As the federal agency responsible for administering core national health insurance programs, the Centers for Medicare & Medicaid Services (CMS) should aim to promote a healthcare system free from divisive politics or discriminatory practices.
Yet during the Biden administration, CMS adopted a number of policies actively working against this ideal. These policies were often in pursuit of the administration’s “health equity” agenda, and encouraged medical providers to advance radical identity politics or even outright discriminate on the basis of race.
Since our founding in 2022, Do No Harm has worked to expose and combat these harmful policies. We’ve repeatedly submitted comments opposing CMS’ divisive agenda and supported litigation against the agency’s discriminatory rules.
It is absolutely imperative that CMS ditch these regressive practices.
A CMS that promotes a robust healthcare system cannot at the same time promote racial discrimination: the two concepts are mutually exclusive.
‘Health Equity’
The core organizing premise of CMS’ discriminatory policies is “health equity,” which holds that the racial disparities in health outcomes and healthcare are due to systemic racism.
Most recently, CMS proposed a rule to implement a new payment model, the Increasing Organ Transplant Access (IOTA) Model, to reduce perceived disparities in treatment for kidney issues. The model, justified on the basis of “health equity,” would encourage hospitals to racially discriminate in the kidney transplantation selection process in order to receive incentive payments.
Do No Harm called on CMS to withdraw the rule in June 2024, arguing it exceeded the agency’s statutory authority as well as promoted illegal discrimination.
“In short, the proposed rule would encourage providers to adopt plans that favor some racial
groups in the kidney-transplant process over others,” Do No Harm’s comment stated. “As a matter of policy, law, and morality, this cannot stand.”
Multiple media outlets, including the Washington Free Beacon, covered the proposed rule and Do No Harm’s reaction.
In November 2024, CMS announced the finalized rule which dropped the proposed requirement for hospitals to submit ‘health equity plans’ to receive incentive payments.
This is a major victory, but this particular policy is just the tip of the iceberg when it comes to CMS’ racially divisive agenda. Since the beginning of the Biden administration, CMS has worked to inject radical concepts like DEI into the healthcare and medical fields.
On his first day of office on January 20, 2021, President Joe Biden issued Executive Order 13985, directing federal agencies to address perceived “systematic racism” and promote “equity.”
CMS, relying on this executive order, published a rule in July 2021 proposing to create an “anti-racism plan” that encourages CMS to address “health equity” and reduce racial disparities, as well as potentially administering anti-racism and implicit bias trainings. In particular, the rule would financially reward doctors for adopting “anti-racist” policies in their practices.
“As physicians try to abide by this policy, they will find it harder and harder to provide equal access to care,” wrote Do No Harm Senior Fellow Benita Cotton-Orr in the New York Post.
Do No Harm supported a lawsuit against CMS over the rule that argued the regulation was not supported by statutory authority and encouraged doctors to engage in racial discrimination. The lawsuit is ongoing, with a federal judge denying the federal government’s motion to dismiss the complaint in 2023. Do No Harm also praised Congressman Gary Palmer (R-AL) for introducing the Prevent Racism in Medicare Act, which would revoke the anti-racist incentive policy.
Then in April 2022, CMS issued a proposed rule for inpatient and long-term hospitals, forcing them to report information on patient race, ethnicity, income, geographic location, sexual orientation, and gender identity. This information could then be used to financially reward or punish healthcare providers based on their adherence to identity politics. Do No Harm urged the public to comment on the rule in July 2022, and submitted comments later that month raising the alarm about the rule’s potential for abuse.
In 2023, CMS proposed two rules that would modify quality reporting programs for skilled nursing facilities and cancer hospitals, respectively. These reporting programs use payment incentives and payment reductions to ensure facilities are providing adequate care.
However, the modifications instead promote the concept of “health equity” once again by including a health equity scoring system in the quality reporting guidelines. This encourages providers to promote health equity, which in practice is essentially racial discrimination. The finalized version of the rules went into effect later in 2023.
Moreover, in September 2023, Do No Harm submitted comments on a CMS rule that would alter physicians’ fee schedule within Medicare and Medicaid to promote health equity, expressing concern that the rule would financially encourage providers to discriminate against their patients.
“Stated plainly, the proposed rule change would directly incentivize healthcare providers to deliver more services to patients of certain races/ethnicities, sexualities, and religions,” the comment stated. “Such a system would constitute a clear violation of the Civil Rights Act of 1964, and pushing individual patients to the front of the line based on any factor other than their health status is morally wrong.”
That rule also went into effect later in 2023.
Unwinding Racial Discrimination
These policies represent the most visible manifestations of how CMS has injected racially discriminatory ideals into the healthcare system.
Financially incentivizing doctors to discriminate against their patients and promote radical ideology goes against the very foundation of medical ethics: to do no harm. These CMS policies instead subjugate public health to an insidious agenda that views Americans by their race, and not by their health needs.
The next administration should take action immediately to unwind these harmful regulations and promote a healthcare system that is free and equal – and not one that punishes Americans based on their race.
How the Biden CMS Corrupted Healthcare With Radical Identity Politics
Uncategorized DEI Federal government Commentary Executive Do No Harm StaffAs the federal agency responsible for administering core national health insurance programs, the Centers for Medicare & Medicaid Services (CMS) should aim to promote a healthcare system free from divisive politics or discriminatory practices.
Yet during the Biden administration, CMS adopted a number of policies actively working against this ideal. These policies were often in pursuit of the administration’s “health equity” agenda, and encouraged medical providers to advance radical identity politics or even outright discriminate on the basis of race.
Since our founding in 2022, Do No Harm has worked to expose and combat these harmful policies. We’ve repeatedly submitted comments opposing CMS’ divisive agenda and supported litigation against the agency’s discriminatory rules.
It is absolutely imperative that CMS ditch these regressive practices.
A CMS that promotes a robust healthcare system cannot at the same time promote racial discrimination: the two concepts are mutually exclusive.
‘Health Equity’
The core organizing premise of CMS’ discriminatory policies is “health equity,” which holds that the racial disparities in health outcomes and healthcare are due to systemic racism.
Most recently, CMS proposed a rule to implement a new payment model, the Increasing Organ Transplant Access (IOTA) Model, to reduce perceived disparities in treatment for kidney issues. The model, justified on the basis of “health equity,” would encourage hospitals to racially discriminate in the kidney transplantation selection process in order to receive incentive payments.
Do No Harm called on CMS to withdraw the rule in June 2024, arguing it exceeded the agency’s statutory authority as well as promoted illegal discrimination.
“In short, the proposed rule would encourage providers to adopt plans that favor some racial
groups in the kidney-transplant process over others,” Do No Harm’s comment stated. “As a matter of policy, law, and morality, this cannot stand.”
Multiple media outlets, including the Washington Free Beacon, covered the proposed rule and Do No Harm’s reaction.
In November 2024, CMS announced the finalized rule which dropped the proposed requirement for hospitals to submit ‘health equity plans’ to receive incentive payments.
This is a major victory, but this particular policy is just the tip of the iceberg when it comes to CMS’ racially divisive agenda. Since the beginning of the Biden administration, CMS has worked to inject radical concepts like DEI into the healthcare and medical fields.
