Do No Harm submitted this request for comment by the Centers for Medicare & Medicaid Services.
Do No Harm, a national association of medical professionals united in protecting medicine from harmful and divisive political ideologies, shares CMS’ goal to advance “the attainment of the highest level of health for all people…regardless of race, ethnicity, disability, sexual orientation, gender identity, socioeconomic status, geography, preferred language, or other factors that affect access to care and health outcomes.” We appreciate the opportunity to comment on CMS’ request for information regarding this goal in the context of Medicare Advantage.
However, we are concerned that this request for information is rooted in a growing and deeply troubling political ideology which seeks to disembody the medical profession’s most powerful means to that end: our strong tradition, beginning with the Hippocratic Oath, of treating all individuals, regardless of race, background, or circumstances, with dignity and our utmost care.
The expansion of this practiced principle from medicine—rather than its modification or replacement—to other institutions and endeavors, is our government’s most realistic and effective tool toward advancing “health equity.” Whatever other problems persist in the provision of health care in the United States, on the issue of equity, the medical profession largely solved the problem long ago.
Put simply, the best way to advance “the highest level of health for all people…regardless of race, ethnicity, disability, sexual orientation, gender identity, socioeconomic status, geography, [or] preferred language” is to advance “the highest level of health for all people…regardless of race, ethnicity, disability, sexual orientation, gender identity, socioeconomic status, geography, [or] preferred language.”
Once, this could be fairly criticized as circular pablum. However, as anti-racism and DEI have soaked our politics, they have inevitably seeped into debates about health care and public health programs. The prompt for this comment suggests that these theories have reached the highest levels of government. Putting aside the merits of those theories in political and historical debates, they have no place in medicine, especially in publicly supported programs like Medicare Advantage.
Almost 30 million Americans rely on coverage provided through Medicare Advantage. Enrollment and support for the program continue to grow because of the program’s unique advantages: more choices for patients have, unsurprisingly, led to more patient-centered coverage and care.
These Americans—the very source of the program’s funding—expect and deserve a program guided by the best ethics of the medical profession and not political ideology of any stripe, let alone ideologies such as anti-racism which promote future discrimination as a solution to past discrimination. No American should ever be subject to racial discrimination in a hospital bed, nursing home, doctor’s office, on the phone with a health insurance company, or any other context.
Reforms in Medicare Advantage should focus on how we can raise standards of care for all patients everywhere—not simply how to twist some knobs up and some knobs down so that eventual outcomes are even, however poor those outcomes may be.
After all, the issues raised in decisions regarding Medicare Advantage, like all coverage programs and health care more broadly—our shared pursuit of minimal pain, our shared desire of maximum dignity, and our shared mortality—transcend race in a way few other issues do.
In the medical context, it hardly needs to be said, efforts to single out certain races for special or different treatment can have perverse consequences whether the intent is pure or not. Even noble and successful efforts along these lines inevitably raise the question: if a certain course of treatment or care benefits racial minorities, why not increase the use of or access to that treatment or care among other groups?
For example, SCAN Health Plan, a not-for-profit Medicare Advantage plan with members in California, Arizona, and Nevada, noticed racial disparities in how often members took cholesterol and diabetes medications. The gaps were modest. For example, 86 percent of white members took their medications as prescribed, compared to 84 percent of Hispanics and 81 percent of Blacks. Nevertheless, over the course of eighteen months, SCAN Health Plan initiated incentives to close that gap, which it did by 35 percent.
The company tied senior executives’ bonuses to closing that gap, hired “more than 15 Black and Hispanic care navigators and pharmacists,” held cultural bias training, and prioritized vendor contracts which would increase targeted “outreach to members,” among other things. In all, SCAN Health Plan estimates that it spent “close to $1 million” on the effort.
Even if we stipulate that SCAN Health Plan’s efforts directly caused the change, it raises questions that go to the heart of this request for information. If the health and care of the 14 percent of white members who do not take their medications as prescribed is not less important than the lives of racial minorities, why did this effort only target minorities, instead of targeting all individuals who did not take medications as prescribed? Surely, there are efforts SCAN Health Plan could have taken, including the efforts they did take, which would have closed that gap too.
