Diversity is an important aspect of our lives. It is so basic, that diversity is literally required for any biological system to thrive. Why do human beings believe we are exempt from this scientific reality? One answer could be that we have for so long believed in meritocracy and rationality, and that anything less would seem biased or prejudiced, even primitive. Unfortunately, humans are emotional begins that sometimes don’t make the right decisions. Meritocracy requires we have access to the same or similar resources, and rationality assumes we would distribute those resources in a logical and orderly fashion. This has never successfully occurred in any human society…ever. Diversity is one way to better understand the human condition in order to notice the various ways the human species can continue to thrive. Difference, variety, diversity. That is the stuff that informs human greatness.
No place is diversity more important than medicine. I ran across two articles that showcase two distinct ways that the medical profession responds to calls for diversity. In a March 20 article in the San Francisco Chronicle entitled UCSF Opens ‘Skin of Color’ Dermatology Clinic to Address Disparity in Care, Erin Allday highlights the way the field of dermatology is addressing the need for diversity in patient care. In responding to the disparity in survival rates for skin cancer (90% among whites, and 66% among African Americans), there is one “deceptively simple explanation: Most dermatologists are white, and white doctors are rarely trained to look at and make diagnoses in dark-colored skin.”
As a result, University of California San Francisco opened a dermatology clinic specifically to study and address the health issues of darker-skinned patients. The hope is that this may positively impact the health outcomes of patients of color. Dr. Bruce Wintroub, chair of dermatology at UCSF states that “People of color have been underrepresented in medicine, and for that reason populations of people of color have really been underserved.” He goes on to say, “We felt that it was time to offer the beginnings of a solution to this problem.” Creating a space for exploring the needs of communities of color requires not only an immediate fix (a clinic) but a long-term plan (diversity in admissions). There is where the next example comes in.
In 2005 Texas Tech University Health Science Center was under investigation for its admissions practices. The suit was filed by the conservative think tank Center for Equal Opportunity. It was ultimately dismissed in 2018. Since 2014, the school came into a voluntary agreement with the US Department of Education, which “prohibits the School of Medicine from considering race in making admissions decisions.” According to the agreement, Texas Tech can consider race as part of its admission criteria only if it “provides a reasoned, principled explanation for its decision and identifies concrete and precise goals.”
The response to diversity from these two institutions cannot be more different. UCSF decided to provide a health service that was specific to the unique needs of a particular population. In so doing they also acknowledge the work that still must be done to produce more doctors of color. Texas Tech, in an attempt to remove what I believe to be unreasonable scrutiny informed by racism, commits to a race-blind admission policy. I’m not sure how this action has impacted their enrollment numbers, but I what I am sure of is that it will impact the type of doctors they will produce and their ability to address the needs of the diverse communities of Texas.
Some would say that there is no real good answer for solving the “diversity problem” in medicine. Personally, I don’t see diversity as a problem. It is a strength, and a possible solution to many of the problems that are creating huge health disparities for our most vulnerable populations. UCSF saw it as a simple solution to at least begin addressing the disparate survival rates of skin cancer. Texas Tech may find that embracing diversity will help them present “a reasoned, principled explanation for its decision and identifies concrete and precise goals.” This may hush their detractors and refocus their efforts to provide valuable health services to the community. Hopefully the two schools will speak to share research and resources in order to better meet their shared goals of ensuring their students and medical teaching staff live up to the hypocratic oath they all take as medical professionals.