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Prescription For Quotas

If I weren?t a product of both undergraduate and graduate programs at Stanford, I would be critical of this report (?Latinos underrepresented in medical profession?) of quota-mongering at the Stanford Medical School (HatTip to reader Ed Chin). But since I am, I am both ashamed and embarrassed as well as critical.

The Stanford Daily article begins by noting that

Latino Americans only make up five percent of California?s doctors, according to a recent study at UC-San Francisco, though they constitute one-third of the state?s population[,]

and goes rapidly down hill from there.

Fernando Mendoza, Associate Dean for Minority Advising and Programs at the Stanford School of Medicine, said the lack of diversity within the medical profession can actually reduce the effectiveness of physicians.

?A lot of work has been done that?s shown how physicians communicate with patients and the barriers to that communication,? he said. ?Studies have reported that there are biases in health care and that they are quite often unconscious; in order to deal with those unconscious biases, we need to diversify the work force and develop more culturally competent positions.?

Along with their diplomas, perhaps medical schools and/or state medical licensing boards could begin issuing certificates of cultural competence. Of course, before they could do that they would have to develop a curriculum in it, devise tests to measure it, etc. Or in the alternative, they could simply let skin color or ethnicity (visible or claimed) be a certified proxy. (What? You say they?re already doing that? Oh well...) In any event, after the Stanford Medical School or the California Medical Association develops a valid test for ?unconscious biases,? I hope they will share it with the world.

But I digress. Let us listen to Dr. Mendoza?s prescription:

In order to increase diversity in the medical school student population, Mendoza ... encourages the admission office to evaluate potential candidates on a broader spectrum of criteria.

?One thing I think is evident,? he said. ?We?re well behind the curve and have a long way to go to get the number of Latino physicians up to where they represent the proportion of the general population.

Note that Dr. Mendoza does not say that he endorses quotas. Defenders of affirmative action never say they they endorse quotas, and usually hotly deny that they do. No, Dr. Mendoza doesn?t call for quotas. All he wants is for the number of Latino students admitted to the Stanford Medical School, and the number of physicians practicing in California and presumably the rest of the United States, ?to represent [their] proportion of the general population.?

And while we?re speaking of proportional representation (not quotas!), if the goal (not quota!) is for the proportion of doctors who are Latino to reflect the proportion of Latinos in the general population, then Stanford and the remainder of the medical establishment must take some rather dramatic steps to reduce the proportion of admitted medical students and physicians who are Asian or Jewish, since those groups are now substantially ?overrepresented? at Stanford and everywhere else.

Weeding out the Jews and Asians, however, can be a tricky business. Asians are usually easy to spot, even where their names are not giveaways, but Jews are not always so obvious. We don?t all have Jewish-sounding names, and many Jewish-sounding names aren?t even Jewish. Nor is photographic evidence, even in profile, completely reliable.

And even if those problems were solved (if Stanford can combat ?unconscious bias,? surely it can come up with ways to spot Asians and Jews), what of the ?Latino? category itself? Should all of the ?Latino? physicians in California be Mexican or Mexican-American, or do Dr. Mendoza and his Stanford colleagues think that, say, Cuban-Americans are ?culturally competent? enough to treat Mexicans?

Sorry, but that?s all I have time for right now. I?m off to meet with our accountant re taxes, though now I?m worried that he?s not culturally competent enough to figure out how the tax code applies to us.

UPDATE

Roger Clegg of the Center for Equal Opportunity has posted this comment on the Stanford Daily?s web site:

Aggressive outreach ? casting a wide net--to make sure that you get the best qualified applicants possible, of all colors and socioeconomic backgrounds, is fine. Getting rid of conscious or unconscious bias in selection is fine, too. So is making sure that your selection criteria really produce the best, most qualified students.

But weighing ethnicity to decide which applicants are admitted is not. If you give weight to ethnicity, then you are no longer admitting the best qualified people. That shortchanges future patients--of all national origins.

It is wrong to discriminate in order to ensure that the med school looks like the general population, and it makes no sense to do so. Cultural competence can be taught to doctors of any color. Gentiles and non-Asians have not suffered from the historical ?overrepresentation? of Jewish and Asian doctors. A quota is a quota is a quota.

What he said. And you can quot[a] me on that.

Full post as published by Discriminations on April 11, 2008 (boomark / email).