And, because all choices involve trade-offs, was $1 million worth spending on a program which modestly closed an already modest racial gap as compared to other health initiatives the Plan could have taken which did not target some racial groups over others?
This road leads to a dark place—one in which some Americans receive more care and attention than others. That is acceptable in a triage situation, in which some patients have conditions of different urgencies. It is unacceptable when the level of care and attention is only being determined by the color of the patient’s skin. It is racial discrimination and it has no place in medicine.
Instead, Do No Harm adheres to a succinct, now fifteen-year old formulation of Supreme Court Chief Justice John Roberts’: the “way to stop discrimination on the basis of race is to stop discriminating on the basis of race.”
To the extent racial discrimination persists in medicine, Do No Harm condemns it as a grotesque and inexcusable violation of the professional standards to which we hold ourselves. The solution, in the provision of coverage through Medicare Advantage or any other context in health care, is to enforce those standards. That is a core principle of our organization and the genesis of our founding.
Again, we appreciate the opportunity to provide this comment.
Sincerely,
Stanley Goldfarb, MD
Chairman, Board of Directors
Do No Harm
The Advisory Board Company’s Bad Advice
Uncategorized Commentary Do No Harm StaffThe Advisory Board Company is proud of its “40 years of making healthcare better.” Yet the big consulting firm, which shapes how countless medical providers operate, is now actively making healthcare worse. Look no further than its recent “identity and inclusion” propaganda booklet for hospitals and doctor’s offices.
An anonymous doctor sent us a copy of the booklet (published in January), which is officially titled “how to address conflict related to identity and inclusion in a team setting.” It’s advertised as being a “tool for healthcare providers worldwide,” yet by page two, it’s painfully clear that no one in medicine should use this ideologically driven farce.
Here’s what the booklet says under its “how to use this tool” instructions. It’s designed for managers responding to the following situations:
Did you catch that? This booklet is meant to force doctors and nurses to buy into the divisive woke concepts of “privilege” and “intersectionality,” among others.
What’s more, bosses should use it to stop medical professionals from criticizing diversity, equity, and inclusion initiatives – even though such efforts tend toward racial discrimination risk more division and frustration by physicians.
There’s no telling how many medical providers are using this so-called “tool.” The Advisory Board Company should be ashamed of pushing it out, and hospitals and doctor’s offices should keep it out of their practices.
Do you know of a healthcare consultant that’s pushing wokeness on medical providers? Please let us know – securely and anonymously.
More Dishonor For The Medical Honor Society
Uncategorized Utah DEI University of Utah School of Medicine Medical School Commentary Do No Harm StaffRemember how the national medical honor society caved to woke demands at UPenn’s medical school? The same thing has happened at the University of Utah Medical School, where Alpha Omega Alpha has decided to choose members based on their wokeness instead of just on academic excellence.
An anonymous tipster sent us a copy of an email laying out the new AOA member selection process. It reads:
Let’s translate: If you want to be part of this prestigious organization, you have to prove you’re woke enough. Yet that’s not what Alpha Omega Alpha was designed to recognize.
As our chairman, Dr. Stan Goldfarb, has written in his book, AOA was established in 1915 as a race-neutral organization committed to recognizing medical students who distinguish themselves academically. Now some chapters are completely flipping, becoming a race-focused group focused on students who set themselves apart ideologically.
Such is the nature of the woke takeover of healthcare. It’s lowering standards across the board, while claiming to raise them. The next generation of physicians will reflect this decline. Worse, the patients these physicians serve will feel it.
Have you seen divisive woke policies or practices at your medical school? Please let us know – securely and anonymously.
NIH Is Funding Race-Based Hires
Uncategorized Washington DC DEI Commentary Executive Do No Harm StaffThe National Institutes of Health (NIH) is spending millions of taxpayer dollars to hire people based on their skin color. That’s the reality of what appears to be a new grant program that’s already active at Northwestern University. It’s one more example of the discriminatory, race-based decision-making that’s corrupting healthcare and jeopardizing its quality.
