These Ohio Medical Schools Are Violating Civil Rights

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Multiple Ohio schools of medicine are violating students’ civil rights—specifically by discriminating on the basis of race. That’s the message of official complaints that Do No Harm filed with the U.S. Department of Education’s Office of Civil Rights on June 14th. These institutions must be held accountable for this blatant injustice.

The schools in question are: 

Combined, these medical schools offer five scholarships that are available to students of certain races and identities. This is racial discrimination, plain and simple, which makes the scholarships illegal under federal law.

The Civil Rights Act holds that “no person in the United States shall, on the ground of race, color, or national origin, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance,” which includes all four medical schools.

We are asking the Office of Civil Rights to “promptly investigate the allegations in [these] complaint[s], act swiftly to remedy unlawful policies and practices, and order appropriate relief.” Racial discrimination is unacceptable – in healthcare as much as everywhere else.

If you know of a discriminatory scholarship or policy at your medical school, please let us know.

This Indiana Medical School Is Violating Civil Rights

The Indiana University School of Medicine is violating students’ civil rights—specifically by discriminating on the basis of race. That’s the message of an official complaint that Do No Harm filed with the U.S. Department of Education’s Office of Civil Rights on June 14th. The school must be held accountable for this wrongdoing.

Our complaint centers on an IUSM scholarship program that is solely available to applicants of certain races and identities. This is racial discrimination, plain and simple, which makes the scholarships illegal under federal law. 

The Civil Rights Act holds that “no person in the United States shall, on the ground of race, color, or national origin, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance,” which includes IUSM.

Do No Harm previously submitted a letter to the IU School of Medicine regarding its mandate that faculty prove how woke they are as a condition of employment.

We are asking the Office of Civil Rights to “promptly investigate the allegations in this complaint, act swiftly to remedy unlawful policies and practices, and order appropriate relief.” Racial discrimination is unacceptable – in healthcare as much as everywhere else.

If you know of a discriminatory scholarship or policy at your medical school, please let us know.

Comment Submitted by Do No Harm

Re: Notice of Proposed Rulemaking; Docket Number CMS-1771-P: Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Proposed Policy Changes and Fiscal Year 2023 Rates; Quality Programs and Medicare Promoting Interoperability Program Requirements for Eligible Hospitals and Critical Access Hospitals; Costs Incurred for Qualified and Non-Qualified Deferred Compensation Plans; and Changes to Hospital and Critical Access Hospital Conditions of Participation

Introduction

Do No Harm is a policy and advocacy organization committed to protecting the integrity of American healthcare. We represent a diverse group of physicians, healthcare professionals, medical students, patients, and policymakers united by a moral mission: Protect and promote the healthcare that improves the health and well-being of every individual patient. We oppose injecting political ideology into healthcare, which should always be apolitical and patient-focused. Do No Harm is dedicated to empowering patients, medical professionals, and a diversity of Americans to promote medical fairness and equal access to care.

Climate Change and Health Equity

Through this proposed rulemaking, CMS is seeking strategies and approaches for addressing climate change, which it says directly impacts the medical community. CMS asserts without evidence that climate change disproportionately harms “underserved populations.” (Underserved populations refers to: “racial and ethnic minority groups, indigenous people, members of religious minorities, people with disabilities, sexual and gender minorities, individuals with limited English proficiency, older adults, and rural populations.”) CMS asserts that “the healthcare sector should more fully explore how to effectively prepare for climate threats.” This new mission is both vague and all-encompassing. 

CMS has requested comments from the public regarding: (1) the likely impacts of climate change on patients, residents and consumers so that they can develop plans to mitigate those impacts; (2) the understanding of exceptional threats that climate-related emergencies cause to patients so they can better address those issues; and (3) taking action on reducing emissions and tracking progress in this regard. CMS has indicated such action could apply to hospitals, nursing homes, hospices, health home agencies, and other providers. However, climate change is not even tangentially related to treating specific patients for specific illnesses. The healthcare industry should focus on improving the health and well-being of patients, including serving each patient’s unique and individual needs. CMS should oppose any rulemaking that distracts from the basic mission of medical care and creates a barrier between medical professionals and their patients.

Under this new potential rule, healthcare entities will be asked and possibly compelled by CMS to divert their focus and resources from serving patients to tracking greenhouse emissions. Medical professionals are not trained or equipped for this type of activity, and it strains credulity to believe that shifting time and attention to this contentious issue will do anything to benefit patients. It is far more likely to harm patients and therefore has no place in healthcare.

Health Equity Approaches

Stratification Methods

In the build-up to this rulemaking process, CMS asserts without evidence that significant and persistent inequities in healthcare outcomes exist today for certain demographics. CMS asserts that the worst health outcomes are often associated with individuals that belong to a racial or ethnic minority group; are a member of a religious minority; live with a disability; are a member of the lesbian, gay, bisexual, transgender, and queer (LGBTQ+) community; live in a rural area; or live near or below the poverty level. Through this proposed rulemaking, CMS hopes to attain an equitable society by “designing, implementing, and operationalizing policies and programs that support health for all the people served by our programs, eliminating avoidable differences in health outcomes experienced by people who are disadvantaged or underserved, and providing the care and support that our beneficiaries need to thrive.”

