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Doctor's Orders: Waking Up the WSJ

Two weeks ago, the Wall Street Journal published an editorial—bylined by its editorial board—condemning the “woke” direction of the Association of American Medical Colleges (AAMC)’s new recommendations for medical schools. “Read and wince at how woke politics is about to infect medical education,” they fret, before detailing how the AAMC now suggests that medical schools include critical race theory (CRT)[1] in the curricula for medical students. [2] Thankfully, the WSJ has diagnosed the real sickness: Schools that teach future doctors to be aware of their biases, in order to treat all Americans, and not just the aging white conservatives who might read their editorial pages: "America faces a looming and severe doctor shortage as baby boomers retire. It won't help attract prospective doctors to tell top students they must attend to their guilt as racial and political oppressors before they can diagnose your cancer." (emphasis mine)

The irony here is multiple. First, if one is training for an occupation that may improve and even save the lives of patients of different races, genders, and ethnicities, then perhaps learning to be aware of those differences and to work in ways that acknowledge and accommodate them is an important, indeed vital, part of that education. Second, to refuse to do so is to operate (pun intended) blissfully but dangerously unaware of this country’s long history of ignoring or, worse, capitalizing on differences in patients, with devastating results. And third, not for nothing: the quote assumes that all medical students are white men—yet in 2021, women made up more than half (55 percent) of all med school students and Black and Latinx students together comprised around 30 percent. They, and the CRT curriculum, are less likely to cast these students as “racial and political oppressors.”

But let’s consider that sneered-at oppression, shall we? It was not even a century ago that medically trained (white male) doctors tricked Black men in Tuskegee into believing they were being treated for syphilis when, in fact, they were made into experimental subjects whose slow and painful deaths were observed for science. Many Black people today had relatives directly affected and, as a result, might be understandably wary of government-issued health mandates. Perhaps a young doctor trying to immunize a Black community against COVID-19 or polio or measles might benefit by knowing this history.

So how about today? Should a new doctor perhaps be aware that Black and Latinx women (and some men) were routinely sterilized against their will in states like North Carolina and even California as recently as 2010? Might that affect the types of treatment offered to, not to say accepted by, their patients?

Or consider BIPOC pregnant people who hope to survive giving birth—and yes, there are thirteen wealthy countries where women of any race are more likely to survive childbirth than in the United States, and for Black women in the US the maternal mortality rate is double that of whites.[3] If I were a budding OB/GYN, I might want to know this—I may not change it singlehandedly, but I could at least avoid being dismissive of my future patients’ concerns.

Obesity is another problem—linked to race, sure, but also to class and gender, and even simple appearance. Fat may not be an identity per se, but fat people are overwhelmingly misdiagnosed due to unexamined ableist prejudices from the medical establishment. Forty percent of the US population between twenty and thirty-nine years old is obese, as are 44 percent of those between forty and sixty; potential doctors should have to examine the fact that their forebears routinely ignored health concerns of the overweight and instead advised such patients just to lose weight. And let’s not forget, the ability to lose weight, if possible at all, is very strongly linked to the social and economic factors that the WSJ finds so “woke.”

Finally, of course, gender plays an enormous role in how or even whether a patient is accurately diagnosed and treated. It wasn’t so long ago that women were deemed sensitive or “hysterical” (as in having to do with the Greek “hysterikos,” or “suffering in the womb”) if they complained of ailments we now recognize as fibromyalgia, chronic pain, hemophilia (long believed, wrongly, to not affect women), autoimmune disorders like lupus or MS, and even heart disease. According to the American Heart Association, women presenting with symptoms of a heart attack are more likely than men to die, since doctors think their symptoms are “atypical”—that is, not like men’s.[4] And of course  this doesn’t begin to address  the unique challenges around trans and nonbinary patient needs.

Luckily for beleaguered med students who don’t want to have to face such icky realities, the WSJ has their back. The editors write, deeply concerned, that

Most young people who pursue a career in medicine want to help patients. Now they will be taught
                 that “an intricate web of social, behavioral, economic, and environmental factors, including access to

                quality education and housing, have greater influence on patients’ health than physicians do” . . .

 This educational element may be tedious, but learning about social, behavioral, economic, and environmental histories won’t make students worse doctors, and it likely won’t deter them from medicine altogether. But it may help correct the fact that the US healthcare system currently ranks eleventh in developed countries—last place—a ranking that is probably not helped by media outlets insisting we’re fine as we are. Add to that that the general life expectancy in the US is five years shorter than in comparable nations, although we pay more than double that of any other wealthy country for healthcare. And we are the only developed country that does not offer socialized healthcare, and so most patients that the students do see will have been sicker longer, and be reluctant or unable to follow medical advice. These strike me as bigger potential deterrents than CRT.

Perhaps the WSJ is onto something, though. Perhaps calling awareness of the multiple ways in which the US healthcare system betrays the most vulnerable “CRT” is self-defeating. Perhaps letting conservative media label it as “woke” is more dangerous as letting wild-eyed liberals demand equity in care. Perhaps it creates a distraction from the very real ways in which medical education at the graduate level can be harnessed to address some of our system’s problems. Perhaps instead we should take a cue from the Journal and its parent company, Fox News, and rebrand: Rather than “CRT,” let’s call it EMT—"Equity in Medical Treatment.” And let’s say our medical students are being introduced to “Fair and Balanced Medicine for All.”


EMILY WOJCIK is the Managing Editor of the Massachusetts Review. 

[1] CRT, it is important to point out, is taught only and exclusively at the graduate-school level, most often in law schools, to help educate future lawyers about the unacknowledged biases that might lead to their demanding far more stringent sentences for BIPOC defendants than for white ones. (The effect of this can be seen in the fact that, while they comprise only 13 percent of the US population as a whole, Black people comprise nearly 40 percent of the prison population.)

[2] It seems similarly important to note that, contrary to what politicians would have you believe, CRT is not taught in K-12 schools. Simply teaching students that John Brown or Emmett Till or segregation existed and were perpetuated by white people in power isn’t CRT—it’s just American history.

[3] Check out Serena Williams’ account of barely surviving her C-section, despite being among the richest and most well-known Black women in the world.

[4] The same study showed that these women were more likely to die if the doctor treating them was male.



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