On his first day of office on January 20, 2021, President Joe Biden issued Executive Order 13985, directing federal agencies to address perceived “systematic racism” and promote “equity.”
CMS, relying on this executive order, published a rule in July 2021 proposing to create an “anti-racism plan” that encourages CMS to address “health equity” and reduce racial disparities, as well as potentially administering anti-racism and implicit bias trainings. In particular, the rule would financially reward doctors for adopting “anti-racist” policies in their practices.
“As physicians try to abide by this policy, they will find it harder and harder to provide equal access to care,” wrote Do No Harm Senior Fellow Benita Cotton-Orr in the New York Post.
Do No Harm supported a lawsuit against CMS over the rule that argued the regulation was not supported by statutory authority and encouraged doctors to engage in racial discrimination. The lawsuit is ongoing, with a federal judge denying the federal government’s motion to dismiss the complaint in 2023. Do No Harm also praised Congressman Gary Palmer (R-AL) for introducing the Prevent Racism in Medicare Act, which would revoke the anti-racist incentive policy.
Then in April 2022, CMS issued a proposed rule for inpatient and long-term hospitals, forcing them to report information on patient race, ethnicity, income, geographic location, sexual orientation, and gender identity. This information could then be used to financially reward or punish healthcare providers based on their adherence to identity politics. Do No Harm urged the public to comment on the rule in July 2022, and submitted comments later that month raising the alarm about the rule’s potential for abuse.
In 2023, CMS proposed two rules that would modify quality reporting programs for skilled nursing facilities and cancer hospitals, respectively. These reporting programs use payment incentives and payment reductions to ensure facilities are providing adequate care.
However, the modifications instead promote the concept of “health equity” once again by including a health equity scoring system in the quality reporting guidelines. This encourages providers to promote health equity, which in practice is essentially racial discrimination. The finalized version of the rules went into effect later in 2023.
Moreover, in September 2023, Do No Harm submitted comments on a CMS rule that would alter physicians’ fee schedule within Medicare and Medicaid to promote health equity, expressing concern that the rule would financially encourage providers to discriminate against their patients.
“Stated plainly, the proposed rule change would directly incentivize healthcare providers to deliver more services to patients of certain races/ethnicities, sexualities, and religions,” the comment stated. “Such a system would constitute a clear violation of the Civil Rights Act of 1964, and pushing individual patients to the front of the line based on any factor other than their health status is morally wrong.”
That rule also went into effect later in 2023.
Unwinding Racial Discrimination
These policies represent the most visible manifestations of how CMS has injected racially discriminatory ideals into the healthcare system.
Financially incentivizing doctors to discriminate against their patients and promote radical ideology goes against the very foundation of medical ethics: to do no harm. These CMS policies instead subjugate public health to an insidious agenda that views Americans by their race, and not by their health needs.
The next administration should take action immediately to unwind these harmful regulations and promote a healthcare system that is free and equal – and not one that punishes Americans based on their race.
Virginia Resurrects Bill Forcing Healthcare Professionals to Submit to Divisive Trainings
Uncategorized Virginia DEI State legislature Commentary Do No Harm StaffThanks to a new bill, Virginia could soon force medical professionals to sit through so-called “unconscious bias” trainings.
The bill, introduced by Democratic Delegate Cliff Hayes on January 3, would direct the state board of medicine to “require unconscious bias and cultural competency training as part of the continuing education requirements for renewal of licensure.”
This means that if medical professionals wish to be licensed in Virginia, they must undergo what often amounts to ideological programming that has no basis in established science.
The Virginia Legislature had already advanced a previous iteration of the bill in early 2024, but Governor Glenn Youngkin vetoed the legislation. He instead proposed an alternative requirement that medical professionals “complete two hours of continuing learning activities that address maternal health care for populations of women that data indicate experience significantly greater than average maternal mortality.”
Yet lawmakers are plowing ahead with this legislation once again.
Specifically, the bill requires the first unconscious bias training to cover “unconscious racial bias affects care during pregnancy and the postpartum period.”
There is no solid evidence finding a causal link between unconscious bias/implicit bias (which is itself a dubious concept at best) and racial disparities in health outcomes. Additionally, the study of racism’s effects in public health is an area plagued by poor scholarship.
For instance, a hugely influential 2020 study 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. Yet a commentary published in September 2024 debunked the results of the 2020 study by examining the same data and finding that, when controlling for low birth weights, the effect of black doctors treating black babies becomes statistically insignificant.
What’s more, the tests used to evaluate or identify implicit bias fail to meet widely-accepted standards of reliability and validity and have been found to be “poor predictors” of real-world bias and discrimination. Ohio State University psychology professor emeritus Hal Arkes described the test as “an extremely feeble predictor of behavior.”
And furthermore, there is no evidence that being treated by a physician of the same race improves one’s health outcomes.
With these facts in mind, the notion that a state-mandated unconscious bias training would materially affect racial disparities in health outcomes strains credulity.
But it’s not just that unconscious bias training is based on shoddy premises: it’s actively divisive.
Asserting without evidence that individuals are implicitly prejudiced against other races breeds paranoia and creates unwarranted inhibitions among medical professionals just trying to do their job.
Moreover, a study released by the Network Contagion Research Institute (NCRI) and the Rutgers University Social Perception Lab in November 2024 found that exposure to DEI trainings increased agreement with rhetoric from Adolf Hitler, and encouraged “punitive responses” to “imagined prejudice.”
And Virginia’s legislation would mandate the trainings leading to these negative consequences.
These requirements are not new: Do No Harm launched its own alternative implicit bias course to meet Michigan’s requirement that doctors and nurses submit to implicit bias training as a condition of their licensure.
But Virginia’s medical professionals deserve better. They should not be subjected to mandatory training that accuses them of racism and pushes unsupported concepts.
Memorial Health’s Discriminatory DEI Pledge
Uncategorized Illinois DEI Health system Commentary Do No Harm StaffMemorial Health, an Illinois-based health system, is advertising its pledge to hire “diverse” candidates while promoting its commitment to DEI ideology.
According to its “Equity, Diversity, and Inclusion” (EDI) pledge, the health system will “actively recruit, hire and promote diverse candidates so that our colleagues more accurately reflect the communities we serve.”
“We know diverse perspectives strengthen our teams and our care, and we are committed to building an inclusive culture where everyone can fully engage,” the hospital states on its EDI page.
Furthermore, Memorial Health participates in the Illinois Health and Hospital Association Racial Equity in Healthcare Progress Report, which requires the hospital to report the racial breakdown of its employees.
The progress report is a voluntary program that tracks Illinois hospitals’ progress toward “health equity” by assessing various metrics of racial diversity and adherence to DEI ideology.
“What is the self-reported racial/ethnic demographic breakdown of the staffing categories below at your organization,” the first question of the progress report asks, with the categories referring to different racial groups.
Additionally, the survey asks the “racial/ethnic demographic breakdown” of each hospital’s patient population.