In order to address healthcare disparities, CMS intends to use measurement and stratification methods, which are defined as calculating measure results for specific groups or subpopulations of patients. In short, CMS wants to collect a wide-variety of personal data from patients to categorize individuals with heightened social risk or demographic characteristics with associations to poorer outcomes. They will be categorized according to their group identity, per the list above, instead of their individual characteristics and medical needs. Such stratification threatens the individualized treatment that healthcare is supposed to provide.

Additionally, CMS wants hospitals to report confidential patient information in an attempt to highlight potential gaps in care between groups of patients. Yet these “gaps in care” are not actually about care. Instead, CMS is seeking to identify information regarding racial, ethnic, income, geographic location, and sexual orientation. By labeling these characteristics as disparities, CMS could use this information to single out healthcare providers and take punitive action against them. 

CMS claims to prioritize measures that focus on access to care. However, it appears CMS is using “access to care” as an attempt to collect more non-health related data from patients. 

Additionally, CMS introduces the concept of “non-clinical drivers of health.” These include “social risk factors such as socioeconomic status, housing availability, and nutrition, as well as marked inequity in outcomes based on patient demographics such as race and ethnicity, being a member of a minority religious group, geographic location, sexual orientation and gender identity, religion, and disability status.” This self-reported data, which by CMS’s own admission complicates its ability to choose effective metrics to evaluate disparity, will be used as indicators for health inequity. This means CMS is creating a reporting system with acknowledged flaws. Such a flawed system should not be used as a basis for rulemaking or policies of any kind.

CMS is inappropriately seeking to restructure how the healthcare system approaches patient care. It asserts that “attributing differences in outcomes to race may inappropriately place the driver of poorer health outcomes on the patient, rather than on structural factors, such as racism in society and the healthcare system that drive the provision of lower quality care.” Rather than addressing individual symptoms and lifestyle choices to treat a patient, CMS sees health equity as an opportunity to address the supposed “racism in society and the healthcare system.” By hijacking the medical relationship between a healthcare provider and his or her patient to include “structural factors,” the well-being of the patient is no longer the primary focus. This is a dangerous precedent for CMS to set. Individual health should always be the main priority in the healthcare system.

Furthermore, CMS acknowledges that once reporting of healthcare disparities is complete, the presentation of results will not be objective. CMS offers four ways for stratified results to be presented: Statistical Differences; Rank Ordering and Percentiles; Threshold Approach; and Benchmarking. For example, when using the Threshold Approach, healthcare providers could be grouped based on their performance using defined metrics, such as fixed intervals of results of disparity measures, indicating different levels of performance. However, this method does not convey the degree of disparity between healthcare providers or the potential for improvement based on the performance of other healthcare providers. It also requires a determination of what is deemed “acceptable disparity” when developing categories. CMS could potentially create a healthcare provider ranking system based on the results of the nonmedical, social risk factors included in the stratification method—another unacceptable and inappropriate use of the healthcare system’s resources.

Taken together, CMS’s efforts at stratification come down to the creation of a confidential database of patient information that will distract healthcare providers from treating patients highest and most individualized level. 

The Hospital Readmissions Reduction Program

CMS seeks comment on (1) The benefit and potential risks, unintended consequences, and costs of incorporating hospital performance for beneficiaries with social risk factors in the Hospital Readmissions Reduction Program; (2) the approach of linking performance in caring for socially at-risk populations and payment reductions by calculating the reductions based on readmission outcomes for socially at-risk beneficiaries compared to other hospitals or compared to performance for other beneficiaries within the hospital; and (3) measures or indices of social risk, in addition to dual eligibility, that should be used to measure hospitals’ performance in achieving equity in the Hospital Readmissions Reduction Program. Once again, the proposed rulemaking threatens healthcare providers’ ability to treat and improve the health of individual patients.

The Hospital Readmissions Reduction Program is a Medicare value-based purchasing program that encourages hospitals to improve communication with patients and caregivers in discharge plans and thereby reduce readmissions. This program is designed to improve the quality of hospital care for all Americans. CMS now wants to use it to improve “health equity” and reduce healthcare disparities, despite there being no statutory authority for changing the program’s purpose and goals.

By pursuing this rulemaking, CMS will change the medical community’s focus from medical diagnosis and treatment to social issues like income, education, employment, and housing quality. However, these indicators remain unconnected from and unnecessary for treating the patient’s individual health needs. CMS should not be distracting healthcare providers from focusing on patients’ specific health concerns and treatment plans. 

Data Collections

CMS seeks public comment on how the reporting of diagnosis codes in categories Z55–Z65 may improve CMS’s ability to recognize severity of illness, complexity of illness, and/or utilization of resources in an effort to advance health equity for all. CMS wants to expand its data collection by requiring medical facilities to report to CMS additional diagnosis codes in the Social Determinants of Health (SDOH). CMS uses SDOH as an assessment for coverage decisions and for designing programs, benefits, and services, yet making decisions based on these factors has no proven correlation with improving patient health and may in fact undermine it.

