Surveying American institutions, one searches in earnest for even a few organizations or systems that progressives have been unable to control. News story after news story confirms that indeed that one, that one, and, yes, that one too have all succumbed to ideological capture.
Naïfs like myself once held out hope for science and mathematics. How could geometry be racist or gravitational waves foster systemic oppression? Sadly, we were wrong. The latest institution to go is medical education.
“Health equity” pushes doctors beyond surgeries or appointments to perform advocacy against systems of oppression.A recent essay at Inside Higher Ed bravely declares that all prospective doctors must be trained not to become skilled surgeons or perceptive dermatologists. Rather, their training must direct them towards “health equity.” This shift pushes doctors beyond surgeries or appointments to perform advocacy against systems of oppression and various “-isms.” Many medical schools have already adopted such advocacy-focused instruction.
For example, the University of North Carolina-Chapel Hill has an entire center dedicated to health-equity research, the stated goal of which is to dismantle systems of oppression, systemic racism, and other internalized oppressions. Among its recommended resources are the 1619 Project’s podcast, Richard Delgado’s Critical Race Theory: An Introduction, and Becoming an Anti-Racist Church. What any of these resources has to do with medical education is left to the imagination.
One resource that the Center for Health Equity Research recommends is worth further consideration. Published by the American Medical Association, “Advancing Health Equity: A Guide to Language, Narrative and Concepts” is a foundational document of the health-equity movement and exposes it as little more than an Orwellian project of re-education.
Per the document, health equity seeks to disrupt harmful narratives about individualism and meritocracy to replace them with alternatives grounded in critical race and gender theories. In other words, health equity seeks to form a progressive understanding about race, gender, and society more broadly in the minds of prospective doctors. It’s an effort at worldview building, not professional training. Indeed, the document argues that the way to fix health disparities is to develop a “critical consciousness” among “physicians and other health care workers.” The guide exists to “stimulate critical thinking about language, narrative and concept,” not, of course, appendectomies or biopsies.
To accomplish this change, doctors must “critically examine the language they use.” The document includes an extensive table recommending word replacements. No longer should physicians use the word “fairness” but instead reference “social justice.” It’s not “gender” but “sex assigned at birth.”
Even the questions that physicians are allowed to ask must shift. Instead of asking, “How can individuals protect themselves against health problems?,” doctors should wonder, “What kind of public collective action is necessary to confront health inequity across identifiable populations?” A clear goal of health equity is to eradicate wrongthink.
This shift in language seeks to disrupt the idea that “individuals, their behavior, or their biology” are ultimately responsible for health outcomes.This shift in language seeks to disrupt the idea that “individuals, their behavior, or their biology” are ultimately responsible for health outcomes. Instead, systemic causes allegedly drive sickness or health, and so we must not encourage individual agency with our language. Remove personal agency, however, and what reason would any patient have for taking control of his own health? Forgo discrete choices—regular exercise, healthy eating, taking medications—in favor of systemic changes, and each individual patient will surely suffer.
After adopting such doublespeak, the next step for physicians towards health equity is an engagement in activism. When helping a “44-year-old man suffering from back pain,” doctors must “grapple with the immediate concern,” yes, but also “the structural violence associated with hyperincarceration.” Fundamentally, then, health equity begins with shaping worldviews and ends in activism.
Other medical schools in North Carolina diverge from genuine medical education and physician training and into ideological indoctrination.
Concerningly, Duke University’s School of Medicine lists “health equity” as a central pillar of its program, and “Cultural Determinants of Health and Health Disparities” is a foundational, two-year course that every student must take. Despite the class’s seemingly innocuous title, the lead professor, Dr. Kenny Railey, once spent a pandemic-era lecture (after a moment of silence for police brutality) ridiculing his own establishment, publicly belittling his dean, denigrating colorblindness, complaining that white tears “threaten and terrorize” minorities, and insisting that racism is at the root of every American institution.
I wonder if such health-equity discussions ever include alternative explanations for health disparities. Regarding emergency-room visits, police do not kill blacks at a higher rate than whites, and de-policing policies increase crime rates and thus black victimhood from various violent crimes. Or consider that crime (not greedy, racist corporations) creates food deserts and thereby unequal health outcomes due to insufficient nutrition.
Even more than the biased content of Duke’s class, the opportunity cost on display here is troubling. I watched my own wife go through medical school. The corpus of knowledge required to become a competent doctor—anatomy, physiology, pharmacology, neurology, organic chemistry, and on and on—is daunting. To spend four whole semesters reflecting and journaling about the latest progressive obsession is shameful. What essential knowledge will these students lack when they graduate and enter the medical profession? What key symptom will one of these doctors overlook because their professors lectured about police brutality instead of diagnoses?
What symptom will doctors overlook because their professors lectured about police brutality instead of diagnoses?Looking elsewhere in the Tar Heel State, Wake Forest University hosts a Center for Advancing Racial Equity, offers a certificate in health equity, and lists health equity as a core value. East Carolina University boasts its own Center for Health Disparities (an anachronistic term for health equity, according to the AMA), and while Campbell University’s School of Osteopathic Medicine remains free of progressive capture, it is sadly the exception that proves the rule.
None of this is a new fight. As John Sailer reported for the Martin Center three years ago, the UNC School of Medicine created a “Task Force to Integrate Social Justice into the Curriculum” in 2020. The Task Force’s final report listed and elaborated on 42 DEI-related recommendations. Efforts on the part of the institution to backtrack in the wake of the Martin Center’s coverage were evasive at worst and dishonest at best.
The nearest analog I can think of to this health-equity initiative in medical schools is the emphasis on “critical pedagogy” in schools of education. Teacher-prep programs are so busy raising the critical consciousnesses of future teachers that they fail to train them in phonics instruction or classroom management. In a dark irony, they’re so focused on social justice that they forgo the kind of preparation that would achieve socially just ends: well-managed schools and a literate populace.
So, too, when medical schools focus on language games, re-education, and advocacy, they forgo the kind of practical training that will actually create the skilled surgeons and primary-care physicians who will ensure the best health outcomes. And the consequences in the medical field are far more acute. A poor education system creates societal ills that are diffuse and with unclear blame; who’s at fault if Jonny struggles to read by third grade? An incompetent physician can produce a cadaver.
American medical education is one of our country’s preeminent institutions. We lead the world in total academic, medical citations. If this health-equity initiative succeeds, it will not only train individual doctors badly and so rob patients of competent medical care, but it will deprive the world of scientific advancement, as well. Health equity ends in medical mediocrity.
Daniel Buck is a former English teacher and the author of What Is Wrong with Our Schools?