The progress report further asks hospitals and health systems whether their governing board and senior leadership “reflect the organizational commitment to promote racial equity” by having “strategies in place” to support diversity among the hospitals’ board, and what percentage of their organizational staff have completed activities like DEI and anti-racism trainings.
It’s difficult to see the purpose of these questions as they relate to hospitals’ medical goals; there is no evidence that patients receive better care when treated by physicians of the same race, or that having a more racially diverse patient and physician population will lead to better health outcomes.
But looking through Memorial Health’s other statements on DEI reveals the health system’s deep-seated ideological commitment.
For instance, Memorial Health’s EDI page also goes on to note that “every colleague” receives health equity training, and that all providers must take unconscious bias training to renew their Illinois state licenses.
The role of a healthcare provider is to heal patients, not pursue an ideological agenda.
And providers should not be racially discriminating against would-be employees in service of misguided racial equity goals.
Georgetown’s ‘Anti-Racist Physician’ Course Pushes Dubious Science on Med Students
Uncategorized United States, Washington DC DEI Georgetown University Medical School Commentary Do No Harm StaffThe Georgetown University School of Medicine, alongside the National Anti-racism in Medicine Curriculum Coalition (NAMCC), developed a medical school elective course aimed at promoting “anti-racism” and tackling “anti-Blackness” in the medical field.
The course, Core Competencies of an Anti-racist Physician, is promoted through the Association of American Medical Colleges’ (AAMC) educational resource journal, MedEdPortal.
“The course sought to advance students’ skills in recognizing how anti-Blackness may influence a clinical encounter and being able to explicitly name the entrenched nature of anti-Blackness in the culture and history of medicine writ large,” the course description in MedEdPortal states.
What does this look like in practice? Well, the course sends students through several activities that amount to either lessons on African American culture or DEI trainings, each with seemingly little pedagogical value pertaining to the practice of medicine.
“During this course, students viewed the documentary 13th and reflected on their results on the Implicit Association Test, as well as engaging in a required visit to the National Museum of African American History and Culture in Washington, DC,” the course description states.
It’s hard to see what a documentary about the incarceration of black Americans has to do with the competencies required to be a physician, or how a field trip to a museum is preparing students to better treat their future patients. These activities aren’t relevant to medical education except in the most attenuated sense, and surely Georgetown can find more useful courses to fill their students’ schedules.
But the more troubling aspect is the promotion of the Implicit Association Test (IAT) as a useful tool.
A 2013 meta-analysis published in the Journal of Personality and Social Psychology found that IATs were “poor predictors” of real-world bias and discrimination, while the test has not been shown to correlate with other indicators of real-word discrimination.
In short, the course asks students to examine outcomes on a test of their racial biases that have very little real world application. This is, at best, a waste of time and resources, but more accurately a great way to engender paranoia and self-loathing among medical students.
Moreover, the assessment that accompanies the course, aimed at gauging students’ learning outcomes, is effectively a test of their adherence to DEI ideology.
For instance, the assessment asked students to set a racial equity goal for themselves. These could include possible affirmations such as “I am planning to read more books by Black authors,” “I will interrupt or redirect racist hate speech in my personal or professional life,” and “I will take the [Implicit Association Test] to better understand my bias.”
But it doesn’t stop there; the assessment also asks students to rate how much they agree with the following statements: “Anti-Black racism is a problem in US healthcare systems,” “Racial minority patients are routinely treated differently in the hospital, especially black patients,” and “I understand the ways that race is falsely biologized in a clinical context,” along with many others.
A score of 5 is given when a student “strongly agrees” with the statement. The “correct” answers for all the previous questions are all 5s.
It’s concerning that a course like this is clogging up medical school curricula when there is already so much a prospective physician must learn. And it’s even more concerning that, should the course succeed in achieving its learning outcomes, students will come away worse off.
Medical schools and educators should focus instead on preparing students for the actual practice of medicine, not inundating students with harmful and radical ideas in the misguided pursuit of “anti-racism.”
How the Icahn School of Medicine at Mount Sinai Came to Embrace DEI
Uncategorized New York DEI Icahn School of Medicine at Mt. Sinai Health system, Medical School Commentary Do No Harm StaffThe Icahn School of Medicine at Mount Sinai has long been one of the foremost drivers of DEI in medical education. Its curriculum and administrative policies are saturated with references to DEI and “antiracism,” and it has openly embraced racially discriminatory practices.
Like many medical institutions, the Mount Sinai Health System began seriously committing to an aggressive, DEI-centered restructuring of its core priorities in the wake of George Floyd’s death.
Per a web page recounting the system’s progress toward its DEI goals, these efforts extend beyond recruiting and hiring at the health system to pedagogy at the Icahn School of Medicine.
The school’s DEI web page notes that its “structures, policies, and practices are aimed at advancing diversity, equity and inclusion in the areas of training and education as well as recruitment, retention, and career development of students, trainees, faculty and staff.”
Moreover, prospective students are met with a litany of “racial justice” resources and links advertising the school’s infatuation with DEI.
For instance, the school operates a program called “Anti-Racist Transformation in Medical Education” that aims to “develop the capacity of medical schools to dismantle systemic racism and bias in their work and learning environments,” and “promote shared learning on how to dismantle racism within and across medical schools.”
These efforts extend not only to the Icahn School of Medicine, but to partner medical schools as well.
Another link goes to the Racism and Bias Initiative, which aims, among other things, to “integrate teaching of anti-racist practice longitudinally across the redesigned curriculum.”
It’s concerning that a medical institution would so completely reorient its mission in service of radical ideology. But how these ideas manifest in practice is all the more disturbing.
Racial Discrimination
Do No Harm has repeatedly exposed how the Icahn School of Medicine’s commitment to racial justice is often a proxy for its own form of racial discrimination, excused in the name of DEI.
In June 2023, Do No Harm Senior Fellow Mark J. Perry filed a complaint with the New York City Commission on Human Rights (CCHR) regarding the Growth in Operations, Administrations, and Leadership Society (GOALS) program at the Icahn School of Medicine. The program was characterized as “an elite Black male Initiative at Mount Sinai Health System that advocates for career advancement opportunities and equitable resources for its members.” Perry later filed complaints over the program with the Department of Education and Department of Health and Human Services’ Offices for Civil Rights (OCR); these cases all remain under review.
Moreover, the Washington Examiner reported on documents, obtained by Do No Harm, showing how the Icahn School of Medicine is evaluating instructors based on their contributions to DEI and is requiring job applicants to demonstrate their adherence to DEI ideology.
Additionally, as John Sailer of the National Association of Scholars reported, the Icahn School of Medicine advertised a job that limited applicants to “early stage investigators who are Black, Latinx, or from a disadvantaged background […].”
In March 2023, Do No Harm filed a complaint with the Department of Health and Human Services OCR against the Mount Sinai Health System for sponsoring Icahn’s Visiting Electives Program for Students Underserved in Medicine (VEPSUM). The program’s eligibility criteria stipulated that applicants must be “underrepresented in medicine, specifically Black/African American, Hispanic/Latino, Native American/Alaska Native, and Pacific Islander/Native Hawaiian.” The Icahn School of Medicine ended up removing the discriminatory eligibility criteria following our complaint.