Specifically, Codes Z55-Z65 include the following data: (Z55) Problems related to education and literacy; (Z56) Problems related to employment and unemployment; (Z57) Occupational exposure to risk factors; (Z59) Problems related to housing and economic circumstances; (Z60) Problems related to social environment; (Z62) Problems related to upbringing; (Z63) Other problems related to primary support group, including family circumstances; (Z64) Problems related to certain psychosocial circumstances; and (Z65) Problems related to other psychosocial circumstances.

The information in Z Codes is self-reported by the patient. According to CMS, “patient self-reported documentation may be used to assign codes for social determinants of health, as long as the patient self-reported information is signed-off by and incorporated into the medical record by either a clinician or provider.” Documentation of social information from social workers, community health workers, case managers, or nurses could be utilized if the documentation is included in the patient’s official medical record.

By expanding data collection to include such characteristics as housing and social environment, CMS could decide to increase Medicare coverage for individuals that fall into these categories. Additionally, CMS could rank and assess healthcare facilities based on their interactions with patients from certain demographic groups. This means CMS is attempting to identify certain demographics in its data collection efforts for non-healthcare purposes. By requiring medical facilities to report this data, CMS is once again diverting resources and time from patient care. CMS should not be spending money on an initiative that is meant to collect data on non-medical information.

Conclusion

CMS’ proposed rulemaking threatens medical excellence and the quality of care provided to patients. It injects controversial, politicized, and non-medical factors into federal healthcare decision-making, which will limit providers’ ability to serve patients’ unique needs and develop individualized treatment plans. CMS should focus on improving health outcomes for everyone, which this proposed rulemaking fails to do.

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New Senior Fellow Joins Do No Harm Team 

Benita Cotton-Orr has officially joined Do No Harm as of June 13, 2022. As a senior fellow, Cotton-Orr will help Do No Harm prevent the woke takeover of America’s health care system.

Cotton-Orr, who immigrated from South Africa in 1986, is a policy expert with a background in journalism. Her outspoken opposition to racially based and discriminatory policies is rooted in personal experience and the discrimination and inequities her family, friends and colleagues suffered under apartheid.

“Benita has a powerful voice to speak on behalf of patients who are tired of divisive ideologies creeping into the healthcare sector,” said Dr. Stanley Goldfarb, chairman of Do No Harm. “Her depth and breadth of experience in shaping public policies is a great addition to our team, and we look forward to her supporting Do No Harm’s mission.”

Cotton-Orr is a respected voice for principled, policy solutions who has moderated events and addressed civic and leadership groups across Georgia on current issues and free-market solutions. She has been a frequent contributor to newspapers and television and radio programs around the state and spent seven years providing free-market perspectives as a conservative commentator on a weekly Atlanta Radio Korea program.

Proposed Federal Rule Would Enlist Hospitals In Woke Activism

Background

On April 18, 2022, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule for inpatient and long-term hospitals that will force these medical providers to advance a divisive and potentially discriminatory agenda. This rule is a danger to the health of millions of Americans.

This rule is part of the Biden Administration’s campaign to impose “equity” goals on healthcare, based on the false narrative that healthcare suffers from “systemic racism.” CMS intends to force healthcare providers to gather and report information on patient race, ethnicity, income, geographic location, sexual orientation, and gender identity. This information will feed into vast patient databases that can be used to reward or punish healthcare providers, based on their fidelity to identity politics. 

The proposed rule would also establish a process in which hospitals screen and identify patients’ non-medical problems (i.e., housing, difficulty paying bills, transportation needs, etc.). This data will be reported to the federal government and could also be used to reward or punish providers.

CMS is also interested in the alleged impact of climate change on patients, residents, and consumers, and seeks greater understanding of threats posed by alleged climate-related emergencies. Like the administration’s “equity” agenda, the focus on climate change is a political intrusion into healthcare.

Health Equity 

Stratification Methods

  • CMS wants to collect a wide variety of personal data from patients in order to create more precise categorizations of patients along race, gender, and other demographic lines.
  • CMS wants hospitals to report confidential patient information to highlight potential gaps in care between groups of patients. By labeling these differences as disparities, CMS could use this information to reward or punish certain healthcare facilities.
  • The proposed rule would distract medical professionals from providing care to patients and instead saddle them with a new mandate focused on politicized and non-medical issues.

Data Collection

  • The Biden Administration wants to use a politicized tool known as the “Social Determinants of Health” (SDOH) for collecting information on racial demographics for each hospital.
  • This includes problems related to employment and unemployment, housing and economic circumstances, and social environment, among other non-medical factors.
  • CMS will use SDOH data to track the interaction of medical facilities with certain demographic groups. The goal is likely to use this information to influence funding, medical supplies, and possibly even the distribution of medicine and therapies.

Climate Change 

  • CMS states that climate change disproportionately harms “underserved populations,” such as minority groups, indigenous people, members of religious minorities, people with disabilities, sexual and gender minorities, etc. This is a non-medical assertion.
  • Under this rule, healthcare providers will have to shift resources away from patient health and start tracking greenhouse emissions, a task that medical professionals have no competence in. 

Comments on the proposed rule must be submitted by June 17, 2022.

Dr. Stanley Goldfarb Responds To His Critics

This blog is authored by Do No Harm chairman, Dr. Stanley Goldfarb.

