“that medicine is an inequity-producing enterprise”

Heather MacDonald:

The AMA’s 2021 Organizational Strategic Plan to Embed Racial Justice and Advance Health Equity is virtually indistinguishable from a black studies department’s mission statement. The plan’s anonymous authors seem aware of how radically its rhetoric differs from medicine’s traditional concerns. The preamble notes that “just as the general parlance of a business document varies from that of a physics document, so too is the case for an equity document.” (Such shaky command of usage and grammar characterizes the entire 86-page tome, making the preamble’s boast that “the field of equity has developed a parlance which conveys both [sic] authenticity, precision, and meaning” particularly ironic.)

Thus forewarned, the reader plunges into a thicket of social-justice maxims: physicians must “confront inequities and dismantle white supremacy, racism, and other forms of exclusion and structured oppression, as well as embed racial justice and advance equity within and across all aspects of health systems.” The country needs to pivot “from euphemisms to explicit conversations about power, racism, gender and class oppression, forms of discrimination and exclusion.” (The reader may puzzle over how much more “explicit” current “conversations” about racism can be.) We need to discard “America’s stronghold of false notions of hierarchy of value based on gender, skin color, religion, ability and country of origin, as well as other forms of privilege.”

A key solution to this alleged oppression is identity-based preferences throughout the medical profession. The AMA strategic plan calls for the “just representation of Black, Indigenous and Latinx people in medical school admissions as well as . . . leadership ranks.” The lack of “just representation,” according to the AMA, is due to deliberate “exclusion,” which will end only when we have “prioritize[d] and integrate[d] the voices and ideas of people and communities experiencing great injustice and historically excluded, exploited, and deprived of needed resources such as people of color, women, people with disabilities, LGBTQ+, and those in rural and urban communities alike.”