The US Supreme Court effectively prohibited university admissions officers from giving preferential treatment to applicants based on their race this summer.

Many medical-school leaders decried the high court’s ruling, claiming the ban will lead to less diversity within their student bodies, a less diverse crop of physicians and worse outcomes for minority patients.

But it’s not clear diversity within the physician workforce improves patient outcomes — which ought to be the primary objective of medical education.

In fact, there’s evidence affirmative-action policies can harm patients as well as aspiring doctors themselves.

It’s an article of faith among affirmative action’s defenders that a more diverse physician workforce benefits patients.

In her dissent from the majority’s ruling, Justice Sonia Sotomayor wrote that affirmative action helps increase “the number of students from underrepresented backgrounds” who become doctors, which in turn “improves ‘healthcare access and health outcomes in medically underserved communities.’”

The Association of American Medical Colleges echoed Sotomayor, saying it was “deeply disappointed” in the majority’s ruling, which “demonstrates a lack of understanding of the critical benefits of racial and ethnic diversity.”

“This decision will hasten the deaths of Black people in this country and we already die prematurely,” Advancing Health Equity founder and physician Uché Blackstock blasted.

They’re referring in part to a handful of studies showing black Americans post better health outcomes when treated by black doctors.

But researcher Ian Kingsbury recently examined those studies’ methodologies and concluded that “systematic reviews” have “found ‘no relationship’ or ‘mixed results’ between race/ethnicity and quality of communication and ‘inconclusive’ evidence for patient outcomes.”

Admissions officers’ obsessive focus on race often causes them to ignore applicants’ academic and clinical aptitude — with dire consequences for the applicants themselves and ultimately the patients they treat.

Affirmative-action policies seek to give underrepresented groups a leg up in the admissions process.

By design, that means admitting applicants who likely would have been rejected based on their test scores and grade-point averages alone.

From 2013 to 2016, 56% of black applicants and 31% of Hispanic applicants with below-average Medical College Admission Test scores and undergraduate GPAs were admitted to medical school, compared with just 8% of white applicants and 6% of Asian applicants with similar scores and GPAs.

It has been exhaustively documented that undergraduate “GPAs and MCAT total scores are strong predictors of academic performance in medical school through graduation,” as one study from the Association of American Medical Colleges itself put it.

In other words, affirmative action might help underqualified applicants get into med school.

But it won’t necessarily keep them there.

Black medical school students drop out, citing academic problems, at a rate 10 times higher than white students.

It’s cruel — not compassionate — to admit students who aren’t qualified for the intellectual rigors of medical school.

It sets them up for failure, saddles them with debt they could have avoided and wastes resources that could have gone towards training qualified applicants who will actually practice medicine.

Worst of all, admitting underqualified students ultimately hurts patients.

“MCAT scores are predictive of student performance” on both Step 1 and Step 2 of the US Medical Licensing Examination, concluded one 2016 study.

Those licensing exams, in turn, are indicative of students’ skill at treating patients during their clinical rotations.

“USMLE scores have a positive linear association with clinical performance as a medical student,” noted a 2019 study, “even after correcting for gender, institution, and test-taking ability.”

The relationship holds after students graduate, complete residencies and become practicing physicians.

A 2014 study of US-licensed doctors who trained overseas found that “after adjustment for severity of illness, physician characteristics, and hospital characteristics, performance on Step 2” had “a statistically significant inverse relationship with mortality. Each additional point on the examination was associated with a 0.2% decrease in mortality.”

The purpose of medical school is not to maximize diversity.

It’s to transform America’s best and brightest students into the most competent physicians possible, no matter their race, gender or any other demographic consideration.

Doctors hold people’s lives in their hands.

It should not matter what color those hands are.

Sally C. Pipes is president, CEO and Thomas W. Smith fellow in health-care policy at the Pacific Research Institute and founder and chairman of the Benjamin Rush Institute. Her latest book is “False Premise, False Promise: The Disastrous Reality of Medicare for All.”

Twitter: @sallypipes

Updated August 22, 2023, at 11:08 a.m.

In an amended complaint filed last month, Harvard Medical School Anatomical Gift Program managers Mark F. Cicchetti and Tracey Fay were added as defendants in a class action lawsuit over the alleged mishandling of donated human remains at the HMS morgue.

The suit, which was filed in the Massachusetts Suffolk County Superior Court by Keches Law Group, originally only named the University and former HMS morgue manager Cedric Lodge. The amended complaint, filed July 10, accuses Cicchetti and Fay — who remain HMS employees — of negligence and infliction of emotional distress.

In June, Lodge was indicted by federal prosecutors for allegedly stealing and transporting human remains. At the time of the alleged thefts, Cicchetti and Fay were employed as the managing director and manager of the HMS Anatomical Gifts Program, respectively.

