How DEI–a neo-Marxist intellectual tradition–has infiltrated medicine and is undermining it from within

Dissecting the causes and consequences of a radical ideology destroying American medicine

“Ms. Smith, great news! This is your new physician Dr. Marx!”

DEI, a radical left-wing ideology, has completely captured the leading accreditation organizations in American medicine

Diversity, Equity, and Inclusion, or DEI, is a catchphrase used by medical schools, professional institutions, and the corporate world throughout the United States. What’s not to like about that? “Diversity, equity, and inclusion” are lofty words. They bestow credibility.

But DEI is a lie. DEI does not promote “diversity, equity, and inclusion”. It does the opposite. The foundational belief of DEI is that white people are successful because they rig the system. According to DEI, Asians are the co-conspirators of whites, because Asians are even more successful than whites. DEI maintains that medical education must lower academic standards for non-whites and non-Asians to compensate for their systemic rigging of society. Because the lowering of standards is an alarming prospect for medical practitioners for whom work is a matter of life and death, DEI uses pseudoscience to maintain that the lowering of standards for medical trainees actually improves the quality of healthcare.

And is unquestioned–even unquestionable–ideological dominance today politicizes medicine and threatens to undermine medical science itself. It is not an exaggeration to say that the implications threaten to plunge American medicine into the darkest chapter of its history.

American medicine underwent an unprecedented political reconfiguration in the 2010s. Starting from a somewhat conservative profession in the 2000s, by the end of the 2010s, it had become overwhelmingly left-leaning. Medicine’s orientation toward identity, gender, sexuality, and race transformed from cautiously liberal to stridently leftist and identitarian. The emerging dominance of DEI reflected this transformation. But in the wake of the George Floyd protests in 2020, what was once a trickle in the 2010s soon became a flood.

In 2022, American Academy of Medical Colleges (AAMC)—American medicine’s premier accreditation organization—published a document “Diversity, Equity, and Inclusion Competencies Across the Learning Continuum”. This document provides recommendations for what medical students, residents, and physicians should know about medicine to be considered competent physicians. This document and others like it are disturbing in what it reveals about the political darkness that today threatens to destroy American healthcare.

Reading like the unlikely offspring of a 1960s political manifesto and a sterile 2000s corporate training manual, the document unsuccessfully attempts to cloak controversial and even demonstrably false claims in the respectable register of medical officialese. It speaks of “systems of oppression”. It denounces “white supremacy”, which it claims is a present-day ruling regime in North America and Europe, “an institutionally perpetuated system of exploitation and oppression of continents, nations, and people of color by White people and nations of European descent”. It reports as a “competency” that medical students, residents, and physicians practice “anti-racism”, which is a form of political activism that its proponents insist entails discriminating against white people; presumably, this means discriminating against white patients. (This occurred during the pandemic, when the Biden administration officially prioritized the treatment of blacks over whites for COVID-19.) It constructs from the thoroughly debunked theory of implicit bias a series of nine separate required competencies. And it declares that “it is our role [as physicians] to continuously examine the multiple forms and kinds of intersectional exclusions. The call for an anti-racist health care system — one which recognizes and addresses the intersectionality of systems of oppression — amplifies every day. [sic]”

DEI is a radical ideology with roots in neo-Marxist thinking

The historical link between DEI and radical left-wing ideologies can be gleaned by looking at one of DEI’s central pillars: diversity training. Erica Sherover-Marcuse was one of the pioneers of the original diversity training template in the 1980s, which she then called “unlearning racism” workshops. The goal of these was “to help people overcome racist attitudes [in] … small groups as well as large gatherings in institutional settings.” Now, Sherover-Marcuse was the third wife of Herbert Marcuse, the most influential Marxist philosopher in American history, and she was awarded a Ph.D. in philosophy under Marcuse’s and Jürgen Habermas’s direction for her dissertation examining Marx's theory of political consciousness. Thus, Sherover-Marcuse was a Marxist intellectual. And her ultimate goal in conducting these workshops was to create revolutionary consciousness and facilitate radical social change. She wrote:

“The achievement of human liberation on a global scale will require far-reaching changes at the institutional level and at the level of group and individual interactions. These changes will involve transforming oppressive behavioral patterns and "unlearning" oppressive attitudes and assumptions.”

Thus, Sherover-Marcuse’s “unlearning racism” workshops, once a part of Marxist strategy to achieve revolutionary consciousness, were adopted by the universities and then the world’s most successful capitalist institutions. Re-christened “diversity training”, a tool of communist revolutionaries became a staple in American corporate HR departments–and in medicine.

But not only have originally Marxist-influenced workshops been embedded into medical education (and the corporate world more broadly); neo-Marxist beliefs have been imported with them. The specialist vocabulary that abounds in AAMC’s DEI medical education guidance abounds in neo-Marxian tropes: “systemic racism”, “institutionalized racism”, “internalized racism”, “oppression”, “oppressors”, “power”, “liberation”, “class”, “class conflict”, “class consciousness”.

