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The misrepresentation of the EDUCATE Act and the future of our health care system

Sylk Sotto, EdD, MPS, MBA
Education
June 27, 2024
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In the past year alone, legislative assaults on diversity, equity, and inclusion (DEI) in higher education have surged across the United States. This disturbing trend threatens the foundational values of our academic institutions and endangers the very essence of health equity in medical education and practice.

The recent introduction of the Embracing Anti-Discrimination, Unbiased Curriculum, and Advancing Truth in Education (EDUCATE) Act by Rep. Greg Murphy, MD, and its 35 cosponsors marks a new low in this misguided crusade. If passed, this bill would prohibit medical schools from receiving federal funding if they implement DEI policies. This move could have devastating consequences for our nation’s future.

According to The Chronicle of Higher Education, since 2023, 84 bills in 28 states have been introduced to prohibit colleges from having DEI offices, staff, and initiatives. These bills ban training, question hiring and promotion practices, and limit diversity goals in admissions and employment. As a result, at least 116 college campuses have altered or eliminated programs that impact individuals from historically marginalized communities.

As a faculty member at my school of medicine, I teach students and faculty about medical and research ethics, trust, and trustworthiness. Today, we discuss historical atrocities to understand the importance of autonomy, beneficence, and justice. We explore how individuals deserve to be treated with respect. Contrary to miseducation claims, I do not blame a majority group for past atrocities. Instead, I teach about the historical foundations of modern medical education and health systems. We must learn from past mistakes and pay attention to how the most vulnerable, including our loved ones, navigate health care today.

I emphasize the physician-patient relationship, the importance of connection and communication, and the need for cultural humility. Treating the patient, not an entire culture, is crucial. We should expect our physicians to listen to what lies behind a patient’s response. Speaking about biases and lived experiences is part of this dialogue. DEI’s miseducation falsely suggests that discussing bias is about making racist accusations, but we all have biases that influence our interactions.

Every year, I review applications and interview residency candidates. I speak with medical school applicants who all want to help people. No one can argue that this country does not need more health professionals. We also need diversity among these professionals to connect with patients’ lived experiences. According to AAMC projections, the U.S. will face a physician shortage of up to 86,000 by 2036. We need to expand our health professional workforce, not limit it. The miseducation of DEI incorrectly claims we are accepting unworthy candidates. Yet, holistic review processes have been in place for years, allowing us to increase class sizes and produce more primary care physicians.

DEI is not just about race and ethnicity but also includes gender equity, accessibility, and rural health. My work in community engagement and health research literacy impacts all populations, including predominantly white, rural areas in Indiana. DEI efforts ensure we address health inequities and include marginalized groups. Health equity happens through DEI despite political challenges. Indiana’s public health funding has increased due to research on health disparities.

I call on all health professionals, faculty, students, staff, and trainees to communicate the importance of DEI for health equity. The miseducation of DEI ignores the critical role of equity in ensuring everyone has a fair chance to achieve their highest health potential. We must address injustices and obstacles to health care, even those within our privileges.

Achieving health equity requires valuing everyone equally. Correct this miseducation with information. We are in medicine and health because we care. The miseducation of DEI has led to the elimination of critical efforts and the silencing of voices that speak to its impact. Educate others about the true meaning of DEI in health and education. DEI is about health. If making people healthy is political, then what are we doing?

The social mission of academic medicine requires us to stand for DEI. Do not be complacent; get involved. Where is the pro-DEI and health equity legislation? A few years ago, we discussed reclaiming academic medicine’s social mission and its social responsibility. We achieve this by viewing everything through an equity lens.

Years ago, I participated in a workshop that shaped my professional identity. We were asked to introduce ourselves without using our titles. I said I am a cheerleader for faculty and students, reminding them they belong here and ensuring communities have access to higher education and health. This is DEI in action, though I had not mentioned the term. DEI has been weaponized, but we must reclaim its true purpose.

We care about patients and their health. We formulate research questions to cure and relieve suffering. We are all in the academic medicine and health sciences professions, with health equity as our goal. By remaining reactive and silent, we become complicit in undermining health equity.

The dismantling of DEI initiatives impacts our patients, trainees, and colleagues. Consider this: over 24 percent of U.S. physicians are international medical graduates, and over 37 percent are women—groups once marginalized in medical training. DEI efforts are pivotal in achieving these milestones. In 2023, more than 200,000 faculty members served in academic medical centers, with my institution housing 5,000 of these dedicated professionals. Imagine the transformative power if each of these individuals championed the message that DEI is synonymous with health equity.

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We must harness our collective strength to uphold these principles as educators and advocates. Institutions must recognize their role as bastions of academic excellence and societal progress. We are called to speak the truth and advocate for justice, ensuring that DEI remains integral to our mission. The future of our health care system depends on it.

Sylk Sotto is a bioethicist.

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The misrepresentation of the EDUCATE Act and the future of our health care system
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