Racism is Being Driven into the Medical Field. What’s the Fate of Patients?
A recent proposal by the Biden administration is set to pay doctors a bonus for taking steps to combat systemic racism and incorporating “anti-racism” into their work.
In a broader, years-long effort to hardwire “race Marxism” into medicine, healthcare professionals are being pressured to repeat the concept that racism produces major health disparities, not lifestyle choices.
Newstalk report that Pediatrician Erica Li told the Daily Caller News Foundation that “race Marxism” pits people in “classes” in order to achieve economic equality, on gender and race rather than based on their economic status as classical Marxism did.
CARE FOR PATIENTS
A growing number of doctors and medical institutions are questioning their method of allocating limited resources in crisis situations due to unequal results for different racial groups. A few medical professionals have advocated rationing limited, life-saving medical resources based on race to prioritize black and Latino patients.
According to the Los Angeles Times, the Centers for Disease Control and Prevention (CDC) prioritized essential workers when deciding which groups received the first vaccines.
As Dr. Sally Satel indicates, the CDC walked back the suggestions after public outcry, but Vermont gave non-white households priority for vaccines based on race before general populations were eligible. White residents had a higher vaccination rate (33%) than non-white residents (20%), and GOP Governor Phil Scott criticized that gap.
As part of a pilot program, the Brigham and Women’s hospital in Boston considered prioritizing patients for cardiovascular care explicitly based on their races. The program would have benefited black and Latino patients by closing the gap between whites and non-whites in cardiac care, as explained by doctors Michelle Morse and Bram Wispelwey in the Boston Review article.
Morrise and Wispelwey believed that health gaps among racial groups are rooted in racism, and considered their plan a kind of reparations for racial injustice. This project was based on a proposal from 2010 entitled “Critical Race Theory, Race Equity, and Public Health: Toward Antiracism Praxis.”
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During this time, Brigham publicly disassociated itself from Morse and Wispelwey’s article. The hospital issued a statement denial, repeatedly stating that it will not be offering preferential care based on race.
A Brigham spokesperson, Mark Murphy, told DCNF that the final version of the program, which will be implemented later this year to address racial health disparities, will provide heart failure patients with “educational notices” before they are admitted to the hospital. In the notices, employees are informed that black and Latino individuals are historically less likely to receive cardiology services, but their individual judgment and decision-making are unaffected.
Murphy disclosed to DCNF that the Boston Review article was “an opinion piece and reflects the perspective of these two physicians,” however, the authors of the article, who work at Brigham, referred to the pilot program as “our pilot program,” something the hospital has not denied.
More than 1,000 health professionals publicly supported mass protests in the wake of George Floyd’s death in June 2020 despite COVID-19 concerns, arguing that racism was a public health threat that superseded the medical community’s social distancing advice. Jennifer Nuzzo of Johns Hopkins argued at the time that “in this moment the public health risks of not protesting to demand an end to systemic racism greatly exceed the harms of the virus.”
As three scientists pointed out, “researchers must name and interrogate structural racism and its sociopolitical consequences as a root cause of the racial health disparities we observe” in the September 2020 issue of the Journal of the American Medical Association. They explained that efforts to erase individual agency within medicine and blame all health disparities on systemic racism are part of the larger effort to ignore personal choice and environmental factors.
One of the largest funders of biomedical research in the world, NIH (National Institutes of Health), is now focusing on racial issues. Going forward, funding will be poured into research projects on structural racism and diversity and inclusion programs will be expanded for NIH administrators as part of its plan to end structural racism in biomedical sciences.
According to recent reports, in October, the NIH granted $3.4 million to a Tulane researcher to develop an app that teaches white parents how to teach their children anti-racism instead of color-blindness. ‘Campus Reform’ also reported the institution gave $600,000 to a professor at the University of Michigan to teach about anti-racism to students.
Researchers found that black babies receiving care from black physicians were half as likely to die compared to black babies receiving care from white physicians. Despite the lack of acknowledgement in the study, department chairs or division heads are more likely to be listed as the doctors of record in cases where NICU outcomes are poor regardless of whether they were ever involved in the newborn’s care.
“It’s garbage data in, garbage conclusion out … but what the public takes away is that white doctors are killing black babies. How is that going to create trust among our African American patients? I worry they will stop going to the hospital if they get sick,” Li remarked.
After publishing a paper questioning the effectiveness of race-based affirmative action, program director Norman Wang was dismissed by the University of Pittsburgh medical school.
Also, JAMA Editor Edward Livingston contended in a podcast that socioeconomic factors, not structural racism, are the culprits holding back communities of color. As a result of public outcry, both Livingston and the chief editor at JAMA resigned, the latter undergoing a three-month suspension before resigning.
The Association of American Medical Colleges noted that academic medical leaders “are weaving content and experiences throughout their curricula to significantly boost awareness of social inequities and structural drivers of health” and argued that equity-related “social drivers need to be woven into the very fiber of medical education.”
According to Li, practices based on “race Marxism” would potentially detract from medical students’ limited time to learn critical scientific information, which would ultimately harm patient care. Also, Dr. Li is concerned that doctors may be forced to pledge allegiance to the ideology of “racial Marxism” in the future as part of the licensing process, which could result in loss of licenses or board certifications for those that do not comply.
Many medical boards offer implicit bias training to examiners and writers of test items. The ABMS website states that more training will be offered in the future. The Daily Caller asked the ABMS for comment but did not receive a response.
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Doctor Carrie Mendoza, an emergency medicine physician based in Chicago, explained how new ideas reach patient care and medical administration through academic institutions, using the opioid crisis as an example.
CPT codes are used by doctors to bill insurance companies and government programs like Medicare. Mendoza explained that since the AMA receives income from its members’ use of CPT codes, there is a financial incentive to make more codes.
Early in the 2000s, legislators became concerned that patients’ pain wasn’t being adequately addressed, therefore requiring doctors and hospitals to measure pain, which was then referred to as the “fifth vital sign,” Mendoza said.
Whether doctors were meeting goals was determined by their improvement of patients’ pain scores, and it even affected their bonuses, according to Mendoza. Through the AMA’s CPT codes for pain treatment, doctors were financially incentivized to prescribe more pain medication.
“In emergency medicine we quickly saw that people were getting inappropriate prescriptions for things like ankle sprains and then becoming addicts, then there were diversions and overdoses,” Mendoza clarified.
“There’s a parallel here where admission requirements for medical schools and residency are being loosened. When these factors converge, you get into an environment where there can be patient harm,” Mendoza said.
Possible Way Out
The government might make use of the SDH codes to rationalize its healthcare priorities, Mendoza speculated.
As another way out, the American Medical Association (AMA), which creates CPT codes, produced a 2021-2023 “strategic plan to embed racial justice and advance health equity” that aims to “understand and operationalize anti-racism equity strategies … develop structures and processes to consistently center the experiences and ideas of historically marginalized … and minoritized (Black, Indigenous, Latinx, Asian and other people of color) physicians” and “amplify and integrate often ‘invisible-ized’ narratives of historically marginalized physicians and patients in all that AMA does.”