’s new National Patient Safety Goal #16, introduced in July 2023, which posits that better patient “safety” will result from identifying patients by race and ethnicity. TJC considers healthcare equity to be “a quality-of-care problem,” and asserts that NPSG 16 will help to “increase the focus on improving healthcare equity versus reducing healthcare disparities.” 

Those who buy into the concept of racial concordance believe, for example, that black doctors will do a better job of taking care of black patients because white doctors supposedly hold implicit biases against them. Yet no one racial or ethnic group can claim bragging rights to biases and perceived instances of discrimination, whether on the giving or receiving end.

Moreover, healthcare organizations face the same inherent risks as other institutions if they hire to satisfy demographics and not on merit. It certainly matters to patients that their caregivers — especially doctors and nurses — are among the proverbial “best and brightest,” regardless of skin color. 

On its website, TJC touts its Health Care Equity Certification as one that “guides forward movement in imbedding healthcare equity in all aspects of care, treatment, and service delivery.” As TJC explains in a webinar, the standards for compliance include asking the staff and leaders of healthcare organizations to self-report race and ethnicity, as well as languages they speak, during a TJC review for HCE certification. Organizations also must report “any incidents or perceptions of discrimination and bias that are experienced by staff or leaders,” just as TJC requires on patients.

Beyond the usual items that a TJC reviewer wants, such as organizational charts, HCE certification requires additional information that is focused on race and health equity:

  • List of active patients with information about age, race, and diagnosis
  • List of discharged patients with information about age, race, and diagnosis (4 months for an initial review, one year for a recertification review)
  • List of self-reported race, ethnicity, and language information from staff and leaders
  • Experience of patient care measures stratified by patient sociodemographic characteristics
  • List of external organizations collaborating with the organization to identify community-level needs for equitable care and to address patient health-related social needs.

The review process for HCE certification begins with a 45-minute Orientation to Health Care Equity Initiatives, involving the organization’s healthcare equity leader — yes, TJC requests they assign one — as well as its certification contact and other team members. The orientation is all about goals to “improve healthcare equity,” including a strategic plan and resource allocation.

Patient population, community demographics, collaboration with stakeholders — these are all topics of discussion, along with assessing health-related social needs (HRSNs). The final part of HCE orientation examines an organization’s support for DEI among its staff and leaders — collecting their data, discussing recruitment and retention policies, and reporting any incidents or perceptions of bias/discrimination.

The Joint Commission intends to compare the data on race, ethnicity, and languages of healthcare staff to that of their local communities — but making such comparisons does not address the need for safe, effective, quality care for patients. The issue is not the skin color of the staff; it is the quality of care. There is no good evidence that the staff racial makeup has anything to do with the quality of care or patient safety. Hiring practices that focus on merit and qualifications are the only effective means of addressing patient safety goals or quality of care.

S2E4: Dr. Kris Kaliebe and the Plea for Scholarly Dialogue Concerning So-called “Gender-affirming Care.”

Dr. Kris Kaliebe, a board-certified General, Forensic, and Child and Adolescent Psychiatrist and professor in the Psychiatry Department at the University of South Florida, joins the Do No Harm Podcast to discuss the plea for scholarly dialogue concerning so-called “gender affirming care” for youth. He has been outspoken on both gender ideology and the impact of DEI in his field. 

Instead of peer-reviewed research and scholarly discussion around so-called “gender affirming care” for youth, there has been little–if any–-open discussion, let alone debate. Instead, the leadership of medical organizations has become influenced by political activists insistent on presenting a single dogma: That gender-affirming care for youth is evidence-based and life-saving. But we know both to be untrue.

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DEI Sentiments Dominate In U.S. Hospitals

A recent report published by the American Hospital Association (AHA)’s Institute for Diversity and Health Equity (IFDHE) highlights that DEI attitudes are widespread in American hospitals.

