Duke University Health System has terminated Dr. Kendall Conger—an emergency room physician in its Raleigh, N.C., hospital. Conger had made waves in recent years for questioning, including in this Martin Center article, Duke’s 2021 “pledge” against racism in medicine.
A respected member of the medical community, Conger took no issue with standing against racism or treating people with decency and respect—primary tenets of the pledge. However, he did question whether racism in medicine was as significant a problem as Duke believed it to be and whether there was legitimate scientific evidence to support that belief. In 2020, for example, Duke Health had gone so far as to declare racism “a public health crisis.”
Conger questioned whether legitimate scientific evidence supported Duke’s “antiracist” stance.After years of being ignored and receiving information from Duke that was long on ideology and short on science and clinical data, Conger apparently pushed his employer over the edge.
In December 2023, Conger’s supervisor told him that the reason the institution was typically reluctant to engage him on its stances was his tendency to discuss those matters outside of the workplace. Conger was understandably puzzled that a prominent institution would take issue with members of the public hearing how it had defended things it strongly believed in. Conger immediately sent a letter to several of his colleagues informing them of the message he had received from his supervisor.
Duke Health notified Conger of his termination a few weeks later.
His employment terms with Duke did not require that any reason be given for his termination. However, Duke stated in a letter to Conger, “We believe your behavior is negatively impacting the emergency physician team, which could jeopardize the care of patients. Given this, we are choosing not to renew your contract for employment.”
While failing to offer any specifics, Duke Health appeared to suggest that Conger’s commitment to treating patients as individuals and rejecting the dynamics of collectivism could potentially put patients in harm’s way, as could his observation of the lack of scientific evidence for Duke’s ominous claims about racism in medicine.
As Conger wrote for the Martin Center last year, Duke’s 2021 “antiracist pledge” said that the institution is “guided by science.” Yet no one at Duke was ever able to prove to Conger that its pledge was anything other than a well-meaning yet unnecessary response to a popular political moment. Duke employees were briefed on the pledge before it was released publicly and were invited to contact their superiors with any questions or concerns. Conger’s trouble began when he decided to take his employer up on that offer.
After being ignored by an outgoing, high-ranking hospital administrator, Conger reached out to Duke Raleigh Hospital president Dr. Barbara Griffith several times, including at an initial in-person meeting. Conger, who wanted to be certain that he wasn’t personally being roped into a political position held by his employer, was never offered any scientific or clinical justification for the idea that racism is a significant issue in medicine.
Conger was never offered any scientific justification for the idea that racism is a significant issue in medicine.This concerned Conger, who desired to perform his job free from the shadow of politics or well-meaning yet false social narratives. He specifically questioned Duke brass as to why they believed it was beneficial to view patients as members of ethnic groups more than as individuals requiring care.
Furthermore, as a respected physician, he was particularly concerned about any ideas being presented as absolutes without accompanying clinical data or scientific proof. A Duke-employed doctor for 12 years, Conger had everyday professional experiences in the intense field of emergency medicine that were at odds with Duke’s claims about racism.
Duke’s antiracist pledge states, “We recognize our own implicit biases.” Ironically, by definition, one cannot recognize his or her own implicit biases as that phrase is traditionally defined. Prior to his notice of termination, Conger did at one point receive an email from a Duke official who said, “I concede that I cannot find a [clinical] trial that proves implicit bias is the cause of worse health outcomes for African Americans. Believe me. I have looked.”
Conger was astounded that Duke had appeared to search for supporting data after it had created and publicly released its pledge.
The Duke administrator who corresponded with Conger did mention “ample causal inference data in the social sciences.” Yet Conger believed that a medical institution should rely on evidence-based clinical data. Social-science data are known to be easily manipulable and are generally viewed as inappropriate and insufficient for forming conclusions or driving actions in the field of medicine.
Conger also recalls being shown an illustration, during a Duke-sponsored function, that depicted white males as agents of oppression and exploitation while ominously labeling members of other demographics as “targets.” Again, no scientific or clinical data was offered to justify or explain why a major healthcare provider espoused such darkly generalized views of individuals.
While Conger is left to plan his next professional move, Duke Health—an arm of a Tier 1 research university and so-called Southern Ivy—has yet to explain its ominous claim that racism is “a public health crisis.”
Mike Markham is a program coordinator with Color Us United, a nonprofit organization that advocates for a race-blind and merit-based society.