The outcome is a bizarre fusion of neo-Marxist ideology into corporate-bureaucratic organizational structures.

The practical outcome–and pseudoscientific rationalizations–of DEI in medicine

Let us evaluate DEI in practical terms.

Consider racial concordance theory: the debunked hypothesis that same-race and same-ethnicity doctors provide better healthcare. As researchers at the non-profit advocacy organization Do No Harm have shown in a recent report, experiments have consistently failed to support racial concordance: four of the five systematic reviews conducted on the subject found no significant effect of the race of the physician on patient care. The one systematic review that did find an effect inexplicably excluded relevant studies and misrepresented the studies it did include.

Racial concordance is one of two main arguments that medical training accreditation organizations use to justify lowering admissions standards. The failure of researchers to confirm racial concordance theory is a major blow to that agenda. The second argument is even less successful. Repeated throughout the literature, the second argument is that physicians who belong to demographic minorities are much more likely to serve minority populations, which historically have had fewer physicians than they need for adequate healthcare; recruiting more of these physicians therefore serves to “correct” some of the healthcare shortage affecting these populations.

Yet, as healthcare policy experts have widely noted, the very organizations making the case for “increasing diversity” also intentionally created the physician shortage in the first place through their lobbying efforts aimed at restricting the supply of doctors and limiting the scope of practice of allied health professionals. Instead of fixing the shortage, organizations like AMA and AAMC propose “diversity initiatives” (once called affirmative action) to shift the physician shortage from one location to another location, increasing healthcare access of some demographic groups at the expense of others.

Yet there is an even bigger wrinkle here: if less qualified candidates are replacing more qualified ones in order to work for underserved populations, how does that make the healthcare of these underserved populations any better? We know that these less qualified candidates underperform compared to their peers at every level of pre-medical and medical education: 1) they have lower undergraduate GPAs and MCAT scores; 2) they have higher rates of dropping out of medical school; 3) they have lower licensing exam scores and pass rates; 4) they are more likely to drop out of residency; and 5) they are more likely to be disciplined by their medical boards and lose their licenses. Ironically, physicians that are less competent by every metric are being unleashed on underserved and vulnerable populations in the name of social justice. The result is the very opposite of equity.

This country needs adequate physicians, who are the most competent candidates to fill that role. This–not DEI–would best serve underserved and vulnerable populations.

DEI is a redistributionist ideology that destroys competence and selects out individuals with strong leadership and scientific qualities

Fundamentally, DEI is an identitarian far-left ideology that seeks to impose equal racial, gender, sexual, etc. outcomes by fiat. If blacks are 15% of the population, they should be 15% of physicians. If women are 51% of the population, they should be 51% of medical school deans. And so on. The unscientific proclamations about the research base supporting DEI are simply the rationalizations and rhetoric of an ideology whose simple-minded conclusions are pre-determined from the start.

If science cannot rationalize these unethical practices, loyalty statements can ensure that they remain unquestioned. A widespread practice among medical schools is the requirement of loyalty oath-like statements in medical school applications. Indeed, a recent report showed that as many as 72% of the top medical schools used such prompts to politically weed out applicants during the application process. Such statements include:

“Our country is reckoning with its history, racism, racial injustice, and especially anti-black racism. Please share your reflections on, experiences with, and greatest lessons learned about systemic racism.”

“Institutionalized racism can be defined as “macro level systems, social forces, institutions, ideologies, and processes that interact with one another to generate and reinforce inequities among racial and ethnic groups.” As a future medical student, how can you play an active role in addressing and dismantling systemic racism?”

These prompts contain unscientific political declarations that it is not appropriate to direct toward a medical student, much less expect for the student to give a “right” answer to these prompts. Yet, a “right” answer is considered crucial for a successful medical school application. This means that medical schools are engaging in ideological pruning, whereby the viewpoint diversity is being intentionally reduced in the profession in the name of DEI.

This is morally repugnant. In the name of diversity, diversity is being reduced, and the profession homogenized. The outcome is that medical schools are selecting for either true believers in DEI, or the type of person who “goes along to get along.” This dangerously politicizes the profession, and eliminates courageous and questioning individuals out of the applicant pool.

Quite often, medicine resides at the boundary between science and politics, especially in areas where the evidence is new and emerging. But when the profession overwhelmingly leans one or another way on a political issue, the danger arises that the profession may overwhelmingly take the side that its political commitments may bias it toward. Yet nature does not take sides. This automatic taking of sides may blind medicine toward the truth and block it from changing course, even going so far as to persecute dissidents, who, as a small minority, might not be taken seriously simply because most of the profession are not familiar with their views. This may occur even when this minority is scientifically correct, while the majority is incorrect.

For instance, the politicization of American medicine is leading to a profession that is, unlike most other Western countries, unwilling to critically evaluate the evidence on pediatric transgender care. This is causing irreparable harm to thousands of children. American medicine’s inability to correct course on this issue is related to its ideological commitment to identitarian sexual politics. And this commitment is directly related to the ideological pruning during the admissions process coupled with reinforcement during the mandatory DEI lectures and modules discussed above.