The report includes the findings of a June 2022 survey which was administered to over 6,000 hospitals with more than 1,300 responses. According to the survey results:

  • 96% of respondents believe diversity is extremely or very important to the future of U.S. health care;
  • 97% believe equity is extremely or very important to the future of U.S. health care; and
  • 97% believe inclusion is extremely or very important to the future of U.S. health care.

Many of these hospitals have acted on their pro-DEI attitudes by signing a so-called “equity pledge” or “anti-racist” statement, such as the AHA’s #123forEquity Pledge. This pledge asks signatories to “increase the collection, stratification and use of race, ethnicity, language preference and other sociodemographic data to improve quality and safety,” among other commitments.

Figure 1. From the American Hospital Association #123for Equity Pledge to Act.

The AHA pledge has been signed by more than 1,700 hospitals, despite a concerning lack of evidence that these commitments will produce improvements in health outcomes for any minority community. The states with the highest concentration of hospitals signing onto the pledge are:

  1. Oregon (40%)
  2. Maryland (39%)
  3. North Carolina (34%)
  4. Connecticut (33%)
  5. New Mexico (33%)
  6. South Dakota (29%)
  7. South Carolina (28%)
  8. Colorado (26%)
  9. Utah (25%)
  10. Alaska (23%)
Figure 2. Map of signers of the AHA #123forEquity Pledge.

West Virginia is the only state with no hospitals reported as joining the AHA’s pledge.

But these actions don’t end with simply signing pledges. According to the report, DEI is increasingly prevalent in both budgeting and medical decisions at U.S. hospitals. Not only do a majority of hospitals report a budgeted department dedicated to advancing DEI goals, but nearly one-third of hospitals indicate these departments have annual budgets in excess of $125,000.

Figure 3. From the IFDHE/AHA “DEI Data Insights” report, page 6.

The report notes that, while some hospitals may not yet have budgets dedicated to advancing DEI, in the future “it will be important to track how hospitals are allocating resources towards DEI and advancing health equity.” This is a sure-sign that the AHA will be pushing hospitals to ramp up their DEI-related spending moving forward.

Nearly 85 percent of hospitals also indicate their use of “race, ethnicity and language data;

sexual orientation and gender identity; and social needs data” to inform clinical and operational functions. Put another way, unspecified and unclear “data” on concepts related to race, gender, and more are influencing hospital functions at these medical institutions. Since this statement is used by the AHA to gauge a hospital’s commitment to “health equity”, it can reasonably be assumed that this variety of DEI is driving medical decisions under the guise of data-informed policies.

The AHA’s advocacy for DEI in medicine is of no surprise—nor is the organization’s efforts to track hospitals’ verbal commitments, financial obligations, and medical decisions that relate to diversity, equity, inclusion, gender identity, and “anti-racism”. In fact, as Do No Harm has previously uncovered, America’s hospitals are increasingly fed by a talent pool of medical universities that seemingly prioritize being “woke” above all else. From California to Florida to Tennessee and more, these colleges and universities have not only implemented DEI and woke curriculum and trainings, but have also begun screening applicants before they even set foot on campus.

As a result, America’s institutions of higher education have greatly influenced its institutions of medicine to incorporate these non-medical factors into operational and financial decisions. These sentiments are no doubt reinforced by the AHA which has both jumped on the woke bandwagon and attempted to steer it further into identity politics and divisive concepts.

As the AHA and hospitals across the country continue to dive into the muddy waters of radical ideologies and political activism, patients will bear the consequences. Prospective doctors and nurses who are interested in delivering quality medical care will be crowded out by providers calling for more and bigger woke medical bureaucracies.

The silver lining? In a dozen states, fewer than ten percent of hospitals have signed onto the AHA’s equity pledge. These hospitals should continue to stand strong against the AHA and those pushing extreme ideologies, and instead focus their efforts on ensuring their patients receive the best medical care possible. The future of high-quality medicine is depending on it.

Dr. Sally Satel Comments on Excellence over Identity in Medicine

Dr. Sally Satel, American Enterprise Institute senior fellow and lecturer at the Yale University School of Medicine, penned a February 6 guest post for the Unsafe Science Substack that urged a refocus on what academic excellence in medical education means.