Northwestern just announced that NIH gave it $16 million to “disrupt systemic barriers that impede the full participation of underrepresented groups… in the areas of cancer, cardiovascular, and brain and behavioral sciences.” With this substantial sum, the university will “hire 15 new tenure-track faculty, and will deploy innovative strategies to ensure the success of faculty members from historically underrepresented populations.”
Is race really the most important factor in hiring faculty for key medical fields? Of course not. What really matters is the quality of hires, regardless of skin color, since the best candidates can conduct the best research that leads to medical progress and treatments. By putting race first with these grants, NIH is both abetting discrimination and potentially undermining medical teaching, research, and innovation.
The leadership of the National Institutes of Health should be ashamed, and better yet, investigated by Congress. Why is the federal government using taxpayer money to hire people based on their race? The name for that is discrimination – and taxpayers should never be complicit in it.
Do you know of a government policy that brings discrimination into healthcare? Please let us know – securely and anonymously.
A Note of Caution from a Medical School Applicant
Uncategorized Medical School CommentaryWe recently received this message from a prospective medical school applicant. We are keeping the applicant’s identity anonymous.
I just wrapped up my primary AMCAS and a handful of secondary medical school applications. I decided to “fight back” by not including my racial identity in my primary application. This fight was short-lived because many of the secondary applications REQUIRED my race and ethnicity to be included.
My question is simple: “Why?”
Many may criticize my decision; after all, they will see me if an interview is extended, so why not just be like the rest and include it? This criticism fails to include the fact that my background may be no different than the applicants who would be considered diverse and, on paper, I may not be able to show that.
Prior to applying to medical school, I grew up in a very diverse community. I had white, black, Asian, and Hispanic friends alike. I never referred to any one of them as my *insert race* friend; they were all just my friends. I do not consider my ancestors privileged, as many were unskilled laborers and some suffered from broken homes. Yes, some races had different and even potentially more extreme hardships, but does that nullify the hardships my family faced?
I recognize prejudice exists, but is the answer to filter out applicants based on skin color? If you say this is not happening, then why is the question of my race even necessary? Why can’t we hold a completely anonymous application system where you didn’t see my skin color until I was accepted? Sadly, these questions cannot be asked.
Having undergone multiple surgeries in my life, I never once thought, “I hope my surgeon is diverse.” Rather, I prayed the doctor would be qualified to get me in and out of surgery without any adverse events. As a future physician, I commit to striving for the highest quality of treatment within my scope to all my patients, regardless of skin color. I hope we can pay that same commitment to the physicians of the future.
When Dentists Go Woke
Uncategorized Commentary Do No Harm StaffDo you want your dentist to discriminate?
Of course not, but the American Association of Public Health Dentistry apparently does. A recent special issue of its flagship journal, Public Health Dentistry, is completely devoted to turning dentists into “anti-racists.” The association is elevating divisive identity politics over providing the best dental care to individual patients.
The Association embraces woke identity politics from the get-go of the new issue, with a note from the journal’s editors:
As a reminder, being “anti-racist” means discriminating against patients based on their skin color – something Ibram X. Kendi, the founder of anti-racism, has made explicit.
The rest of the journal doubles down on this radical approach. One article proposes “a structural intersectionality approach to population oral health,” while another “explore[s] dental undergraduates’ understanding, experiences, and responses to racism in a dental school.” The journal issue also lays out anti-racist “solutions” in dental research, education, practice, advocacy, and workforce. The list naturally includes emphasizing race over merit and pushing research to focus on skin color.
The woke move into dentistry proves there’s no part of healthcare this ideology won’t infect. Providers and patients alike should demand that dentists treat their patients equally and fairly, instead of letting wokeness corrupt and even ruin yet another key aspect of medicine.
Have you seen woke politics at your dentist or doctor? Please let us know – anonymously and securely.
Woke Healthcare Goes To Space
Uncategorized Texas DEI Baylor College of Medicine Medical School Commentary Do No Harm StaffHouston, we have a problem.
An organization affiliated with the Baylor College of Medicine is spending $600,000 to promote “diversity” in grant recipients who are focused on helping humans survive in space. It goes to show there’s no part of healthcare that wokeness ignores.