I recently tweeted about an article in the journal Academic Medicine. The article found that a group of minority residents (who are referred to as “underrepresented in medicine”) scored worse than a group of white residents on all dimensions of the assessment system used by the faculty at three academic medical centers. The authors entertained only three possible explanations for this finding: attending bias, a less hospitable training environment, or a racist assessment system. 

My tweet posed an obvious question: “could it be they were less good at being residents?” 

It’s a logical question. In the name of diversity, medical schools have lowered admission standards for years, to the point of abandoning standardized tests and changing candidate evaluation systems. This has led to a situation in which some minority students come to medical school with marginal academic records and then struggle when they enter  medical school. Moreover, assessments have become less rigorous, so identifying struggling students has become more difficult.

This raises the possibility that the assessments in the Academic Medicine journal are correct: While many minority students could be excelling, many others could be performing less well. It’s the obvious explanation and research should examine whether it’s the correct explanation, which it may not be. Yet the study authors did not allow for the possibility—even for the purpose of debunking it.

In the absence of any analysis to the contrary, my question points to a plausible reality. Yet instead of debating the merits of my argument or doing a deeper dive on the underlying research, I received an onslaught of criticism—including from medical leaders who should know better.

Dr. Michael Parmacek, the Chairman of the Department of Medicine at the Perelman School of Medicine (where I served as associate dean until 2019), wrote to the faculty and staff of the department. He was surely responding to the predictable and unremarkable anger on Twitter and presumably from some students, staff, or faculty at Penn. Yet instead of showing leadership or standing up for medical standards and academic freedom, he engaged in ad hominem attacks and called my words “racist.”

His statement was as unacademic as it was cowardly. He refused to engage with the question of why some students perform worse in evaluations. Nor did he attempt to substantiate his accusation that I made racist statements. Most disturbingly, he failed to reflect on whether his institution’s own admissions policies could degrade the quality of medical students and therefore the care that current and future patients receive from them. 

Instead, Dr. Parmacek simply denounced me and genuflected before his own constituents—the administrators and students determined to reorient medical education away from science and rigor and toward their own view of social justice. 

The practice of medicine demands that the practitioner first Do No Harm. By refusing to ask hard questions, let alone obvious questions such as the one I posed, the Perelman School of Medicine (and most medical institutions, for that matter) are threatening patient well-being and the excellence of the entire medical system. 

What if lower standards in medical school admissions are producing quantifiable decreases in the quality of the residents those schools produce—as the study seems to suggest? What if these admissions policies are actually hurting minority students, and for the many who succeed, casting a cloud over their success? And is it really better to ignore these questions in service of “social justice”? 

Surely not. The patients we serve deserve better. The physicians we’re training deserve better. It is incumbent on medical schools and researchers to address these questions honestly and fairly. Burying their heads in the sand and attacking those who refuse to do so as racist is appeasement—and a total abandonment of the critical thinking that scientific and medical progress depend on.

As a long-time medical educator and practitioner, I will not be deterred by slanders and acts of intimidation. I will continue to ask uncomfortable questions in pursuit of the truth and improved outcomes for patients, not least because I’ve heard from countless other medical professionals who are deeply concerned yet afraid to speak out. The pursuit of truth must be the lodestar of medical education—not the feelings, political agendas, and employment prospects of health care providers.

Must Read: A Letter From A Medical School Faculty Member

Do No Harm received this letter from a clinical faculty member at University of Washington School of Medicine. We are keeping the person’s identity secret for their professional protection.

May 31, 2022

To Do No Harm,

I am a physician on the clinical faculty of our local medical school. I have been quite concerned about recent developments at the school, which recently opened an “Office of Healthcare Equity.” At least some of it appears to be agenda driven, hijacking and distracting the focus of the school from evidence-based medicine into the social realm. 

Recently, following the tragic shooting in Buffalo by a racist man who targeted African Americans, the following was sent out by the Office:

Please join the Office of Healthcare Equity in affinity groups for our BIPOC colleagues and a caucus for our white colleagues who want to stand in solidarity with BIPOC colleagues… These sessions will offer a safe space, respite and community to process and support one another following the racially motivated shooting in Buffalo, New York… We will join as one group at the start and then meet in breakout rooms based on identity (Black, People of Color and White). 

In response to this invitation, I sent this anonymous note to them: 

Greetings,

I am a faculty member at UW Medicine. I am writing from an anonymous account because I do not trust my professional safety were I to disclose my name. 

This is prompted by the upcoming affinity groups that the school is organizing and promoting. 

I will state unequivocally that the shooting in Buffalo was horrific and driven by unacceptable beliefs that we as a society must confront and deal with. 

But I am not supportive of this selective horror being a focus of organized efforts on the part of the school. Staying in our lane of medical education is demanding enough. There are innumerable injustices and causes that warrant attention by society, but is the school the right place and if so, why stop there? 

Furthermore I believe that organizing groups on the basis of personal identity is racist, divisive and not appropriate for any tax supported institution. 

Much more can be said about the Office of Healthcare Equity, as I have real concerns about an outsized influence and agenda setting that may not suit the school or society in the short and long-term, but which few are willing to call out. 