Jonathan D. Sweet, an attorney representing the affected families, wrote in an emailed statement that the new defendants were named due to their roles as directors of the Anatomical Gift Program and “supervisory responsibilities as to the donor bodies and the morgue manager Cedric Lodge.”

“Defendant Mark F. Cicchetti and Defendant Tracey Fay had a duty to safeguard the donors’ bodies and to ensure that their loved ones’ bodies were not defiled for non-anatomical research purposes,” the amended filing reads. “Harvard and HMS directors breached this duty when they failed to take reasonably supervisory steps to verify that the bodies of the donors were treated with proper and reasonable decency after Harvard had no further use for them in the HMS.”

Families of the deceased initially filed a class action lawsuit against the University and Lodge on June 16, alleging negligence, breach of fiduciary duty, and infliction of emotional distress. Two more class action lawsuits were filed against the University last month by affected families.

“Harvard and HMS and its managers failed to exercise the minimal reasonable level of care with respect to the safe custody, handling, and supervision of donor bodies after their use for anatomical study,” the amended complaint reads.

HMS spokesperson Ekaterina D. Pesheva declined to comment on the pending litigation or the allegations made against Cicchetti and Fay.

“Harvard does not comment on pending litigation,” Pesheva wrote in an email. “It is important to note, however, that other than former employee Cedric Lodge, no one at HMS is facing any criminal charges or is suspected of any wrongdoing. As stated in the indictment, Lodge’s activities were carried out without the knowledge or permission of anyone else at HMS.”

Attorneys on behalf of the Medical School, Cicchetti, and Fay did not respond to a request for comment. An attorney for Lodge could not be identified.

—Staff writer Nia L. Orakwue can be reached at nia.orakwue@thecrimson.com. Follow her on Twitter @nia_orakwue.

Abstract and Introduction

Between 10% and 15% of individuals in the industrialized world have gallstones. The standard treatment is laparoscopic cholecystectomy, making gallstone disease the second most costly digestive disorder in most Western countries. Despite a rapid convalescence, the procedure is not devoid of morbidity or even mortality. Bile duct injury is particularly troublesome, occurring in 0.1% to 0.5% of cases, even in the most experienced hands. Moreover, some 20% of patients continue to suffer from pain (the main indication for treatment) after cholecystectomy. In patients with mild symptoms, surgical treatment has been associated with a higher morbidity than the natural course of the disease. Medical dissolution therapy with bile acids is an alternative for patients with mild-to-moderate symptoms due to cholesterol gallstones. Chenodeoxycholic acid (CDCA, chenodiol) has been largely replaced by the safer and more efficient ursodeoxycholic acid (UDCA). The main drawbacks of UDCA treatment are its low efficacy (approximately 40%), slowness in action, and the possibility of stone recurrence. However, this treatment is extremely safe, and the efficacy and slowness can be somewhat improved by stricter patient selection. Moreover, patient symptoms may respond to this therapy even without complete stone dissolution. New strategies employing more efficient bile acids or related compounds may increase the efficacy of medical dissolution. Furthermore, recent advances in the understanding of biliary lipid secretion and regulation should offer novel opportunities to further Boost the prospects of medical treatment of gallstones.

Gallstones are one of the most common and costly digestive disorders in the modern industrialized world.^[1] Some 15% of populations in most Western countries have gallstones. The primary treatment for gallstones has been surgery ever since the introduction of cholecystectomy by Langenbuch approximately 120 years ago. However, the costs as well as the risks associated with surgical therapy have stimulated attempts to treat gallstones by nonsurgical means. Although initial reports of medical therapy were published almost a century ago, it was not until the 1970s that medical dissolution of gallstones became a practical option.

The first drug, CDCA, was largely replaced by the safer UDCA during the 1980s. Shock-wave lithotripsy introduced in Germany in the mid-1980s increased the pool of potential candidates for nonsurgical therapy and made medical therapy quite popular, especially in Europe. However, the success rate of dissolution was low, and the introduction of laparoscopic cholecystectomy about 15 years ago rapidly extinguished the demand for nonsurgical therapy in most countries. Hence today, despite a significant increase in cholecystectomies performed during the last decade, the popularity of medical dissolution therapy has declined, and many gastroenterologists (not to mention surgeons) do not even offer the option of medical therapy to their patients.

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If 100 respected medical journals all reported that people around the world could do one particular thing to drastically Boost their long-term health prospects, I suspect there would be a global rush to get that one thing done. The response might be uneven; some countries would do more to persuade their citizens to take up that particular healthful thing than others. But because medical journals tend to be fact- and data-driven, and because they tend to be restrained and careful in their judgements, healthful-thing programs would likely spring up, almost everywhere.

So it’ll be interesting to see how the leaders of the United States, Russia, China, France, the United Kingdom, India, Pakistan, Israel, and North Korea respond, now that over 100 top medical journals have called for urgent action to reduce the risk of nuclear war. In an editorial appearing in multiple publications—including the esteemed Journal of the American Medical Association, the British Medical Journal, and The Lancet—11 editors of leading medical and health journals and other medical experts have called on health professionals “to alert the public and our leaders to this major danger to public health and the essential life support systems of the planet—and urge action to prevent it.”

