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The M.E.D.S.
Send us tips about what is happening at your institution or company regarding DEI. We want to assure you that any names or responses to this DEI Tip form will remain completely anonymous.
M.E.D.S.—
An Alternative Framework to DEI that Focuses on High-Quality Outcomes Instead of Division
In January of 2023, Color Us United launched our campaign to persuade healthcare leaders to drop DEI.
DEI programs result in lower-quality care, more division, and fewer patient rights.
But the good news is that the system can be reformed.
It can be reformed through M.E.D.S.
Read the framework here.
Merit Over Diversity
Where proponents of DEI are looking at immutable traits, proponents of meritocracy are looking at character and achievement.
Race, ethnicity, gender, sexual orientation, disability, religion, and military status should not factor in the hiring of a qualified doctor. Transparent, merit-based criteria should be the primary way doctors and nurses are hired and promoted.
Color Us United has discovered that race and ethnicity are factors used in the admission, promotion, and hiring of medical school candidates and faculty, including at The University of North Carolina’s Medical School – where up to 15 percent of a staff member’s financial package is tied to incentives that could include DEI.
DEI shouldn’t matter in the promotion of a doctor. Instead, merit — character and achievement — should be the primary way doctors are admitted and promoted. The best marker we have for character and achievement is standardized testing, grades, and strong communication skills — a combination of objective and subjective characteristics filtered through neutral parties.
There are various tests and measurements we can use to evaluate these characteristics, and the MCAT is one of them. High MCAT scores mean that doctors-in-waiting are capable of retaining and synthesizing large amounts of information — essential to diagnosing illness and attending to a patient’s unique individual needs.
The selection process should have nothing to do with race. Immutable characteristics should be the least important factor considered in the selection process, especially when it results in a significant depreciation in the measured quality of an applicant. The evidence is bearing out that DEI is causing it to be an increasingly important factor in selecting a doctor, and if this continues to be the case, patients will suffer.
Equality of Opportunity over Equity (or Equal Access)
Under an “equality of opportunity” society, people are entitled to the same basic rights and freedoms, but equal outcomes are not expected.
Equal opportunity says that no one will be treated differently based on their immutable characteristics but it does not expect outcomes to be equal between groups. Equity is a term that suggests that outcomes should be relatively balanced across different groups. “Racial equity,” the context in which the term is often used, asks institutions to make reforms to improve the outcomes of certain underrepresented racial groups.
While the idea of complete equality in outcomes (everybody having what they need to be successful) sounds appealing, equity presents an unreasonable standard for our doctors. Who are we to ask doctors to correct people’s different genetics, family circumstances, and individual behaviors?
Consider an obvious example: proximity to a hospital. Most everyone knows that the closer you live to a hospital, the higher chance you have of being effectively treated. (Making it in time to a hospital for treatment increases your rate of cardiac arrest survival by four or five times.) In fact, many in older age make their living decisions based on this fact. Yet, unless we put a hospital on every street corner, we could never ensure complete equality in cardiac arrest outcomes, and some people will just by virtue of location not have the same chance of medical outcomes as others.
An equal opportunity focus would ensure that hospitals run in a non-discriminatory manner, and do not purposely withhold care because of a person’s race, religion, or lack of connection to the hospital.
People are entitled to the same basic rights and fairness in healthcare, but they are still responsible for their own life choices — such as how close to a hospital they want to live.
Diversity of Thought Over Inclusion
A better approach to inclusion would be to emphasize promoting a culture of free speech and conflict resolution.
When we fixate on inclusion over other values in healthcare, such as results, the quality of our care falls. Hospitals and medical schools should foster a climate where doctors and doctors-in-training feel free to speak and ideate, where they don’t feel like they are checking boxes just to get to the next patient.
While inclusion should be modeled in our personal and private lives, in a field as important as healthcare we must keep our focus on ensuring the highest quality health care.
People are different, culturally and otherwise, and different views should be welcomed — including those that are popular or sometimes offend others. A policy of helpful inclusion would emphasize that people are different in thought and that we can leverage those differences to the advantage of the institution. A “Red Hat” model involves a person on your team putting on a thinking “Red Hat” and attempting to dissuade people from the consensus in the room. A forceful advocate on the other side of the issue helps to ground everyone in reality and keeps the dialogue focused on results. Of course, sometimes employees get genuinely offended, and sometimes people are genuinely offensive. HR policies should emphasize peaceful conflict resolution, and if none is reached, they should explain to the team why a person is removed from the situation.
Straight Talk
Euphemizing problems or phrasing them in politically correct language can often lead to incorrect diagnoses of what our issues in healthcare truly are.
Instead of making diversity, equity, or inclusion the goal, which incentivizes politicization and falsehoods, make understanding of root causes the goal, which leads to straight talk about the health problems facing certain groups.
If proponents of DEI were honest, they would admit that their ideology should include one more enforced pillar: political correctness, with its discriminatory effects on employees.
Bill Andersen, MD, is an orthopedist and a brave outspoken advocate against DEI policies at UNC’s Healthcare system and elsewhere. He is already seeing DEI ideology hurt his patient practice, with UNC forcing “racial equity training’ for him, stifling inter-doctor communication and sometimes even relationships with his patients. “With sensitivity training for all and quick dismissal of anyone who offends another because of the other person’s ‘lived experience,’ DEI personnel dictate what everyone can say and do at work,” he says. “This is certainly destructive to the doctor-patient and doctor-employee relationships; it used to be a non-issue to discuss people’s culture, family history, etc, and it may have helped the physician to understand the patient’s and employee’s needs and concerns better. Now we’re starting down the road of not assuming gender based on name, physical characteristics, or how people dress?” Instead, hospitals and medical schools should foster a climate where doctors and doctors-in-training feel free to speak and ideate, where they don’t feel like they are checking boxes just to get to the next patient. In fewer words: the more our healthcare system begins to resemble the current state of our education system, with its speech codes and intellectual monocultures, the worse off everyone will be.
Instead, allow doctors to be frank with patients about their specific needs and the evidence-based treatment they would recommend to them. For example, doctors should be allowed to cut the bull about a patient’s gender. If a person is born a girl, they have specific girl-related biological problems; thinking that they are a boy should play no role in their treatment and diagnosis. Furthermore, doctors should not be censured for asking patients about their individual and family circumstances, their behaviors, or other parts of their history, like Dr. Andersen was. Although intercultural communication can sometimes be an issue due to language barriers, only 25 percent of Black Americans see it as a major issue in healthcare for them.
People appreciate doctors who are straight to the point. Let’s build a medical climate that emphasizes straight talk.
We would like to thank Dr. Nche Zama, cardiothoracic surgeon, and Dr. Bill Andersen and Nancy Andersen, MD, orthopedist and UNC general surgery residents, respectively, for their contributions to the M.E.D.S. framework.
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AMPLIFY MY VOICE
Please sign up if you agree with our goal of living in a United and Free America. We will speak out — via all forms of media — against those who claim America is fundamentally a racist, homophobic, anti-Semitic or anti-Asian society. We will present the caring America that wants liberty and prosperity FOR ALL.