Diversity vs. Ideology at the Doctor’s Office

The most important level of diversity to which all clinicians must attend is the individual patient

Letter to WSJ.

"In answering the editorial “Medical Education Goes Woke” (July 27), some writers (Letters, Aug. 1-2) note that social and environmental conditions affect health, and are thus reasons for the push of the diversity-equity-inclusion (DEI) model.

That such factors affect health is hardly new knowledge. In the late 1970s, George Engel developed the biopsychosocial model to account for forces beyond the biochemical. Millennia before Engel, serfs and czars alike understood that wealth and social status fostered longer, better lives. These are critical data to understand population and individual health.

Nevertheless, the national DEI conversation seems imbued by ideological extremes, focusing on political narratives of oppressed and oppressor, defined by virtue of race, ethnicity, sexuality or gender. I fear that this comes at the expense of actual human diversity, which includes propagated waves from historical or current injustices, but comprises so much more: one’s unique experiences, aspirations, family, resilience, agency and dignity. I worry most that DEI extremism risks imposing on a given patient a rote political narrative to which the patient may not subscribe.

The most important and granular level of diversity to which all clinicians must attend is the individual patient. Each of our medical trainees and colleagues merit this same respect, and I desire it for myself. Draw what conclusions you might about the social and political determinants of health, but when I take my place on the exam table, I ask you to please never see me as a pawn in some sociopolitical drama. I am your patient, and I am trusting that you are there to help me—not what an activist imagines me to be.

David A. Kareken, Ph.D.

Indianapolis"