The group in question is the Translational Research Institute for Space Health (TRISH for short) which is funded by NASA and located at Baylor’s Texas campus. It announced this significant new funding after discovering that “15 percent of its grant applicants identified as Asian, 3 percent as Hispanic or Latino and 2 percent as Black or African American.”
One TRISH leader says this $600,000 is about “starting to really turn on the pipe and really increase the pipeline for underrepresented researchers.” It is targeted to “develop a larger network of underrepresented researchers,” including “women, people with disabilities, people who identify as LGBTQ and people from racial and ethnic groups that the National Science Foundation reports are underrepresented in health-related sciences.”
But why does diversity matter to space-related research? Helping humans survive in space depends on finding – and funding – the best possible research. Focusing on diversity first threatens that goal by making the skin color of a scholar more important than actual scholarship. Far from advancing human survivability in space, race- and gender-based efforts like these could hold back the very progress they’re supposed to promote.
The woke push for diversity is all-encompassing, and no part of healthcare will be left out in the push to make decisions based on race. Apparently that includes medical research involving outer space.
Have you seen “diversity, equity, and inclusion” corrupt a surprising part of the medical field? Please let us know – securely and anonymously.
Open Letter to Kirsten Bibbins-Domingo of JAMA
Uncategorized Medical Journal CommentaryDear Kirsten Bibbins-Domingo,
Congratulations on your appointment as editor-in-chief of the Journal of the American Medical Association!
You now hold one of the most prestigious positions in the elite world of health publications. Medical researchers, professionals, and policymakers now look to you for leadership, and it is incumbent on you to set the highest standards of scholarship and allow the broadest scope of debate. The tone you take, and the decisions you make, will shape healthcare in extraordinary ways. You can either advance or undermine physicians’ life-saving work, patients’ health, and the public’s trust.
As the leader of an organization focused on ensuring excellence and equality in healthcare, I look forward to hearing your vision in your conversation with Usha Lee McFarling on September 20. Along with countless other medical professionals, educators, and patients, I hope your remarks will touch on the following issues:
Your answers to these questions will shape not only the journal you oversee, but also the very future of healthcare in America. For the sake of physicians and patients alike, I hope you move JAMA upward, toward world-class scholarship and scientific debate – not further downward, toward ideology, division, and racial discrimination.
Sincerely,
Dr. Stanley Goldfarb
Chair, Do No Harm
Image credit: Christopher Michel via CC BY-NC-ND 2.0
SLU is the Latest Missouri Medical School to Violate Students’ Civil Rights
Uncategorized Missouri DEI St. Louis University School of Medicine Medical School Commentary Executive Do No Harm StaffDo No Harm has filed a federal civil rights complaint against St. Louis University School of Medicine for its discriminatory Scholarship Program for Visiting Medical Students Underrepresented in Medicine. To be eligible to apply, students “must identify as a member of a group underrepresented in medicine.” SLUSOM refers to the American Association of Medical College’s definition of “underrepresented in medicine,” which states, “This lens currently includes students who identify as African Americans and/or Black, Hispanic/Latino, Native American (American Indians, Alaska Natives, and Native Hawaiians), Pacific Islander, and mainland Puerto Rican.”
By advertising and administering this discriminatory scholarship, the SLUCOM Department of Psychiatry and Behavioral Neurosciences is violating Title VI of the Civil Rights Act of 1964. We are requesting prompt investigation and resolution from the Office of Civil Rights for these unlawful eligibility standards, as applications are being accepted until September 30. 2022.
Does your medical school offer a discriminatory scholarship? Please let us know – anonymously and securely.
We’re Suing Pfizer For Its Racially Discriminatory Fellowship
Uncategorized Commentary Do No Harm StaffDo No Harm sued pharmaceutical giant Pfizer on September 15th. Why? It runs a fellowship program that explicitly discriminates by race. This is illegal, immoral, and insulting – so we’re fighting to hold Pfizer accountable.
