May
5
Disparate Impact Thinking in Medicine Puts Lives at Risk
“[I]t is the progressive elites, not their conservative opponents, who are engaging in cultural revolution!” — Heather Mac Donald, Manhattan Institute
As you may know, I often share excerpts from relevant articles at other publications. One semi-regular source is Imprimis — the newsletter from Hillsdale College, which adapts presentations from their seminars and lecture series into articles. This week I would like to present part of one such talk/article by Heather Mac Donald, a conservative author, commentator, attorney, and the Thomas W. Smith Fellow at the Manhattan Institute, where she also serves as contributing editor of City Journal.
The article in question is “Disparate Impact Thinking Is Destroying Our Civilization”, which addresses more than just medicine, of course. But, I thought that this sampling would be a good introduction to see if you want to read the full article. (Take note: She lays out some “uncomfortable facts” and also upbraids “most conservatives today” for “not even playing defense”.)
What follows is from the first section of the adaptation of Ms. Mac Donald’s talk….
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The most consequential falsehood in American public policy today is the idea that any racial disparity in any institution is by definition the result of racial discrimination.
If a cancer research lab, for example, does not have [at least] 13 percent black oncologists — the black share of the national population — it is by definition a racist lab that discriminates against competitively qualified black oncologists; if an airline company doesn’t have [at least] 13 percent black pilots, it is by definition a racist airline company that discriminates against competitively qualified black pilots; and if a prison population contains more than 13 percent black prisoners, our law enforcement system is racist.
The claim that racial disparities are proof of racial discrimination has been percolating in academia and the media for a long time. After the George Floyd race riots of 2020, however, it was adopted by America’s most elite institutions, from big law and big business to big finance. Even museums and orchestras took up the cry.
Many thought that STEM — the fields of science, technology, engineering, and mathematics — would escape the diversity sledgehammer. They were wrong. The American Medical Association today insists that medicine is characterized by white supremacy. Nature magazine declares that science manifests one of “humankind’s worst excesses”: racism. The Smithsonian Institution announces that “emphasis on the scientific method” and an interest in “cause and effect relationships” are part of totalitarian whiteness.
As a result of this falsehood, we are eviscerating meritocratic and behavioral standards in accordance with what is known as “disparate impact analysis.”
Consider medicine. Step One of the medical licensing exam, taken during or after the second year of medical school, tests medical students’ knowledge of anatomy, physiology, and pathology. On average, black students score lower on the grading curve, making it harder for them to land their preferred residencies. Step One, in other words, has a “disparate impact” on black medical students. The solution, implemented last year, was to eliminate the Step One grading disparity by instituting a pass–fail system. Hospitals choosing residents can no longer distinguish between high and low achieving students — and that is precisely the point!
The average Medical College Achievement Test (MCAT) score for black applicants is a standard deviation below the average score of white applicants. Some medical schools have waived the submission of MCAT scores altogether for black applicants. The tests were already redesigned to try to eliminate the disparity. A quarter of the questions now focus on social issues and psychology. The medical school curriculum is being revised to offer more classes in white privilege and focus less on clinical practice. The American Association of Medical Colleges will soon require that medical faculty demonstrate knowledge of “intersectionality” — a theory about the cumulative burdens of discrimination. Heads of medical schools and chairmen of departments like pediatric surgery are being selected on the basis of identity, not knowledge.
The federal government is shifting medical research funding from pure science to studies on racial disparities and social justice. Why? Not because of any assessment of scientific need, but simply because black researchers do more racism research and less pure science. The National Institutes of Health has broadened the criteria for receiving neurology grants to include things like childhood welfare receipt because considering scientific accomplishment alone results in a disparate impact.
What is at stake in these changes? Future medical progress and, ultimately, human lives.
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To be frank, this is so screwed up!
And if you dare to question the disparity-equals-unfair-discrimination mindset or disagree with the wisdom of the resulting “woke” policies (as described above), then you are labeled a racist yourself, just as Mac Donald has been. I, for one, would rather risk that than have someone who got their medical degree under these new policies treat me or my loved ones. I want professionals who have proven (via proper instruction, testing, and practice) that they know their stuff and are not preoccupied with “woke” baloney. And I really don’t care what shade of skin they have, as long as they uphold the Hippocratic Oath — or, at least, a modern, non-woke version of it (e.g., the Louis Lasagna revision (1964)).
Btw, if you’re interested, Mac Donald has a relatively new book on this topic: When Race Trumps Merit: How the Pursuit of Equity Sacrifices Excellence, Destroys Beauty, and Threatens Lives.