And in September 2023, Perry filed another complaint with the CCHR against the Mount Sinai Health System over a paid fellowship that discriminated on the basis of race.
“Anti-Racist Pedagogy”
The Icahn School of Medicine also contributed to the Association of American Medical Colleges’ (AAMC) DEI efforts.
While investigating the AAMC, Do No Harm discovered that the Icahn School of Medicine’s Center for Antiracism in Practice developed a program aimed at embedding “antiracism” within “all courses and clerkships” at the school.
In 2021, the school established the Center for Antiracism in Practice “to integrate anti-racism efforts” across the school’s departments; the center was later subsumed under the Institute for Equity and Justice in Health Sciences Education in 2023.
“Participants work one-on-one with CAP facilitators to implement and assess the effectiveness of anti-racist pedagogy, policies, and practices within their courses,” the program description reads.
What does this antiracism look like in practice? Well, the school’s Office for Diversity and Inclusion advertised a book by anti-racism “scholar” Ibram X. Kendi, who openly calls for racial discrimination to achieve racial equity and remediate past injustices.
And given the school’s open embrace of racially discriminatory policies, it’s clear that to the Icahn School of Medicine, DEI and “antiracism” involves overt discriminatory practices.
Do No Harm is committed to eliminating DEI and its divisive concepts from medical education.
As evidenced by the Icahn School of Medicine at Mount Sinai, these ideas not only degrade the quality of medical education but lead to overt racial discrimination that unjustly disadvantages individuals based on their race.
Do No Harm will remain vigilant and continue exposing racial discrimination in the medical field.
The American Thoracic Society Shells Out Discriminatory ‘Diversity’ Grant
Uncategorized United States DEI Medical association Commentary Do No Harm StaffModern medicine is overflowing with grants doled out on the basis of race, ethnicity, and sexual orientation as medical schools and societies embrace radical DEI ideology. The American Thoracic Society (ATS) is no exception.
The “ATS Diversity Grant” is a $40,000 opportunity geared toward investigative researchers who are focused on either “basic science, translational, or clinical research in pulmonary, critical care, and sleep medicine.” But here is the catch: the grant opportunity is available only to individuals from “underrepresented groups.”
The ATS goes on to explain that it uses the NIH’s definition of underrepresented populations: “Blacks or African Americans, Hispanics or Latinos, American Indians or Alaska Natives, Native Hawaiians and other Pacific Islanders.” Under that criteria, whites and Asians are out of luck.
Early-stage investigators are researchers who have begun their careers relatively recently; the grant is open to investigators working “in basic science, translational, or clinical research in pulmonary, critical care, and sleep medicine.”
Discriminating among applicants on the basis of any sort of “underrepresented” status is not in line with a commitment to scientific excellence. And emphasizing race and other arbitrary criteria over skills and expertise inevitably leads to worse outcomes for medicine and science alike.
But perhaps this is not altogether surprising, given that the ATS has had a standing “Health Equity and Diversity Committee”, a written policy on “Diversity and Inclusion”, and various pieces embracing DEI, such as one piece entitled “Creating a Fairer, More Equitable Future for the Global Respiratory Community.” Indeed, ATS President Irina Petrache proudly tweeted earlier this year about the “Diversity Forum” at the ATS 2024 conference.
Additionally, the ATS grant is yet another discriminatory funding opportunity that makes reference to the NIH’s racialized language.
Earlier this year, Do No Harm reported how a National Institutes of Health (NIH)-backed grant blatantly discriminated in a similar fashion for its Enhancing Science, Technology, Engineering, and Math Educational Diversity (ESTEEMED) grant program.
Moreover, Do No Harm previously uncovered various fellowship and research awards through the Thoracic Surgery Foundation that discriminated on the basis of race and gender.
Discrimination should have no place in medicine. Arbitrarily excluding certain groups from grant opportunities because they don’t meet racial criteria is exclusionary, unfair, and runs contrary to advancing scientific progress.
The sooner these types of grant practices are phased out, the better for grant applicants and the entire medical community alike.
Landmark Transgender SCOTUS Case Could Reshape A Doctor’s Oath To ‘Do No Harm’
Uncategorized Op-Ed Aida Cerundolo, MDSince it is impossible to diagnose which children will persist with a transgender identity into adulthood, misdiagnosis is a significant concern. Most children who experience natural puberty will outgrow the distress about their bodies, with many discovering they identify as non-heterosexual.
Read more on The Federalist.
Do No Harm Files Lawsuits Challenging Two Racially Discriminatory Scholarship Programs
Uncategorized Colorado, United States DEI University of Colorado School of Medicine Medical association, Medical School Press Release Do No Harm StaffRichmond, VA; December 12, 2024 – This week, Do No Harm filed two lawsuits against racially discriminatory medical scholarships offered by the University of Colorado School of Medicine and the Society of Military Orthopaedic Surgeons.
Do No Harm sued the University of Colorado School of Medicine to challenge the Underrepresented Minority Visiting Elective Scholarship because the scholarship is offered only to students from groups “historically underrepresented in medicine.” This scholarship thus excludes – and disfavors – white medical students in violation of the U.S. Constitution and Title VI of the Civil Rights Act of 1964.
Do No Harm sued SOMOS and the U.S. Navy to challenge the E. Anthony Rankin Scholarship – which SOMOS administers in partnership with the U.S. Navy – because that scholarship is offered only to medical students from an “underrepresented gender or racial background in orthopaedics.” This scholarship also excludes and disfavors white medical students in violation of the U.S. Constitution and the Civil Rights Act of 1866.
“Racial discrimination in all forms is unacceptable. Excluding medical students from scholarships because of their skin color is not only unfair but is also damaging to the integrity of medical education,” said Dr. Stanley Goldfarb, Chairman of Do No Harm. “If patients are to receive the highest standards of care, medical schools and societies must prioritize merit, not identity politics. We call on these two organizations to renounce their discriminatory practices and to open their scholarships to all qualified applicants.”
Click here to read the University of Colorado School of Medicine complaint.
Click here to read the Society of Military Orthopaedic Surgeons complaint.
Do No Harm, established in April 2022, has rapidly gained recognition and made significant strides in its mission to safeguard healthcare from ideological threats. With 14,000 members, including doctors, nurses, physicians, and concerned citizens across all 50 states and 14 countries, DNH has achieved over 10,000 media hits in top-tier publications and garnered widespread attention through numerous broadcast news appearances.
Do No Harm Releases New Report Exposing the Association of American Medical Colleges for Politicizing Medical Education
Uncategorized United States DEI Association of American Medical Colleges Medical association Press Release Do No Harm StaffRichmond, VA; December 10, 2024 – Today, Do No Harm released a new report exposing the role of the Association of American Medical Colleges (AAMC) in politicizing the nation’s medical schools.
The report, titled, “Activism Over Meritocracy: How the Association of American Medical Colleges is Corrupting Medical Education with Endless DEI Ideology,” is broken into the three parts:
“The AAMC corrupts medical education by blatantly embedding DEI into American medical schools,” said Dr. Jared Ross, Senior Fellow at Do No Harm. “Our report offers practical solutions to restore excellence in the medical school curriculum. The medical education system in this country should be focused on science-based teachings rather than forcing students to engage with a radical political ideology.”