Pfizer’s “Breakthrough Fellowship Program” is a highly prestigious and competitive program that includes a summer internship, full-time employment, and a scholarship for an advanced degree – nine years of substantial benefits, all told. Yet not everyone can apply. One of its requirements is that applicants “meet the program’s goals of increasing the pipeline for Black/African American, Latino/Hispanic and Native Americans.”
In other words, White and Asian applicants aren’t welcome.
This is the exact kind of racial discrimination that so-called “anti-racism” requires. Similarly offensive fellowships and scholarships can be found across healthcare, from the journal Health Affairs to leading medical schools. It’s part of the woke push to ensure “diversity,” even if it means engaging in discrimination.
Do No Harm is suing on behalf of two of our members. Pfizer’s racial discrimination is illegal under the Civil Rights Act, the Affordable Care Act, the New York State Human Rights Law, and the New York City Human Rights Law. We’re asking the federal courts to stop the company from picking winners and losers based on their skin color.
The Wall Street Journal broke the news of our lawsuit. Now it’s up to the courts to say this injustice cannot stand. Pfizer should know better than to racially discriminate – a backwards practice that has no place in healthcare or anywhere else in America.
Image credit: Montgomery County Planning Commission via CC BY-SA 2.0
We Forced A Change at The University of Florida
Uncategorized Florida DEI University of Florida College of Medicine Commentary Executive Do No Harm StaffA discriminatory woke scholarship is no more.
Thanks to Do No Harm, the University of Florida College of Medicine has eliminated its requirement that only members of certain races can apply for a visiting student scholarship. This about-face comes after Do No Harm filed a complaint with the federal Department of Education’s Office of Civil Rights. It’s a win for fairness and equality, which is what more medical schools across America urgently need.
Here’s what we wrote when filing our initial complaint:
Fortunately, these racially discriminatory requirements are no more. The University has informed us that it has made the necessary changes and notified students.
We’re grateful to the University of Florida’s leadership for taking our complaint seriously and then taking action to right this wrong. Other medical schools should learn from its example, especially the 30-plus institutions which we’ve brought to the attention of the Office of Civil Rights. Racial discrimination is unacceptable – in scholarships and every other facet of medical education.
Does your medical school offer a discriminatory scholarship? Please let us know – anonymously and securely.
What You Need To Know About “Social Determinants of Health”
Uncategorized Commentary Do No Harm StaffIt’s not just DEI. Woke activists are increasingly relying on another acronym – SDOH – to advance their divisive agenda within healthcare. It stands for the “Social Determinants of Health,” and when you unpack it, it’s clearly part of the campaign to move healthcare in a divisive and discriminatory direction.
To understand what “Social Determinants of Health” are, consider the definition used by the federal Department of Health and Human Services under the Biden administration:
HHS groups these determinants into 5 key areas:
Do these topics bear on the care provided by physicians to individual patients? Of course not, with the exception of “health care access and quality.” But they are inherently politicized. “Social determinants of health” are squarely in the domain of elected officials and social workers, not physicians.
Physicians, nurses, and medical professionals can’t solve these kinds of problems, no matter how much activists want them to. Even if they could, there’s no causal link between social conditions and negative health outcomes. It’s much more likely that poor social conditions simply result in patients seeking healthcare late in the course of their medical problems. They may also adhere less to difficult treatment programs once a disease is diagnosed. Forcing healthcare to focus on education and economics won’t do anything to change these underlying issues.
Focusing on the “social determinants of health” will not lead to the desired outcome of improving health. But it will be costly, especially as healthcare devotes precious resources to issues in which it has no expertise. Medical professionals should focus on providing the best care to individual patients, not economic factors, community housing, or the quality of K-12 education.
Duke University School of Nursing Gives In to Wokeness
Uncategorized North Carolina DEI Duke University Medical School Commentary Do No Harm StaffDo No Harm received a tip that the Duke University School of Nursing is creating a Racial Justice Task Force (archived link). Its mission? Address “racial injustices and/or inequities” within the school. You can bet the prestigious school is going down the road of woke divisiveness and racial discrimination.