I found myself wondering when you offered up an opinion and action on this tragedy, if you will consider similar interventions the next time a group of people are murdered based upon hatred of their group. This could include but sadly is not confined to:

– Antisemitic attacks on synagogues or individual Jews.

– Attacks on Asian identified individuals based upon their origins.

– Attacks on gays and lesbians.

– Misogynistic attacks on women.

– Perhaps expanded attention to genocides and religious and gender persecution in China, the Middle East, Africa and elsewhere.

I do not expect a response to this as I am sure this sort of message does not sit well with some at the school, though I suspect that I am not alone. 

Thank you for your attention and careful consideration. 

– A faculty member

I respect my profession and have been in practice for decades. The above is one of several grievances I have experienced of late at my school that cause great concern. I am grateful that Do No Harm has been organized, to among other things, call out racial divisiveness and social agendas contaminating our valuable profession.

– A Concerned Physician

What Counts for “Education” At Stanford’s Medical School

Another day, another medical school pushing woke ideas on physicians. This time it’s Stanford University School of Medicine, which has a course focused on “unconscious bias in medicine.” As with similar efforts nationwide, this course is consciously steeped in ideological bias.

The course, which is specifically designed for current physicians looking to fulfill “Continuing Medical Education” requirements, immediately admits that it’s a “seemingly non-science topic.” Sure enough, it lays out goals that have nothing to do with science or medicine. The list includes getting physicians to acknowledge “the effects of unconscious bias in everyday interactions” and “identify where personal unconscious biases may reside across gender, race/ethnicity, and/or cultural attributes.”

Once they sign up for the course, physicians take a test that shows their “baseline” bias. They are then bombarded with ideology to convince them of their bias and help them overcome it. Far from helping physicians view people equally, the course pushes physicians to focus primarily on their patients’ racial, cultural, or gender identity, which is itself discrimination. The course also involves Harvard University’s discredited Implicit Association Test, which falsely claims to show someone’s bias.

At the end of the course, physicians must take another test and get at least 75% of questions right in order to pass. One question focuses on using something called the “camera technique” to overcome bias toward a transgender patient. Overall, the questions reinforce the perception that physicians are biased – a dangerous assertion that insults physicians and injures patient trust in healthcare.

Such courses are rapidly becoming mandatory. States like Michigan and Massachusetts have already implemented a requirement that physicians take regular courses on unconscious bias, and to fulfill it, they’ll turn to courses like Stanford’s. The deeper this so-called “education” seeps into healthcare, the more damage it will do.

Michigan’s Governor Couldn’t Be More Wrong

Michigan Governor Gretchen Whitmer is all-in when it comes to corrupting healthcare. On June 1, the state began mandating that all current and future physicians take recurring implicit bias training. The Governor celebrated by claiming this woke policy will “make Michigan safer, healthier, and more just.” Nothing could be further from the truth.

Look no further than the kind of divisive and destructive indoctrination this mandate involves. The Michigan State Medical Society recently hosted an “Implicit Bias Training” event that meets the requirements of the new policy, and it’s already clear it’s more concerned with ideology than medicine.

The course is designed around the basic assumption that physicians are biased, an unsupported claim that can destroy patient trust in healthcare. The training’s supporting materials all but accuse physicians of adopting stereotypes that stop them providing the best care to minority patients. This is standard fare: Activists want to convince physicians they’re inherently biased in order to rebuild healthcare on a woke foundation.

What is that foundation? A post-training survey explicitly condones radical ideology: “it is important for primary care providers/physicians to devote extra attention/time to the health needs of their minority patients.” The name for that is racial discrimination, which has no place in healthcare. 

We’ve heard from numerous Michigan physicians about how insulting this training is – and the entire Michigan mandate, for that matter. Contrary to what Gov. Whitmer is saying, putting identity politics ahead of individual patients is unhealthy and unjust. 

These Five Medical Schools Are Violating Civil Rights

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Why are so many medical schools violating civil rights? That’s the question Do No Harm is asking in five complaints filed on Wednesday with the U.S. Department of Education’s Office of Civil Rights. These schools offer scholarships that are eligible to people of certain races, which is incompatible with the Constitution and federal law.

The medical schools in question are affiliated with the University of Florida, the University of Oklahoma, the University of Utah, and the University of Minnesota, as well as the Medical College of Wisconsin. While more than 140 medical schools and institutions nationwide offer questionable scholarships, these five medical schools are particularly noteworthy.

Consider the scholarship at the University of Florida College of Medicine. It is available to members of certain “racial and ethnic populations.” They spell out what that means – people who are “African Americans and/or Black, American Indian, Alaska Native, Naive Hawaiian, Hispanic/Latinx, and Pacific Islander.” The application also asks for an applicant photograph! 

Similar problems exist in the other four medical schools’ scholarships, all of which are restricted to people of specific skin colors or backgrounds. As our complaints note, the Constitution’s Equal Protection Clause prohibits racial preferences, as does the 1964 Civil Rights Act for universities that receive federal funds. 

We look forward to seeing how the U.S. Department of Education Office for Civil Rights and these medical schools respond to our complaints and end unnecessary and illegal discrimination. And we hope this starts a trend of medical schools abandoning racial discrimination in favor of equal treatment for all.