Click here to read the full report.
Do No Harm, established in April 2022, has rapidly gained recognition and made significant strides in its mission to safeguard healthcare from ideological threats. With 14,000 members, including doctors, nurses, physicians, and concerned citizens across all 50 states and 14 countries, DNH has achieved over 10,000 media hits in top-tier publications and garnered widespread attention through numerous broadcast news appearances.
Vermont Med School Discontinues Racially Discriminatory Program After Do No Harm Complaint
Uncategorized Vermont DEI University of Vermont Larner College of Medicine Medical School Commentary Do No Harm StaffThe University of Vermont Larner College of Medicine discontinued its discriminatory Visiting Student Elective Scholarship Program (VSESP) following a Do No Harm federal civil rights complaint filed against the school.
The program was a four-week clerkship for emergency medicine medical students and included a $2,500 stipend for travel and housing costs. The original eligibility requirements stated that applicants should “describe how you identify as one or more of the Larner College of Medicine’s diversity categories (such as Black/African American, Hispanic/Latino, Native American, Pacific Islander, or low socioeconomic status).”
In other words, the scholarship effectively excluded students who were white, Asian, Middle Eastern, and from other unfavored racial groups.
Additionally, the scholarship’s description stated that its purpose was to “provide mentorship and networking for fourth-year medical students underrepresented in medicine such as racial and ethnic minorities, LGBTQ-identified or gender nonconforming individuals.”
The requirements, in short, amounted to explicit and unlawful racial discrimination in clear violation of federal civil rights laws.
Do No Harm Senior Fellow Mark J. Perry filed a federal complaint against the university with the Department of Education’s Office for Civil Rights (OCR) in November 2023 and sent a copy courtesy of the complaint to several of the university’s leaders, including the General Counsel and President. The complaint alleged the university violated federal civil rights protections under Title VI and Title IX.
By May of 2024, the university had removed the discriminatory eligibility criteria for the program and replaced it with a brief blurb on the program’s selection criteria.
“Successful applicants will be those who are able to demonstrate their commitment to the Larner College of Medicine’s Tenets of Professionalism and how their unique lived experience will advance diversity, equity, and inclusion in medicine and improve health care delivery to underserved areas and populations,” the updated description read.
However, it now appears that the discriminatory program has been discontinued altogether, as the link to the scholarship program has not been active since July. Rather than a specific VSESP program for emergency medicine students, there is now a general scholarship program for all medical students that does not include discriminatory eligibility requirements.
“OCR determined that the University currently advertises VSESP on this website, which does not indicate any restriction or preference based on race, color, national origin, or sexual orientation,” OCR wrote in a letter to Do No Harm.
“Based on this information, OCR has determined that the facts underlying the allegations of race, color, national origin, and sexual orientation discrimination are no longer present and OCR has no evidence that the law is violated,” the letter reads.
This OCR ruling is a welcome victory for all of the students who have been denied educational opportunities due to the University of Vermont’s unlawful discriminatory eligibility criteria. Moreover, it’s a welcome sign that the University of Vermont realized the error of its ways and took corrective action to comply with federal civil rights laws in response to Do No Harm’s complaint.
Have you been unfairly affected by discriminatory scholarships or programs at your institution, or are you aware of any discrimination at a U.S. medical school? If you or others did not apply because you thought you were ineligible, please let us know – anonymously and securely.
University Hospitals of Cleveland Pushes ‘Reparations’ in DEI Trainings
Uncategorized Ohio DEI Hospital System, Medical School Commentary Do No Harm StaffWould you want your hospital inculcating staff members on the benefits of racially discriminatory policies?
Do No Harm obtained video recordings of four virtual trainings held for staff members at University Hospitals of Cleveland this summer. The trainings featured discussions on topics such as implicit bias that are staples of DEI discussions.
But one particular training, featuring Cleveland’s Director of Public Health David Margolius, extolled the virtues of racial reparations, with Margolius recommending reparations as a way of closing the racial gap in health outcomes.
“The problems that we’re facing all stem from the wealth gap between predominantly white families and predominantly black families,” he said, referencing a talk he gave in 2023 that explored his reparations activism in greater detail. “So, the way to fix that is reparations.”
“Ultimately, if we want to directly address this [disparity], it’s reparations,” he added.
Additionally, in the 2023 talk, Margolius argued the best way to sell reparations to the public (who by and large are not fans of racially discriminatory policies) is to frame it as a “public health intervention.”
“I think we need to continue to communicate it as a public health intervention to make it more mainstream,” he said.
Ideastream Public Media reported in August 2023 that Margolius would continue to advocate for reparations.
“It’s a proven public health intervention that we should continue to advocate for on a national level,” he said.
A more cynical viewer might interpret Margolius’ comments as smuggling an unpopular political agenda into the mainstream through a more socially-acceptable veneer.
This is part of a larger issue in the healthcare field, especially among medical associations and educational institutions, in which the lines between “health” and “politics” are increasingly blurred. Do No Harm’s latest research project, Outside Their Lane: Mission Creep in Medical Specialty Societies, demonstrated how medical specialty societies use their expertise to take positions on hot-button social and political issues, often cloaking their activism under the guise of advocacy for “public health.”
This training is in a similar vein: openly pushing a particular public policy prescription (that happens to be racially discriminatory, for what it’s worth) under the guise of public health education.
Regardless of whether these arguments have merit, they belong in the political sphere.
DEI trainings, especially in the public health sector, have always been thinly-veiled excuses to platform a political agenda.
University Hospitals should reconsider its priorities and abandon DEI: the medical field deserves better.
Do No Harm Hosts ‘Stop the Harm’ Rally on Steps of Supreme Court
Uncategorized Tennessee, United States Gender Ideology Federal government Commentary Judicial Do No Harm StaffOn Wednesday, as the Supreme Court heard oral arguments in a case pivotal to future efforts to restrict child sex change interventions, Do No Harm hosted our “Stop the Harm” rally featuring prominent voices advocating against these dangerous practices.
The event was an enormous success, even going viral on social media, as crowds of Americans gathered to cheer on our cause and the importance of protecting our country’s children. Advocates, lawmakers, and physicians alike all joined together to explain why the Supreme Court must uphold prohibitions on child sex change interventions.
Hosted by our own Beth Serio, the rally’s speakers included the Daily Wire’s Matt Walsh, the American Principles Project’s Terry Schilling, and representatives from over a dozen other organizations such as the Alliance Defending Freedom.
Do No Harm was also joined by Tennessee lawmakers William Lamberth and Jack Johnson, who were behind the Tennessee law restricting child sex change interventions at the center of the Supreme Court case. Moreover, the rally featured members of Congress including Rep. Marjorie Taylor Greene (R-GA) and Rep. Gary Palmer (R-AL), and Do No Harm staff, fellows, and advocates.
The case in question, United States v. Skrmetti, concerns a Tennessee law prohibiting doctors from performing so-called “gender-affirming care” on children. This includes cross-sex hormones, puberty blockers, and surgical procedures.