The task force will focus on three strategic areas:
Equity accountability. Faculty and staff will be held responsible “for racial injustices in all programs and settings.” In fact, a formal reporting system is under development that tracks and holds faculty and staff members accountable for “micro-/macro-aggressive, biased, and racist” behavior.
Performance measures. Faculty and staff will be judged on their “racial justice behavior” when it comes to promotion and retention. Their level of participation in racial justice activities will factor into annual or semester evaluations.
Training recommendations. The task force will ensure that every program within the curriculum “intentionally” includes content on microaggressions, bias, and anti-racism. Training is mandatory, and engagement with learning activities is monitored for compliance.
By pushing such blatant ideology, the Duke University School of Nursing is readying students to adopt racial and identity politics when providing care. Spending time on these issues detracts from the objective of becoming competent, compassionate clinicians who advocate for their patients. The Racial Justice Task Force has no place at Duke University School of Nursing or anywhere else.
If you are aware of a discriminatory policy or divisive initiative at your medical or nursing school, Do No Harm wants to hear from you – anonymously and securely.
Editor’s note: This post has been updated with an archived link to the Racial Justice Task Force. The original link was removed after March 27, 2025.
Do No Harm Is A Peterson Prize Finalist
Uncategorized Commentary Do No Harm StaffDo No Harm is a finalist for a prestigious award – the Gregor G. Peterson Prize in Venture Philanthropy. As we enter the final stages of this competition, we’re grateful to the Peterson family for their interest in our fight to keep healthcare principled and patient focused.
The Peterson Prize is one of the biggest in the non-profit space. It offers $250,000 to a “trailblazing start-up in the non-profit sector.” Moreover, its “mission is to identify founders with bold ideas; to help bring these ideas to fruition, and to partner in building sustainable, life-changing organizations.” It’s an honor to be described in such a way.
The final Peterson Prize will be announced soon, and we’re glad we’re in the running as a finalist. Now is the time to stop wokeism in healthcare. This prize is key to realizing that vision.
We’re Suing Health Affairs For Racial Discrimination
Uncategorized Medical Journal Commentary Do No Harm StaffHealth Affairs is discriminating on the basis of race. That’s why Do No Harm is suing the prestigious medical journal and Project Hope, which publishes Health Affairs, in federal court. In our lawsuit, filed on Tuesday, September 6, we’re asking the court to hold Health Affairs and Project Hope accountable for violating federal law and D.C. law.
Health Affairs’ discrimination comes via its Health Equity Fellowship for Trainees, which provides mentorship and publication opportunities for health policy scholars. It may be hard to believe, but the journal explicitly excludes white applicants from applying:
Our plaintiff is an anonymous individual who is ready and willing to apply to the fellowship but cannot apply solely on the basis of race.
Since Health Affairs’ publishing organization Project Hope accepts federal funding, Health Affairs is subject to the race discrimination ban under the federal Civil Rights Act, which states: “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.” Health Affairs and Project Hope are also violating the Affordable Care Act which applies specifically to health programs and activities. Furthermore, Health Affairs is violating D.C. law, which bans racial discrimination in training programs like the Health Equity Fellowship for Trainees.
Health Affairs plays a prominent role in pushing discriminatory woke concepts like “anti-racism” and “diversity, equity, and inclusion” in healthcare. And despite its claims of wanting to achieve inclusion, the journal engages in racial discrimination. Its actions are illegal and immoral—and Do No Harm’s lawsuit will hopefully help end this injustice.
Medical Students Shouldn’t Swear Woke Oaths
Uncategorized Minnesota DEI University of Minnesota Medical School Medical School Commentary Do No Harm StaffWith a new academic year set to start, the University of Minnesota is pushing medical students to swear an oath to divisive woke ideas (archived link). It’s the latest example of the woke conquest of medicine and a sign of what’s coming to every medical school.
The oath at the Twin Cities campus starts off on an explicitly ideological note. It states, “We, the students of the University of Minnesota Medical School, a state funded institution located on Anishinaabe and Dakota land…” This language reflects the woke obsession with grievance politics, with an implicit apology for the expansion of the United States across the continent. Never mind that today’s medical students weren’t alive and are studying medicine, not history.