Citing a recent Perspective feature article in the New England Journal of Medicine titled “Centering Women of Color to Promote Excellence in Academic Medicine,” Dr. Satel challenged the injustices in NIH funding and career advancement the authors allege.

“I am not persuaded that “centering” women of color – or any group for that matter – is a path to academic distinction,” Satel wrote. “Increasing diversity is not necessarily in tension with academic merit—and in general, worth striving for, but not at the expense of excellence.” She concluded, “The proposals from these authors will not promote excellence. In academic medicine, that must take precedence.”

Do No Harm founder and chairman Dr. Stanley Goldfarb encourages members to review her post. “Sally Satel is an American treasure,” he said. “She is a psychiatrist and an author who has written extensively on the issues of the problems that progressivism has brought to American medical education and healthcare. Her latest article beautifully shows the foolishness of applying identity politics to the research establishment.”

Read the full guest post here.

Virginia Senate Bill Seeks to Fast-Track Mandatory Implicit Bias Training for Physicians and Nurses – With a $3.5M Price Tag

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Last December, we reported that both chambers of the Virginia legislature had introduced bills that would force the state’s physicians and nurses to complete “unconscious bias” training in order to obtain and keep their licenses. This week, the budgetary impact of the Senate version of this bill was revealed – and it’s significant.

Senate Bill 35 (SB35) “directs the Board of Medicine and the Board of Nursing to require unconscious bias and cultural competency training as part of the continuing education and continuing competency requirements for renewal of licensure.” This is a novel requirement for Virginia’s doctors and nurses – and the Commonwealth is sparing no expense to make it a reality. According to the Department of Planning and Budget fiscal impact statement for this legislation, the preliminary estimate of the cost is no less than $3,478,000, beginning in FY25. Each Board will require five new full-time equivalent positions – at a cost of $140,750 each – to fulfill the internal requirements created by the bill.

It’s no wonder the anticipated price of implementation is so high. SB35 requires the Boards of Medicine and Nursing to:

  • Identify and designate organizations that will be approved providers of the training. With approximately 320,000 practitioners licensed by these Boards, this mandate provides a new revenue stream for establishments that offer continuing education.
  • Regularly update the training on the most recent research findings. An “evidence-based curriculum” is required to be compliant with the provisions of the bill.
  • Conduct studies of the “impact of training on practitioners.” This is specifically noted for licensees who work with obstetric patients and newborns, who must be educated about “how unconscious racial bias affects care during pregnancy and the postpartum period.”
  • Develop methods to test for and measure training effectiveness. This indicates the current lack of methods and tools for determining the efficacy (if any) of implicit bias training.
  • Maintain records of the number of practitioners that complete the training. Traditionally, physicians and nurses have self-reported their compliance with their profession’s continuing education requirements. However, due to the mandatory nature of the new requirement, each Board’s data system must be modified to collect this information.
  • Submit recommendations on how to improve future iterations of the training. However, “any cost at Department of Health associated with this inclusion will be incidental.”

But these costs are not limited to the state government’s budget. SB35 imposes even greater expense onto individuals practicing medicine or nursing in Virginia. Physicians are assessed a fee of $302 for an initial license application, and $377 for every biennial renewal. Nurses must pay $190 for an initial application and $140 for each renewal. The “unconscious bias” training requirement adds even more to the expenses associated with obtaining the mandatory 60 hours of continuing education for physicians and 30 hours for nurses. Providers of approved courses charge up to $30 per contact hour, and the required number of hours for SB35’s “comprehensive” training is yet to be determined.

Why is the Virginia General Assembly concluding that the Commonwealth’s doctors and nurses are racists who must be subjected to continual re-education about supposed biases that they presumably can’t change? This so-called “science” has been proven to be flawed, and already-burdened healthcare professionals have much better things to be doing with their time, energy, and money. Residents and taxpayers will eventually need to encounter the local healthcare system. They must be fully aware of this insulting attack on Virginia’s badly needed physicians and nurses, and ask the same questions.