The ACLU first sued Tennessee over the law, and the Department of Justice under President Joe Biden intervened in the case in 2023, arguing the law violated the Equal Protection Clause of the Fourteenth Amendment. Seeing as 26 states including Tennessee have passed laws restricting child sex change interventions, the Supreme Court’s decision in this case will likely have wide-reaching consequences for the protection of children across the country.
“I’m confident that the highest court in our land will stand for not only what is morally and ethically right, but with the scientific and medical literature, and ban the medical and surgical experimentation on innocent children once and for all,” said Do No Harm Senior Fellow Dr. Jared Ross.
“The most central and fundamental duty of any society is to protect their children,” said the Daily Wire’s Matt Walsh. “Children are innocent and helpless. They know very little about themselves and very little about the world around them. They rely on us for clarity and guidance … they trust us adults implicitly.”
“If we will not fulfill that obligation then we are worse than useless,” he continued.
Do No Harm Parent Advocate January Littlejohn shared her own harrowing experience with her thirteen year-old daughter.
“Our daughter at thirteen was encouraged through activism and peer pressure to disassociate from her body and to believe her body parts could simply be removed, modified or replace,” Littlejohn said. “She cavalierly talked about getting puberty blockers and getting a double mastectomy, that has been rebranded as ‘top surgery.’ But it was clear to us she did not understand the gravity or scope of what she was requesting.”
Her thoughts were echoed by American Principles Project President Terry Schilling.
“I have a very simple message to the trans industry: You will not take our children,” Schilling said. “And your days of harming [other] children are numbered.”
Inside the courthouse, the majority of the justices were skeptical of the federal government’s arguments and of the efficacy of so-called “gender-affirming care” more broadly, with many of them bringing up evidence that
“It strikes me as a pretty heavy yellow light, if not red light, for this court to come in, the nine of us, and to constitutionalize the whole area, when the rest of the world, or at least the people who the countries that have been at the forefront of this, are pumping the brakes on this kind of treatment,” said Justice Brett Kavanaugh.
“Why isn’t it best to leave it to the democratic process?” Kavanaugh asked at another point.
Justice Samuel Alito cited the Cass Report, a nearly 400-page report that examined “gender identity services for children and young people” in the United Kingdom. The report, which was commissioned by the National Health Service (NHS) England roughly four years ago, found “remarkably weak evidence” to support the use of puberty blockers and hormone treatments for gender distressed children.
Alito brought attention to a particular passage that found no evidence child sex change interventions reduced suicides in gender distressed youth. ACLU lawyer Chase Strangio admitted that this was the case.
Chief Justice John Roberts noted that the lack of evidence for these practices made it all the more reasonable to allow states to restrict them.
“Doesn’t that make a stronger case for us to leave those determinations to the legislative bodies rather than trying to determine them for ourselves?” he said.
However, not all the justices appeared to quite understand the gravity of what was at stake, or the serious harms of these medical interventions.
For instance, Justice Sonya Sotomayor trivialized the harms of child gender medical interventions by stating that every medical procedure carries some degree of risk, bringing up the example of taking an “aspirin.”
This line of reasoning fails to acknowledge that there are medical procedures with high risks and uncertain to nonexistent benefits (like, say, gender medical interventions), and it would be grossly irresponsible for a physician to perform such procedures in almost any other scenario.
Nevertheless, the outpouring of support evident at the rally today only reinforces the empirical reality that the public is on our side. Americans do not want their children subjected to dangerous and unproven medical interventions in service of radical gender ideology. Laws prohibiting these practices are essential to protect this country’s youth.
We hope the Supreme Court agrees.
S3E11: Examining Gender Ideology and Free Speech with Simon Amaya Price
Podcast, Season 1, Uncategorized Gender Ideology PodcastIn this thought-provoking episode of the Do No Harm Podcast, hosts Ian Kingsbury and Scott Centorino are joined by college student and former transgender individual, Simon Amaya Price, to explore the complex intersection of politics, medicine, and gender ideology. Simon shares his personal story of de-transitioning, the challenges he faced as an outspoken critic of gender affirming care, and the controversy surrounding his attempt to host a campus event on this topic.
The conversation dives deep into the political and scientific tensions around gender dysphoria, the role of diversity and inclusion in academic settings, and the experiences of de-transitioners who often face opposition on all sides. Gain unique insight into the narratives left unheard, the role of activism in shaping public discourse, and why protecting free speech and medical integrity is more crucial than ever. You won’t want to miss this candid and compelling discussion.
This video contains graphic medical content that some viewers may find disturbing. Viewer discretion is advised.
Listen in via Apple Podcasts, YouTube, Spotify, or Amazon Music.
The Supreme Court Weighs the Future of Child Sex Change Interventions
COMMENTARY Tennessee, United States Gender Ideology Federal government Judicial Do No Harm StaffOn Wednesday, the Supreme Court will hear oral arguments in a case that could dramatically alter the legal landscape surrounding so-called “gender-affirming care” for children.
The case, United States v. Skrmetti, concerns a Tennessee law that prohibits children from accessing sex change interventions including surgeries, puberty blockers and cross-sex hormones. The Department of Justice (DOJ) intervened in the ACLU’s case against Tennessee over the law in 2023, arguing it violated protections guaranteed by the Constitution.
Currently, 26 states including Tennessee have passed laws restricting child sex change interventions. The Supreme Court’s decision in this case could therefore have wide-reaching consequences for the protection of children across the country.
Do No Harm is hosting a rally Wednesday morning on the steps of the Supreme Court to expose these harmful practices and urge the court to uphold the Tennessee law.
The Case
Tennessee’s law reflects the fact that child sex change interventions are dangerous, carry unknown long-term risks, and are supported by weak, dubious, and error-filled evidence. As such, the law prohibits minors, who cannot provide informed consent to life-altering procedures, from accessing these interventions.
Specifically, the law bans procedures enabling “a minor to identify with, or live as, a purported identity inconsistent with the minor’s sex” or to address “purported discomfort or distress from a discordance between the minor’s sex and asserted identity.”
However, the federal government, along with advocacy groups such as the ACLU and others, argue that the law discriminates against “transgender” children on the basis of gender identity.
The DOJ under President Joe Biden intervened in the case 2023, arguing the law denied minors “medically necessary” care and that it violated the Fourteenth Amendment’s Equal Protection Clause. Specifically, the DOJ argued that the law “permits all other minors to access the same procedures and treatments” for conditions unrelated to gender dysphoria, but prevents “transgender” children from accessing medical interventions to alter their appearance in accordance with their gender self-identification.
The U.S. Court of Appeals for the Sixth Circuit upheld Tennessee’s law, and the federal government appealed to the Supreme Court, which took up the case earlier this year.
Fundamentally, this case is about whether states can protect children from dangerous procedures and treatments that are completely out of step with the principles of evidence-based medicine.
And the scientific basis for these procedures is wanting, to say the least.
The Science
Child sex change interventions are not consistent with evidence-based medicine, and Tennessee’s law reflects this.
