Bad Prescription

The New England Journal of Medicine has an editorial calling for the continued use of racial preferences in university admissions. But the argument that it puts forward — that racial preferences are justified because we need physicians who can understand their patients — has lots of problems. First, it’s not being asserted by the University of Texas and has never been recognized by the Supreme Court. Second, even if there is some benefit along these lines, the argument ignores the many costs — which I have listed many times, and to which I would add here the fact that our physicians will not be as qualified if they are being chosen in part because of their color, which ought to give everyone some pause. It’s one thing to have an bad plumber; it’s something else to have a bad doctor.

In any event, it really makes no sense to use race and ethnicity as a proxy for being able to “understand the communities and cultures” of some patients. For example, most of the African Americans who would get these preferences come from middle- and upper-class backgrounds, so their “cultural competence” will not be much different from whites and Asians (who are discriminated against) from these backgrounds (to say nothing of the fact that some whites and Asians, conversely, may come from underserved communities themselves). A particular cultural competence can be learned by people from any racial or ethnic background, and there is no assurance that the African-American med student will end up returning to his particular community. And indeed why should we be pushing black doctors — with lower qualifications, mind you — to focus on treating black patients, as if we were still in the Jim Crow era? Finally, there are so many racial and ethnic groups and subgroups now in the United States that going down this road is a futile exercise.

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