Author: Zachary Robert Caverley

The Problems with Discrimination Research in Medicine

Like many professions in Western society, medicine is examining itself for the presence of racial inequities and strategies that can ameliorate these differences. Many publications have focused on the disproportionately poor outcomes of minorities in our healthcare system with an emphasis on systemic and structural forces that shape such inequities. As I concluded in my last article for Quillette, these discussions should proceed with the utmost scientific caution, as the answers and implications stand to affect the most vulnerable populations. With this in mind, there are limitations in the current literature on alleged medical discrimination and the associated health outcomes. In addition, much of the literature on this topic relies heavily on surveys and patient self-reports to assess bias and discrimination while downplaying or ignoring alternative hypotheses. The narrative that has emerged from the conclusions of these limited studies could inadvertently cause some populations to avoid medical follow-up and form an inaccurate view of healthcare practices. As background, the relevant literature appears to show that black and Hispanic patients tend to view medicine as more …

Rethinking Health Disparities

In the last few decades, the proliferation of diversity, inclusivity, and equity literature throughout the medical profession has become institutionalized. Medical organizations such as the World Health Organization (WHO), the National Institute of Health (NIH), and the American College of Cardiology (ACC) have embraced this ideology and its accompanying bureaucracies and web-based material, and have called for cultural changes in some of our most important fields of study. Reforms are ostensibly intended to address healthcare disparities between groups, and new initiatives are frequently justified with reference to what the Sullivan Commission called the “ghosts of discrimination.” 1 The authors of reports like these will invariably go on to talk about implicit bias, the need for diversity in the healthcare workforce, and an examination of structural forces and power distributions that shape group disparities in health outcomes. In January 2020, the ACC published a cover story stating that healthcare group disparities and the lack of diversity in healthcare were a “national emergency” and strongly promoted the use of the Implicit Association Test (IAT).2 Even as late as …