Member’s Letter to the Medical Society of Delaware

Do No Harm member Dr. Jim Lally recently sent us a copy of a letter he wrote to the Medical Society of Delaware in response to their promotion of the discredited Implicit Association Test. A shortened and adapted version is posted below: 

Dear Medical Society of Delaware:

I have been a member of the Medical Society of Delaware for forty-six years. I have also been on the editorial board of the Delaware Medical Journal for thirty years. I was greatly disappointed in the Society’s recent mailing, “Committee on DEI Requests your Participation” and its implications for the Delaware medical community. 

At the heart of the communique is this statement: “An Implicit Association Test (IAT) measures attitudes and beliefs that people may not know about.” I join many others who are academicians and well-versed in psychological testing who have argued that this attempt to measure implicit bias and unconscious racism is flawed in its methodology and its application—it is a fool’s errand. Meta analysis has shown that the above techniques are “a weak predictor of behavior.” I will be forwarding to you two articles that analyze IAT in detail. One was published in Quartz and the other in Scientific American. I suggest that you read them.

The cultural storms that have engulfed America in the last few years have seductively cajoled organizations such as the AMA to embrace wokeism. The Medical Society of Delaware has thoughtlessly joined the parade of lemmings who are marching to the AMA’s tunes.

The AMA has a pseudo-scholarly manifesto, “Advancing Health Equity: A Guide to Language, Narrative and Concepts,” that asks physicians to “promote critical reflection on language and word choice.” It is taking a page unedited from George Orwell’s dystopian novel 1984, in which he creates a new language, Newspeak. Orwell later commented that Newspeak was “designed to diminish the range of thought.”

Political philosophers have shown that centralized power is held by those who control the narrative and that is defined by the language employed. The AMA manifesto writes of “changing the narrative” and it “is essential to transform power…end dominant privilege.”

It is in the ten page “Glossary of Key Terms” in the AMA’s manifesto that the uninitiated will find most illuminating. Take its definition of “class consciousness,” which includes the phrase “recognition by workers as a social class in opposition to capitalists and to capitalism.” One has to wonder why the “Discovery of The Americas” is also included in the glossary. It is defined as: “The land known as the Americas was not discovered; it was conquered and appropriated.” 

In my opinion the AMA and MSD have lost their way and are heading in the wrong direction in this watershed moment for American medicine. So after all these years I find it distressing that I feel compelled to break off all contact with the Medical Society. That is most unfortunate but I feel it is the only way that I can say: I PROTEST.

Sincerely yours,

James F. Lally, MD

Michigan Is Corrupting Medical Licensing

Are you or someone you know a medical professional in Michigan? As of June 1, anyone who fits this description is now required to take ongoing courses on their supposed “implicit bias.” The Great Lakes State is well on its way to politicizing medicine and destroying patient trust in healthcare.

Michigan’s mandate is blunt: It says medical professionals need to combat their “attitude[s] or internalized stereotype[s]” that “contribut[e] to unequal treatment of people based on race, ethnicity, nationality, gender, gender identity, sexual orientation, religion.” In other words, medical professionals can’t be trusted to treat patients equally. Rarely will you see a more brazen insult to those who’ve devoted their lives to helping people.

The new rule covers physicians, nurses, counselors, therapists, athletic trainers, and about two dozen other types of medical professionals. Anyone applying for a license to practice medicine must complete two hours of implicit bias training, while those renewing their licenses must take an hour of training per year. This means medical professionals will be constantly bombarded with accusations of bias.

As we’ve pointed out many times, such training injures everyone involved. It tells medical professionals they aren’t capable of providing the highest quality care, while also telling them to focus on their patients’ race above real medical concerns. And it tells patients that their physicians and nurses can’t be trusted, since the entire profession is apparently biased. That’s a recipe for incentivizing people to avoid the care they need.

Such is the nature of woke healthcare: It hurts the people it claims to help. Michigan should abandon this absurd medical licensing mandate immediately, before it hurts medical professionals and patients alike.

If you’re dealing with this mandate in Michigan, or know of a similar requirement in another state, please let us know.

Beware The Biden White House’s Plans For Healthcare

The Biden White House is quietly trying to force woke ideology into healthcare. So every American should pay attention to what the administration’s “COVID-19 equity initiatives” leader recently said: Namely, that more radical and divisive healthcare policies are on the way.

Dr. Cameron Webb said as much in a May 17th Washington Post event on health equity. He said:

 “I think what the president has done pretty intentionally is [ask] how can we make equity a thread through all of government, infused in everything that we do… It’s certainly better than the alternative, and I think it’s an important turning point, inflection point for our country.”

We already have a hint about what this means. As our executive director Kristina Rasmussen has written, the current White House is bribing doctors to implement potentially discriminatory “anti-racism” plans. It’s also working with Congress to spend hundreds of millions of taxpayer dollars on “equity” in healthcare. 

The transparent goal is to put identity politics – not individualized patient treatment – at the heart of medicine. Equity is fundamentally opposed to medical excellence, since it requires that everyone be guaranteed the same outcomes, even if that means offering some people preferential care because of their skin color. The goal of healthcare should be to improve outcomes for everyone, regardless of what they look like.