In October, Do No Harm filed an amicus brief laying out the lack of evidence supporting child sex change interventions, as well as the scientific errors in the DOJ’s argument against Tennessee’s law.
Another amicus brief filed by over 50 physicians explains how, given the marked lack of medical evidence for these procedures, Tennessee’s law is a perfectly reasonable prohibition. Do No Harm funded the preparation of that brief.
Several entities have conducted systematic reviews of the use of cross-sex hormones and puberty blockers to treat gender dysphoria, and all have concluded that the evidence underlying medical interventions for gender dysphoria in minors is weak.
For instance, health authorities in Finland, Sweden, and the United Kingdom have all restricted minors’ access to child sex change procedures in recent years as a result of these findings.
Moreover, the studies that purport to provide evidence for the efficacy of so-called “gender-affirming care” are riddled with flaws. Do No Harm recently published a report exposing many of the most often-cited studies for their methodological issues.
Unfortunately, the federal government and other advocates rely on studies that systematic reviews have concluded are flawed, subject to bias, or otherwise weak.
The Consequences
Should the Supreme Court find that Tennessee’s law violates the constitution, the consequences could be devastating to children across the country. Similar protections in dozens of states could be revoked, and children would once again be at the mercy of a medical establishment all too eager to subject minors to dangerous medical interventions.
Likewise, if the Supreme Court upholds Tennessee’s ban, states will likely be free to continue protecting children from harmful and unsupported medical procedures.
CMS Removes Equity Requirement from Kidney Transplant Rule Following Do No Harm Comment
Uncategorized United States DEI Federal government Press Release Do No Harm StaffRichmond, VA; November 27, 2024 – The Centers for Medicare and Medicaid Services (CMS) announced a new rule intended to increase access to kidney transplants. The finalized rule dropped a proposed requirement for hospitals to submit “health equity plans” to receive incentive payments. The change comes after Do No Harm submitted a comment on the original rule stating that the health equity plan requirement would have encouraged race-based discrimination.
Click here to read Do No Harm’s comment and the reporting on the original proposed regulation.
“Racial discrimination has no place in healthcare,” said Dr. Stanley Goldfarb, Chairman of Do No Harm. “Had the rule taken effect as proposed, the government would have been putting its thumb on the scale by incentivizing providers to consider race when selecting patients for kidney transplants. We are pleased the CMS took our concerns seriously and made the necessary adjustments to the final rule.”
See below for an excerpt from the final rule:
Last month, Do No Harm released a continuing medical education course that examines the impact of considering race in kidney disease assessments. Click here to take the free course.
Do No Harm, established in April 2022, has rapidly gained recognition and made significant strides in its mission to safeguard healthcare from ideological threats. With 14,000 members, including doctors, nurses, physicians, and concerned citizens across all 50 states and 14 countries, DNH has achieved over 10,000 media hits in top-tier publications and garnered widespread attention through numerous broadcast news appearances.
Study Finds DEI Training Increases Agreement With Hitler’s Rhetoric – And the Media Won’t Touch It
Uncategorized United States DEI Health system Commentary Do No Harm StaffWe at Do No Harm have long been sounding the alarm over the deleterious effects of DEI training, particularly in the field of medicine where lives are literally at stake. DEI is a radical ideology that encourages hate, divisiveness, and prejudice, the very things its proponents purport to oppose.
Well, a new study found exactly that, and then some.
“Instructing Animosity: How DEI Pedagogy Produces the Hostile Attribution Bias,” released by the Network Contagion Research Institute (NCRI) and the Rutgers University Social Perception Lab on Monday, found that exposure to DEI trainings increased agreement with rhetoric from Adolf Hitler and had a greater desire to punish those they perceived as harboring prejudice, even when none existed.
That’s hardly a ringing endorsement for the DEI project.
The study examined the impact of DEI narratives on participants’ responses on three subjects – race, religion, and caste. The control group was exposed to a neutral essay about corn, while each other group was exposed to various DEI narratives pertaining to each of the subjects. Then, each grouping was presented with a hypothetical scenario and asked questions about their subject.
“Across all groupings, instead of reducing bias, [DEI materials] engendered a hostile attribution bias [ ], amplifying perceptions of prejudicial hostility where none was present, and punitive responses to the imaginary prejudice,” the study found. “These results highlight the complex and often counterproductive impacts of pedagogical elements and themes prevalent in mainstream DEI training.”
The results were particularly disturbing for participants exposed to DEI narratives about the Hindu caste system. DEI materials increased participants’ agreement with quotes from Adolf Hitler in which the word “Jew” was replaced with “Brahmin,” the highest caste.
“Participants exposed to the DEI content were markedly more likely to endorse Hitler’s demonization statements, agreeing that Brahmins are ‘parasites’ (+35.4%), ‘viruses’ (+33.8%), and ‘the devil personified’ (+27.1%),” the study found. “These findings suggest that exposure to anti-oppressive narratives can increase the endorsement of the type of demonization and scapegoating characteristic of authoritarianism.”
Participants exposed to DEI narratives about race read materials from Ibram X. Kendi and Robin DiAngelo, two “scholars” whose “work” is closer to a barely-coherent ideological pretext for racial discrimination and divisiveness. Shockingly, the study found that participants exposed to these materials were considerably more likely to find racial prejudice when none existed, and were more likely to support punishment of the “racist” actor.
But it seems that these damning findings may have been a little too over the target.
National Review reported that editors at both Bloomberg and The New York Times elected to kill stories about the study after reporters had previously agreed to cover it.
“Unfortunately, both publications jumped on the story enthusiastically only for it to be inexplicably pulled at the highest editorial levels,” a NCRI researcher told National Review. “This has never happened to the NCRI in its 5 year history.”
Bloomberg failed to provide an explanation, while some inside The New York Times had concerns the research was not peer reviewed.
“I told my editor I thought if we were going to write a story casting serious doubts on the efficacy of the work of two of the country’s most prominent DEI scholars, the case against them has to be as strong as possible,” a New York Times reporter wrote to the NCRI, per National Review.
It’s a shame these publications refused to run these stories so that this research could not reach a wider audience. The study highlights the dangers of DEI in the medical field and why it is absolutely imperative that healthcare professionals don’t simply turn a blind eye to these practices, but actively resist.
Engendering racial paranoia and encouraging physicians to find prejudice under every bed is a recipe for disaster. And in the medical field, where patients are trusting healthcare professionals with their lives, it is completely unacceptable to subject these doctors and nurses to propaganda that encourages authoritarian, prejudicial impulses.
Activists Trot Out Bogus Studies to Defend DEI in Medicine
Uncategorized United States DEI Medical Journal Commentary Ian Kingsbury, PhD, PhDA look around the political and corporate landscape reveals that DEI is in retreat. Its champions are trying to salvage it with claims that it’s beneficial, but they remain as wrong as ever.
Take, for example, an article published November 11 in STAT News called Cardiovascular health disparities persist in puzzling ways, studies find. The author admits that DEI is facing “political winds” but insists that four recent studies demonstrate why DEI is supposedly beneficial. Closer inspection reveals this assertion to be false.
