The fallout from the recent decision of the Supreme Court of the United States (SCOTUS) to ban racially conscious admissions at Harvard and The University of North Carolina has had major repercussions throughout the medical profession. I would say that physicians are highly divided on the issue of affirmative action, with many believing that meritorious performance should determine admission to medical school rather than race and ethnicity. In fact, a poll of 1003 Americans prior to the SCOTUS ruling showed that only a slight majority (54 percent) believed it was important for the Supreme Court to protect affirmative action.

Physicians for and against diversity have been quite vocal in their views on medical websites. In a previous essay, I captured the reasons why medical organizations believe the SCOTUS decision is a significant setback to diversity efforts. Now I present comments representative of physicians in favor of the ruling, as they appeared on KevinMD and MedPage Today:

• “The most pressing need in the medical community is better diagnosticians and better treatments. This is not advanced by DEI [diversity, equity, and inclusion].”
• “Ethnicity, race, and sexual orientation [are only] important in terms of a patient’s predilection for a certain disease, such as Sickle Cell in African, or Tay-Sachs in Ashkenazi populations, for instance.”
• “It [admission to medical school] should be based on intelligence and previous education.”
• “How about letting the most qualified in? If someone is not as qualified offer additional training to become more qualified. Basing everything on race is counterproductive.”
• “I find the proportionality obsession with physicians’ looking like America’ as concerns race, gender, etc., to be disingenuous.”
• “I want the best educated and best trained person regardless of what they look like to operate on me.”
• “Dr. Martin Luther King, in his ‘I had a dream’ speech, longed for the day when our kids will be judged by their character, not ‘the color of their skin.'”
• “The beneficiaries of affirmative action are not those who really will bring diversity, but rather are cherry-picked.”
• “While I can understand ‘diversity’ I don’t want it used as a go-no-go metric when it comes to education and filling positions.”
• “The most highly qualified candidates should be admitted, and the schools should be judged on the demonstrated quality of their graduates. Anything else may short-change patients and society.”
• “The voices of common sense have been shouted down for too long and it’s affecting every aspect of the education system. Why should ‘diversity’ be the most important goal for any institution?”

In line with the last comment, a group of physicians from the conservative group Do No Harm are fighting identity politics, specifically reverse discrimination. Do No Harm has filed more than 100 legal complaints against medical schools that allegedly discriminate by offering scholarships and programs based solely on race, ethnicity, color, gender, or national origin. Such programs, it is argued, cater to minorities and exclude other classes of people, in violation of federal civil rights laws.

Do No Harm is concerned about the antiracist movement embodied, for example, by a Maine hospital executive who was at the center of a DEI antiracist prayer service in which a group of white people were made to apologize for their internalized racism simply for being white, a Nevada middle school teacher who called white people “problematic” and education in general “racist,” and medical students at Ohio State University who were required to read antiracism literature, including an opinion piece that recommends a white colleague not ask a Black colleague how they are doing. These and other cases cited by Do No Harm leave the impression that whites are perceived as racist just by virtue of their race, even though there are millions of white people in the United States whose ancestors had nothing to do with slavery or Jim Crow.

Stanley Goldfarb, MD, a nephrologist and the founder of Do No Harm, has been an ardent critic of the antiracist movement and its leader, Ibram X. Kendi, the noted author and director of the Center for Antiracist Research at Boston University. Kendi postulates that systemic racism is prevalent in higher education, especially STEM, and past discrimination can only be overcome by future discrimination.

“This undermines the whole idea of a trusting physician-patient relationship. And that’s what we’re trying to combat,” Goldfarb told Fox News. Goldfarb views health inequities mainly due to poor access to care and health illiteracy in marginalized populations. He argues that antiracist practices incorporated into the field of medicine will only exacerbate the current crisis in health disparities, including discrimination.

The issues are undoubtedly complex and not simply black or white (no pun intended). Whose side you are on depends on your shade of grey and tolerance for rhetoric. But one thing is certain. We are promoting DEI initiatives more than ever, from the classroom to the TV rec room. There isn’t a day that goes by where I do not see diversity represented in television commercials, including gay, lesbian, interfaith, and interracial couples and families. Representation of multiple ethnicities, genders, and identities in advertising and marketing campaigns has become a key component of brands’ strategies.

Nowhere is this more evident than in direct-to-consumer pharmaceutical advertising, which accounts for 75 percent of the total ad spend and where campaigns speak to the identity-based way patients view their conditions. AstraZeneca and Amgen have emphasized diversity and authenticity in campaigns for lupus and severe asthma therapies. Several manufacturers of HIV drugs have represented the wide range of people living with or at risk for HIV, so they chose Black, Latino, male, female, gay, bisexual, and transgender actors for ads that encourage people to “prep,” “detect this,” and “keep being you.” The medicalization of such mental illnesses as depression and bipolar disorder by enlisting actors from diverse backgrounds in drug ads has been used to reduce mental health stigma, but with unproven results.

I enjoy watching some television commercials, but I resent that Madison Avenue has been hired to covertly infiltrate our collective unconscious. It is not genuine. I am not likely to buy products branded for their sociopolitical agendas and contexts – and studies have shown this to be true for consumers in general. Achieving diversity and inclusion in advertising and marketing in the United States requires clearing many of the same hurdles that impede its incorporation into medicine. I would like to think that as a nation we can embrace diversity on “face” value: to create a more equitable and inclusive society for everyone.

Arthur Lazarus is a former Doximity Fellow, a member of the editorial board of the American Association for Physician Leadership, and an adjunct professor of psychiatry at the Lewis Katz School of Medicine at Temple University in Philadelphia, PA. His forthcoming book is titled Every Story Counts: Exploring Contemporary Practice Through Narrative Medicine.