Dr. Webb’s recent comments indicate that what we’ve seen is just the beginning. The federal campaign to turn physicians into activists and replace medical science with social demands is just getting started. If it isn’t stopped, patients will suffer most.

If you’re aware of federal plans to bring woke ideology into healthcare, please let us know.

Medical Society: Don’t Say Kidney Disease

The American Society of Nephrology (ASN) exists to support the study and treatment of kidney disease. So why is it wading into the debate over Florida’s new education law? The answer is simple: In the world of woke healthcare, medical institutions and their members must be political activists, even if it comes at the expense of helping patients and treating diseases. 

A Do No Harm member clued us into the Society’s increasing politicization. In a recent email about its upcoming Kidney Week conference in Orlando, ASN President Susan E. Quaggin criticized Florida’s legislation, which the media has referred to as the “Don’t Say Gay” bill:

“Legislation [that was] passed in Florida… endangers some of our most vulnerable patients, family members, friends, colleagues, and communities—the lesbian, gay, bisexual, transgender, queer, and other sexual & gender minority (LGBTQ+) communities. This sort of legislation has the horrifying potential to adversely impact the very future of this country.”

What does this bill, which dealt with K-3 education, have to do with kidney disease? Absolutely nothing. Yet the ASN still feels the need to prove its commitment to woke ideology. 

While it doesn’t plan to cancel or move the conference, the Society promises to devote its scarce resources toward social activism. That includes, among other things, “voicing our opposition to the ‘Don’t Say Gay’ bill and other discriminatory practices” and “continuing to advocate for the health of undocumented immigrants.” 

Such is the sorry state of virtually every leading medical institution. At a time when chronic kidney disease is soaring, the professional association focused on dealing with this crisis is more concerned about education laws in Florida. The American Society of Nephrology should be ashamed – and its members should ask what else it’s doing to undermine its own mission and American healthcare.

These Medical Scholarships Are Discriminatory – And Unconstitutional

Should medical schools and research fellowships pick students based on race? The obvious answer is no. Yet a growing number of medical schools and institutions are explicitly discriminating by skin color. Not only is this destructive of medical standards, it’s likely unconstitutional.

The Association of American Medical College currently lists more than 140 scholarship opportunities for visiting medical students who are “underrepresented in medicine.” These scholarships are offered by medical schools, hospitals, and a variety of other healthcare institutions. While their details differ, the scholarships generally share making racial preferences the key to an applicant’s success.

This is wrong for two reasons. First and foremost, making race the decisive factor in awarding scholarships will lower the standard of medical care and excellence. Candidates for visiting student positions and fellowships should be judged on test scores, grades at their home institutions, and other professional criteria, all of which demonstrates their ability to excel in the medical field. Ignoring or downplaying these standards does not bode well for healthcare. While there’s small room for non-merit-based criteria, the line should be drawn at economic need or the first member of a family to go to medical school.

Second, these scholarships are broadly unconstitutional. Both the Constitution and federal law prohibit racial preferences. Yet that’s exactly what these scholarships are: Preferential treatment based on race. While some institutions have tried to get around this by adding tricky language to their scholarship criteria, it’s clear that the goal is to hire people of some skin colors over others. That is unacceptable and un-American.

Medical schools and providers that offer these scholarships are opening themselves up to lawsuits. They should abandon this racial discrimination before that happens.

Do you know of a race-based scholarship or program at your institution? Let us know.

Don’t Weaken Medical Residency Standards

The ACGME, the guiding body of graduate medical education, is obsessed with assessment. That makes sense, since it’s responsible for assuring that residents who complete training programs are ready to enter the independent practice of medicine. To ensure such readiness, the ACGME has decreed that training programs should establish a fairly uniform assessment system based on demonstration of competencies in a number of domains of practice.

But this is a problem for activists focused on woke identity politics. A coalition of training programs from Harvard, University of Virginia, and Emory University recently examined how their “underrepresented in Medicine” (URiM) trainees were performing. They studied 3,600 individual assessments of 703 residents, 13.4% of which were URiM. These residents consistently scored lower on five key dimensions including medical knowledge, systems-based practice, practice-based learning and improvement, professionalism, and interpersonal and communication skills.

Most people, when encountering such results, would conclude that either the assessment system might be flawed and unreliable or that these trainees were simply not performing as well as their peers. The authors of the study, Drs. Robin et al, ignore the latter possibility. They offered three explanations for the results. First, the faculty might be biased; second, the learning environment may not be “inclusive”; or third, the assessment system itself has “structural inequities”. Yet by not even considering the possibility that many of these trainees were actually performing poorly, the study authors should cause patients to worry that less capable students might be entering the medical profession.

Do No Harm chairman, Dr. Stan Goldfarb, had the temerity to point out this possibility on Twitter. He wrote, “Three possible explanations are provided. All are due to external agents. Could it be they were just less good at being residents?” The mob appeared. 

For them, every question must be viewed through the lens of Critical Race Theory. Thus, the only answer to the performance problems exposed by the study is racism. And questioning URiM trainees’ competence is apparently racist. So is worrying about the decline in meritocracy as the basis of acceptance into the most demanding training programs.