It gets worse. The Twin Cities campus oath includes even more divisive language:
The oath for Duluth students is similar, though less on the nose: “We will embrace our roles as advocates for patients by engaging in systemic change to ensure equity in medicine.”
What do privilege, police brutality, climate change, and other politicized topics have to do with medical school? Nothing, and that’s the point. The school is deliberately turning future medical professionals into political activists. And by making students pledge to be “anti-racist,” it’s pushing tomorrow’s physicians to engage in racially discriminatory practices, such as preferential care.
The University of Minnesota Medical School is doing a profound disservice to students and the patients they will eventually serve. This new oath should never be uttered or adapted at any medical school, period.
Does your medical school want you to swear a woke oath or be “anti-racist”? Please let us know, securely and anonymously.
UAB Heersink School of Medicine Offers Discriminatory Scholarships
Uncategorized Alabama DEI University of Alabama Medical School Commentary Executive Do No Harm StaffDo No Harm has asked the U.S. Department of Education’s Office of Civil Rights to investigate the University of Alabama – Birmingham Heersink School of Medicine for offering medical school scholarships that discriminate on the basis of race.
Three endowed scholarships to attend the Heersink School of Medicine listed in UAB’s institutional database (archived link) are “restricted to African-American medical students.” By advertising and administering these discriminatory scholarships, UAB appears to be in violation of Title VI of the Civil Rights Act of 1964. We filed complaints for these discriminatory eligibility standards and are requesting prompt resolution from the OCR.
Do No Harm works to protect the healthcare industry and individual practitioners against divisive ideologies and practices. If you are aware of a discriminatory scholarship or policy at your medical or nursing school, or if you didn’t apply because you thought a discriminatory policy worked against you, please let us know.
Do No Harm Comment on Medicare Advantage
Uncategorized United States DEI Testimony and CommentsDo No Harm submitted this request for comment by the Centers for Medicare & Medicaid Services.
Do No Harm, a national association of medical professionals united in protecting medicine from harmful and divisive political ideologies, shares CMS’ goal to advance “the attainment of the highest level of health for all people…regardless of race, ethnicity, disability, sexual orientation, gender identity, socioeconomic status, geography, preferred language, or other factors that affect access to care and health outcomes.” We appreciate the opportunity to comment on CMS’ request for information regarding this goal in the context of Medicare Advantage.
However, we are concerned that this request for information is rooted in a growing and deeply troubling political ideology which seeks to disembody the medical profession’s most powerful means to that end: our strong tradition, beginning with the Hippocratic Oath, of treating all individuals, regardless of race, background, or circumstances, with dignity and our utmost care.
The expansion of this practiced principle from medicine—rather than its modification or replacement—to other institutions and endeavors, is our government’s most realistic and effective tool toward advancing “health equity.” Whatever other problems persist in the provision of health care in the United States, on the issue of equity, the medical profession largely solved the problem long ago.
Put simply, the best way to advance “the highest level of health for all people…regardless of race, ethnicity, disability, sexual orientation, gender identity, socioeconomic status, geography, [or] preferred language” is to advance “the highest level of health for all people…regardless of race, ethnicity, disability, sexual orientation, gender identity, socioeconomic status, geography, [or] preferred language.”
Once, this could be fairly criticized as circular pablum. However, as anti-racism and DEI have soaked our politics, they have inevitably seeped into debates about health care and public health programs. The prompt for this comment suggests that these theories have reached the highest levels of government. Putting aside the merits of those theories in political and historical debates, they have no place in medicine, especially in publicly supported programs like Medicare Advantage.
Almost 30 million Americans rely on coverage provided through Medicare Advantage. Enrollment and support for the program continue to grow because of the program’s unique advantages: more choices for patients have, unsurprisingly, led to more patient-centered coverage and care.
These Americans—the very source of the program’s funding—expect and deserve a program guided by the best ethics of the medical profession and not political ideology of any stripe, let alone ideologies such as anti-racism which promote future discrimination as a solution to past discrimination. No American should ever be subject to racial discrimination in a hospital bed, nursing home, doctor’s office, on the phone with a health insurance company, or any other context.
