Affirmative action is dead in name only.
That’s the reality as college and graduate school applicants finalize their submissions for the 2024-25 academic year. While many institutions have found workarounds to the Supreme Court’s ban on affirmative action last June, resistance is most brazen at medical schools.
They feel especially justified in continuing to discriminate because they have an argument that other institutions lack – that recruiting more minorities is essential to patient health.
It’s a compelling claim, but it’s a lie. And worse, it’s an implicit argument for re-segregating health care.
The health care establishment has rallied around the idea that matching patients with physicians of the same race – so-called "racially concordant" care – improves health outcomes. The Association of American Medical Colleges made that clear in its amicus brief to the Supreme Court last year, falsely claiming that "Black physicians are far more likely than others to accurately assess Black patients’ pain tolerance," and "for high-risk Black newborns, having a Black physician is tantamount to a miracle drug."
Health and Human Services Secretary Xavier Beccerra, meanwhile, lamented that "we need more health workers, especially those who look like and share the experiences of the people they serve." And leading medical schools have made similar claims.
Harvard Medical School’s dean of medical education said in October, "patients have better health outcomes when care providers represent the diversity of the communities they serve" – i.e., Black patients need more Black doctors. Naturally, the media claims the same thing, repeating it over and over as if there’s no room for disagreement.
Hence why medical schools are still discriminating by race. Instead of explicitly focusing on applicants’ skin color, they’re adopting new strategies. One medical school dean told the New York Times that using a "socioeconomic disadvantage scale" – which focuses on how much "adversity" an applicant has faced – is especially popular. It’s a thinly veiled proxy for race, and the American Medical Association wants all of America’s 155-plus medical schools to try this trick.
But racial concordance has no health benefits, making medical schools’ continued discrimination completely unjustified, to say nothing of immoral.
The two of us have analyzed the full body of scholarly research, with a special focus on the five systematic reviews of racial concordance in medicine published in the last 15 years. Four conclude that racial concordance between patient and provider is not associated with better care.
Take the review that came out last year. It looked at 106 outcomes that could be affected by racial concordance. Only 12 showed benefits, 8 showed harm, and 86 showed no difference. The authors concluded, rightly, that racial concordance makes no meaningful difference.
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But what about the fifth review, which claimed the opposite? It suffers from major flaws, the most notable of which is that it completely ignores studies that demonstrate that racial concordance has no benefits.
Ignoring evidence isn’t science – it’s politics. And that’s what’s happening at medical schools and across the health care establishment. Activists are cherry-picking evidence that aligns with their political objectives, while ignoring reality.
American medicine is built on a foundation of evidence, and the best evidence shows that patients and physicians of all races work well together. It makes sense:
Physicians take an oath to help their patients, no matter who they are or what they look like. Medical schools should be ashamed for claiming the opposite, not least because it accepts the same premise of segregated, Jim Crow medicine.
What medical schools are doing will hurt patients, not help them. They need to stop discriminating – now.
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Jay Greene is senior fellow at Do No Harm.