Do No Harm has now heard from hundreds of physicians and other healthcare workers – including prominent figures in academic medicine – who are distressed and concerned about this trend. We’re seeing more and more evidence that medical educators are withholding direct feedback and criticism to trainees because they fear being labeled as racist or sexist. This gives rise to even more concern. Is it possible trainees are not improving (to the same degree) without this constructive criticism? Is it possible that assessment is a necessary place for faculty to be honest about the performance of trainees? And why didn’t the study authors even consider that?

Medicine has always prided itself on its meritocratic ethos, hence the prevalence of honor societies, yearly award ceremonies, national and international prizes, academic advancement, and other forms of recognition for excellence. Abandoning meritocracy in the name of “equity” is profoundly depressing and will be harmful to physician expertise and patient well-being. And the many minority trainees who do excel deserve to be recognized, instead of being told they’re victims.

When Harvard Medical School Started To Go Wrong

This week, Do No Harm is launching a major advertising campaign around Harvard Medical School’s graduation. We’re shining a light on the school’s dangerous slide toward woke ideology. So it’s worth asking: When did America’s most prestigious medical school turn toward division and discrimination?

A big part of the answer can be found in the school’s “Task Force on Diversity and Inclusion Report.” Released in 2020, the document is breathtaking in its embrace of identity politics. The report lays out a comprehensive plan to make woke ideology central to the school’s work. That includes wholesale changes to student and faculty recruitment, the promotion of faculty and administrators, and the entire infrastructure of Harvard Medical School and its affiliated hospitals and research institutions. 

To start, the plan calls for a dramatic expansion of “the frequency, quality, impact, and reach of current unconscious bias training” for faculty. That includes “greater and regular re-engagement” to ensure that faculty are constantly forced to “discuss and learn about unconscious bias and microaggression.” It also calls for the school to “support efforts” focused specifically on “social justice,” while making race, not merit, a key consideration in the students it recruits. 

The plan also urges the school to create “protected time for diversity-related work” (meaning less time for medical education and research) as well as “financial support for programs that directly address diversity, inclusion and belonging strategic priorities.” It also demands “official groups and committees focused on monitoring diversity efforts” school-wide. Practically speaking, that means a vast bureaucracy charged with forcing ideology on students, faculty, and beyond.

The report even attacks Harvard Medical School’s home city. It says Boston is a “deterrent” to its diversity goals because the city “has had a history of being viewed as racist and noninclusive.” Boston residents may be interested to know what Harvard Medical School thinks about them – and how this flagship institution has a plan to let divisive political activism crowd out real medical education.

Harvard Medical School also has launched an “anti-racism initiative,” which embeds discriminatory ideology in student admissions, faculty advancement, and the school’s curricula. One of Harvard Medical School’s teaching hospitals, Brigham and Women’s, has announced it will use race as a factor in determining who receives access to certain medical care. Residency programs have deliberately lowered standards in the name of diversity. Professors have backed reparations as a form of “medical restitution.” Harvard has pushed “unconscious bias training” on employees and students. Numerous other examples of HMS’ embrace of divisive ideologies and practices can be found here. 

Watch our recent video that discusses why this is such an important issue:

Our campaign calls these actions what they really are: Unacceptable and dangerous. And it calls on graduates, faculty, employees, and affiliates to help us draw attention to what Harvard Medical School is doing.

If you’ve seen radical ideology corrupt Harvard Medical School – or any other medical school or teaching institution – let us know immediately. We want to hear your story and help you fight back.

Do No Harm Applauds Rep. Palmer’s Fight Against Anti-Racism Plans In Healthcare

Do No Harm, a diverse group of physicians, healthcare professionals, medical students, patients, and policymakers working to prevent the woke takeover of our healthcare system, praised Congressman Gary Palmer (R-AL) for introducing today the Prevent Racism in Medicare Act. If passed, the bill would revoke the Department of Health and Human Services (HHS)’s new policy of financially rewarding doctors who adopt “anti-racism plans” that discriminate against patients on the basis of their race.

This legislation follows a recent lawsuit filed by Dr. Ralph Alvarado and Dr. Amber Colville, supported by Do No Harm, against HHS Secretary Xavier Becerra and Centers for Medicare and Medicaid Services (CMS) Administrator Chiquita Brooks-Lasureor. The suit accuses Becerra and Brooks-Lasureor of violating the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) by creating a financial rewards system that incentivizes doctors to engage in racial discrimination. 


Dr. Stanley Goldfarb, Chairman of Do No Harm, said:

“Congressman Palmer and his colleagues are protecting the American healthcare system. Their bill would stop the Biden administration’s dangerous effort to force divisive and discriminatory ideas into the doctor-patient relationship. The White House should be trying to make healthcare more accessible for all, not pushing doctors to prioritize some patients over others based on skin color. Identity politics has no place in medicine — and Congress has the right and the duty to protect us from these destructive policies.”

About Do No Harm:

Do No Harm is a non-partisan non-profit rallying physicians and patients to stop a radical, divisive takeover of healthcare. Do No Harm believes in medical fairness, equal access, and individualized treatment for every patient, without exception.