Reforms in Medicare Advantage should focus on how we can raise standards of care for all patients everywhere—not simply how to twist some knobs up and some knobs down so that eventual outcomes are even, however poor those outcomes may be.
After all, the issues raised in decisions regarding Medicare Advantage, like all coverage programs and health care more broadly—our shared pursuit of minimal pain, our shared desire of maximum dignity, and our shared mortality—transcend race in a way few other issues do.
In the medical context, it hardly needs to be said, efforts to single out certain races for special or different treatment can have perverse consequences whether the intent is pure or not. Even noble and successful efforts along these lines inevitably raise the question: if a certain course of treatment or care benefits racial minorities, why not increase the use of or access to that treatment or care among other groups?
For example, SCAN Health Plan, a not-for-profit Medicare Advantage plan with members in California, Arizona, and Nevada, noticed racial disparities in how often members took cholesterol and diabetes medications. The gaps were modest. For example, 86 percent of white members took their medications as prescribed, compared to 84 percent of Hispanics and 81 percent of Blacks. Nevertheless, over the course of eighteen months, SCAN Health Plan initiated incentives to close that gap, which it did by 35 percent.
The company tied senior executives’ bonuses to closing that gap, hired “more than 15 Black and Hispanic care navigators and pharmacists,” held cultural bias training, and prioritized vendor contracts which would increase targeted “outreach to members,” among other things. In all, SCAN Health Plan estimates that it spent “close to $1 million” on the effort.
Even if we stipulate that SCAN Health Plan’s efforts directly caused the change, it raises questions that go to the heart of this request for information. If the health and care of the 14 percent of white members who do not take their medications as prescribed is not less important than the lives of racial minorities, why did this effort only target minorities, instead of targeting all individuals who did not take medications as prescribed? Surely, there are efforts SCAN Health Plan could have taken, including the efforts they did take, which would have closed that gap too.
And, because all choices involve trade-offs, was $1 million worth spending on a program which modestly closed an already modest racial gap as compared to other health initiatives the Plan could have taken which did not target some racial groups over others?
This road leads to a dark place—one in which some Americans receive more care and attention than others. That is acceptable in a triage situation, in which some patients have conditions of different urgencies. It is unacceptable when the level of care and attention is only being determined by the color of the patient’s skin. It is racial discrimination and it has no place in medicine.
Instead, Do No Harm adheres to a succinct, now fifteen-year old formulation of Supreme Court Chief Justice John Roberts’: the “way to stop discrimination on the basis of race is to stop discriminating on the basis of race.”
To the extent racial discrimination persists in medicine, Do No Harm condemns it as a grotesque and inexcusable violation of the professional standards to which we hold ourselves. The solution, in the provision of coverage through Medicare Advantage or any other context in health care, is to enforce those standards. That is a core principle of our organization and the genesis of our founding.
Again, we appreciate the opportunity to provide this comment.
Sincerely,
Stanley Goldfarb, MD
Chairman, Board of Directors
Do No Harm
This North Carolina Health System Is Now Woke
Uncategorized North Carolina DEI Hospital System Commentary Do No Harm StaffA major North Carolina health system has gone woke. An anonymous stakeholder at Cone Health showed us how the large network of hospitals and medical centers in the Greensboro area is pushing doctors, nurses, and staff to make radical ideology a core part of their work.
The concerned individual sent us several examples showing Cone Health’s descent into identity politics. It has set the tone that everyone it employs must get on board with divisive concepts. A recent email sent to all staff members states: “Creating a Cone Health where diversity, equity and inclusion are our way of being requires all of us to commit to this marathon together… we all own this vision, and we must walk the walk and take action.”
Beyond the rhetoric, Cone Health is pushing employees to participate in specific activities, including:
By forcing these principles onto doctors, nurses, and staff members, Cone Health is injecting dangerous and divisive ideas into its hospitals and clinics, which undermines patient trust. Cone Health should be empowering doctors and nurses to do their jobs at the highest level, not lowering itself by focusing on identity politics.
Have you seen wokeness at your health system or provider? Please let us know – securely and anonymously.