America Needs Doctors, Not Activists

The United States is projected to face a shortage of over 100,000 doctors by 2030, leaving millions of Americans with inadequate access to health care. Yet, some voices within the medical community would like to see medical schools prioritize the training of students in political activism, even if that means higher costs for students and more distractions from quality medical education.

A recent article in the American Association of Medical College’s (AAMC) journal Academic Medicine featured the perspectives of five medical students and residents on expanding medical schools’ curricula to include more instruction in public policy advocacy and added flexibility for student-activists to attend protests. The publication of this article is the latest example of the AAMC’s fervent support for institutionally sanctioned activism, alongside its Diversity, Inclusion, Culture, and Equity (DICE) Inventory, which grades medical schools based in part on how engaged those institutions are in political and legislative advocacy. Other instances include vocal opposition to efforts by communities to restrict dangerous gender transitions for minor patients.

Figure 1. Excerpt from an April 9, 2021 press release by the AAMC.

The article, “The Case for Advocacy Curricula and Opportunities in Medical Education: Past Examples to Inform Future Instruction,” argues for three primary changes: adding “advocacy-centered formal teaching,” expanding extracurricular advocacy opportunities, and accommodating academic interruptions due to student-activism. These aims may not seem wholly unreasonable at first, but there are several reasons that institutions and the medical community should reject them.

Foremost, creating advocacy curricula requires institutions to add additional classes, which in turn will lead to needless increases in the cost of attendance. An additional course at the University of New Mexico School of Medicine, such as the one praised by the authors of the article, costs thousands of dollars. Meanwhile, medical student debt has ballooned from $88,495 in 2000 to $241,600 in 2022. The financial burden of medical school remains a formidable barrier for many potential medical students, especially for students from the lowest income brackets. Adding expensive activism-focused coursework that is irrelevant to the practice of medicine is at best a decadent luxury for the wealthiest students; at worst, it is a perverse prioritization of ideology over concern for the financial limitations of most students’ budgets.

The high cost of medical school has national implications. Rising tuition costs and student debt undermine efforts to address physician shortages in high-need, low-paying states. The shortage of physicians varies considerably based on geography, and states that have lower average salaries for physicians are further disadvantaged when the costs of medical school increase and new doctors have to prioritize paying off student loans.

Training and coursework, however, are not enough for student-activists, who also want more opportunities for students to participate directly in political advocacy. But their demands are not just for more student-led groups on campus—they insist on schools accommodating their absences from class or rotations to attend protests and political rallies. The AAMC went even further, urging medical schools to overlook arrests of applicants and students if they were related to Black Lives Matter protests.

Medical students, like all Americans, enjoy the freedom to assemble and speak freely, but medical schools should not be compelled to accommodate, overlook, and even endorse students’ political activities, especially when those students violate the law.

The trend of medical education towards radical political activism distracts from the pressing needs of the American health care system to fill out its ranks of quality, capable doctors. The AAMC is driving much of this shift, and it is emboldening the most vocal students towards the same end. Meanwhile, a majority of Americans have a negative view of the health care system, and roughly half of Americans are dissatisfied with the quality of their medical care. Activism will not fix this crisis of confidence—but well-equipped, financially unencumbered doctors will.

S2E3: David L. Bernstein on the Rise of Antisemitism out of Toxic DEI 

David L. Bernstein, founder of the Jewish Institute for Liberal Values (JILV), joins the Do No Harm podcast to discuss the rise of anti-semitism, particularly with “woke” groups on university campuses seeking to ban Jewish speakers and those who support Israel. Since the October 7 terrorist attack, the blatant antisemitism raging across college campuses has continued to increase in a clear demonization of one group in an effort to prop up another.

David L. Bernstein speaks on this harmful phenomenon that has been carefully baked into the very foundation of universities for the past decade via toxic DEI initiatives that have prevented free thought and active debates.

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