“Once a nuclear weapon is detonated, escalation to all-out nuclear war could occur rapidly,” the co-authors wrote. “The prevention of any use of nuclear weapons is therefore an urgent public health priority and fundamental steps must also be taken to address the root cause of the problem—by abolishing nuclear weapons.”

The editorial advocates that the nine nuclear-armed countries and their allies adopt no-first-use policies and take their nuclear weapons off hair-trigger alert. In what could be seen as a reference to Russia, the editorial also urges that countries involved in current conflicts pledge publicly and unequivocally not to use nuclear weapons. In a more ambitious (and potentially more provocative) vein, the piece also proposes that the nuclear-armed nations work toward a definitive end to the nuclear threat through negotiations “for a verifiable, timebound agreement to eliminate their nuclear weapons in accordance with commitments in the [Non-Proliferation Treaty], opening the way for all nations to join the Treaty on the Prohibition of Nuclear Weapons.”

The editorial begins with a reference to the Bulletin’s Doomsday Clock, now set at 90 seconds to midnight, the closest it has ever been to catastrophe, and ends with a ringing call for immediate action to reduce the nuclear threat: “The danger is great and growing. The nuclear armed states must eliminate their nuclear arsenals before they eliminate us. The health community played a decisive part during the Cold War and more recently in the development of the Treaty on the Prohibition of Nuclear Weapons. We must take up this challenge again as an urgent priority, working with renewed energy to reduce the risks of nuclear war and to eliminate nuclear weapons.”

I will report any responses from the leaders of the world’s nuclear-armed nations to this public health advice, as I see them.

There is an urgent need to enhance access to quality acute stroke management in India due to the escalating burden of non-communicable diseases and the significant rise in brain stroke incidences in the country, experts said on Tuesday. The country has seen nearly 100 per cent increase in brain stroke cases from 1996 to 2019. In the realm of stroke care, the adage 'time is brain' holds profound significance, said Dr Girdhar GYANI, Director General, AHPI-Association of Healthcare Providers (India). Swift recognition of stroke symptoms and prompt intervention are paramount in preserving brain function and averting dire consequences, he said.

''The urgency of immediate action cannot be overstated as timely treatment not only offers the potential to salvage vital neural cells, but also holds the promise of mitigating and even reversing damage. The gravity of strokes, which can prove fatal or lead to debilitating paralysis/life-long disability, underscores the imperative of early intervention," he said.

As India grapples with an escalating burden of stroke cases, seamless access to comprehensive stroke care emerges as a pivotal requirement, according to Gyani. "We need to have sustained campaign among community to identify symptoms and rush to nearest facility which has CT scan. Achieving these objective mandates sustained collaboration and concerted efforts from a spectrum of stakeholders, encompassing government and private entities," he added.

According to Shuchin Bajaj, Founder, Director, Ujala Cygnus Group of Hospitals, enhancing access to quality acute stroke management in India is not just a medical imperative, it is also a commitment to saving lives and ensuring a healthier future for all. ''To Boost access to quality acute stroke management in India, several steps could be taken, including awareness campaigns, telemedicine, training and education, emergency medical services, public-private partnerships, mobile stroke units, and government policies. Apart from that, community engagement, affordable medications, and research and innovation are also needed in this direction,'' he said. Early diagnosis and detection of acute stroke symptoms are significant in its management as fast and accurate diagnosis is vital for selection of appropriate acute stroke treatment, Dr Aakaar Kapoor, CEO and Lead Medical Advisor, City X-Ray and Scan Clinic said.

''MRI brain is the investigation of choice while suspecting CVA (cerebral vascular accident), and can also be coupled along with MRI angiography. Also neurologists frequently prescribe for MRI perfusion to evaluate for the ischemic penumbra. More and more availability of quality diagnostics with high-end equipment in the country is crucial for improving access to quality stroke management," he said. According to reports, stroke is India's fourth leading cause of death and fifth leading cause of disabilities, however, there is still very limited awareness about the various forms and causes of stroke. Many people confuse stroke with heart attacks and there is a need to create awareness of the early symptoms of stroke, which is a growing threat to the Indian population. ''It is also time we ensure accessible and affordable stroke ready hospitals and infrastructure not only for medical interventions during the critical 'Golden Hour', but also for specialised medical techniques like mechanical thrombectomy to reverse the damage to some extent or in full, and lessen the chances of death and disabilities. ''The IHW Council has been working relentlessly to bring all stakeholders together through its unique yearly Stroke Summit and has been striving to make impactful progress as far as stroke management in the country is concerned,'' Kamal Narayan, CEO, IHW council said.

(This story has not been edited by Devdiscourse staff and is auto-generated from a syndicated feed.)