The first “study” mentioned in the STAT News article is called “Relationship Between Race, Predelivery Cardiology Care and Cardiovascular Outcomes in Pre-Eclampsia/Eclampsia Among a Commercially Insured Population.” The researchers observe that among white mothers with eclampsia or preeclampsia (dangerous hypertensive pregnancy disorders), receipt of predelivery cardiology care is associated with a lower incidence of major adverse cardiovascular events, or MACE (a composite measure of heart failure, acute myocardial infarction, stroke, or death). However, for black mothers with eclampsia or preeclampsia, receipt of cardiology care is not associated with a lower incidence of MACE.
In making sense of the different outcomes, the researchers couch their explanation in default DEI positions, blaming “structural racism” and “racial biases in the delivery of appropriate and timely post-partum cardiology care.” As is so often the case with health disparities, a closer look reveals less interesting but more sensible explanations.
One plausible explanation for the disparity is that preeclampsia is “more severe in women with African ancestry.” Likely, black women with preeclampsia who receive cardiology care have worse outcomes because they have more severe disease. The researchers theoretically address this concern by statistically adjusting their estimates to account for differences in preexisting heart conditions (cardiac dysrhythmia, valvular heart diseases, ischemic heart diseases, cardiomyopathies, and heart failure) and clinical morbidities (e.g. diabetes, assisted reproductive technology, dyslipidemia, hypertension, gestational hypertension, stroke, obesity, and obesity in pregnancy). However, this data does not perfectly capture differences in health across populations, and these differences can matter when interpreting results. A study purporting to show that black babies were less likely to die if assigned to black doctors was recently debunked by the discovery that researchers did not account for differences in the incidence of “very low birth weight.” In a similar vein, controlling for “obesity” masks significant racial differences in the incidence of morbid/clinically severe obesity.
Another factor that plausibly explains the phenomena observed by the researchers is average group differences in how patients interact with the health care system. Black women are more than twice as likely as white women to receive late or no prenatal care. Likely, many who receive delayed care would have received an earlier referral to cardiology and better outcomes if they had secured timely care. In writing about limitations, the researchers correctly note that “we were unable to ascertain the frequency and timing of cardiology care throughout the pregnancy period. We appreciate that these factors may have [a] substantial impact on the care and outcomes for both races.” Nevertheless, this possibility is eschewed in favor of a radical, racialized hypothesis.
The second “study” in the STAT News article is called “Racial and Ethnic Differences in Semaglutide Prescriptions for Veterans with Overweight or Obesity in the Veterans Affairs Healthcare System.” The researchers observe that black veterans in the VA health system are marginally less likely to be prescribed semaglutide as a treatment for obesity (8.9% for black veterans vs. 9.1% for white veterans). As the authors reasonably argue, the small difference masks the true magnitude of the disparity since black patients are, on average, in greater clinical need of weight loss treatment.
What the researchers get wrong is asserting “structural bias” as a plausible explanation for the disparity. The idea that structural bias permeates the healthcare system is born of the fallacious ideas that group differences are indicators of maltreatment and that the pseudoscience of “implicit bias” provides meaningful insight into American healthcare. Likely, the lower receipt of semaglutide simply reflects average group differences in demand for treatment or treatment hesitancy.
Not only is the assertion about “structural bias” wrong, it is also logically inconsistent. The next study highlighted by STAT News is called “Social Determinants of Health and Disparities in Guideline-Directed Medical Therapy Optimization for Heart Failure.” According to that study, black and Hispanic patients with heart failure with reduced ejection fraction (HFrEF) are more likely than white patients with the same condition to receive quadruple therapy optimization, the optimal treatment plan for that condition. According to the logic that disparities that disadvantage a group are evidence of maltreatment against that group, the findings would suggest – absurdly – that “structural bias” in healthcare exists against white patients. In reality, disparities that at times favor one group and at other times favor a different group reveals the complex, multifaceted nature of health disparities as well as the absurdity of DEI orthodoxy and its default explanation of racism.
The final study cited by STAT News is called “Perceptions About Diversity, Equity, and Inclusion Among Cardiovascular Fellows‐in‐Training.” The “researchers” observe that some of the cardiovascular fellows-in-training who answered their survey feel that DEI efforts in their programs are insufficient. For example, “Although 66% felt DEI was an institutional priority and 63% a fellowship priority, 34% of participants strongly or somewhat agreed that community engagement and outreach was not valued by their institution.” The trouble is that the efficacy and wisdom of DEI aren’t ultimately determined by the sentiment of a small group of activist physicians but by how DEI impacts medical education and patient outcomes. The verdict couldn’t be clearer.
The $400,000 DEI Program to Turn Internal Medicine Inside-Out
Uncategorized United States DEI Medical association Commentary Do No Harm StaffFollowing the “racial reckoning” of 2020, numerous medical associations and specialty societies took it upon themselves to delve into the realm of political and racial activism, promoting DEI and radical ideology to the detriment of medical education and, ultimately, patients themselves. This is a phenomenon that Do No Harm has extensively recorded.
These efforts often manifested in projects intended to rewire the landscape of medicine through trainings and continuing education that pushed the precepts of DEI onto the healthcare system.
Take the Alliance for Academic Internal Medicine (AAIM). This is the fourth year that AAIM will be offering its $400,000 grant program, “Building Trust through Diversity, Health Care Equity, Inclusion and Diagnostic Excellence in Internal Medicine Training.”
We don’t have to speculate about whether the grant program is intended to reform medical education in accordance with a radical ideology; AAIM literally says that’s the case. The purpose of the funds, per AAIM, is to “integrate diversity, equity, and inclusion (DEI) into the fabric of internal medicine education and training.”
In fact, the inaugural grant announcement contained this same language. It further noted that “bias and discrimination in health care have slowly but steadily eroded trust in the entire system, including in clinicians directly responsible for care.” (We agree! Although not for the same reasons as AAIM).
The grant program specifically courts applications to develop “training programs that incorporate DEI, and in particular those that employ inter-professional education best practices.”
One previous grant recipient aimed to “expand the curriculum for primary care residents to include education about […] patient mistrust and physician bias.” And to illustrate just how tied this program is with political activism, a 2023 grant recipient received $40,000 for a project titled “Integration of Voter Registration within a Safety-Net Health System to Address Voting as a Social Determinant of Health.”
AAIM even appears to invite applications to develop newfangled methods for racial discrimination, asking for “approaches that foster and support diverse and equitable pathways into medicine and faculty and leadership positions.”
But what makes this program particularly problematic is the fact that AAIM is composed of several organizations that represent not just medical providers or students but the educational decision-makers. These include department chairs of internal medicine at medical schools, fellowship program directors, residency program directors, and more.
In other words, AAIM represents the standard-setting movers and shakers in internal medicine education. And its focus is to propagate DEI throughout the field of academic internal medicine and in its own words, integrate DEI into internal medicine’s fabric.
Let’s not sugarcoat it: This is a full-fledged ideological assault intended to remake medicine into a new, DEI-centric discipline that prioritizes activism and supports racial discrimination to achieve its “equity” goals.
The physicians of tomorrow should not be ideologues. And AAIM should take its responsibility more seriously and commit to excellence, not “equity.”