Neo-Nazis Target Health Equity Docs: Take Action Today.
Advocacy from Just Equity for Health| Stella Safo, MD MPH
Racial equity work requires healthcare workers and health systems to acknowledge that the legacy of America’s white supremacist culture had led to embedded preferential treatment for white populations. To move from this reality to a more just healthcare delivery system, we must embrace equity-based redesign in medicine. Equity-based health systems improvement utilizes data to create interventions that preference historically marginalized racial and ethnic groups where appropriate.
Drs. Michelle Morse and Bram Wispelwey shepherded one such intervention in cardiac care at Brigham and Women’s hospital. Using the Healing ARC framework, first described by economist William A. Darity, Drs. Morse, Wispelwey and their team of health equity practitioners proposed the implementation of care that would adjust for the historic under-representation of Black patients on the heart failure service. It’s radical work and one that should be replicated across the country if we are serious about addressing health inequities.
Instead, what we see is backlash from bigots and white supremacists in the form of malignment from cable news anchors and a recent Neo-Nazi protest outside of the Brigham and Women’s hospital, which specifically targeted Drs. Morse and Wispelwey.
We in medicine have too often been silent or complicit when it comes to race-based violence against historically marginalized groups. This account of carefully orchestrated backlash against those engaged in active reparations-based health equity improvement work should concern us all and requires supportive action.
There are three simple steps each of us can consider taking, today, to stand in solidarity with those at the front lines of equity-based redesign in healthcare.
First, talk to your peers. Between Covid-19 and the ever-present demands of medical care, many healthcare workers are simply unaware of situations like what Dr. Morse and others are facing. Sharing this story is an important first step to draw attention to the risks associated with moving from simply talking about diversity, equity and inclusion, to actually implementing change in clinical care delivery.
Second, ask your academic institutions to partake in work similar to the Healing Arc Framework. Part of why Neo-Nazis are so comfortable targeting Brigham and Women’s Hospital is because there are few academic systems currently implementing this kind of race-based corrective care delivery. We need more academic institutions to join in the mix.
Finally, ask your professional societies to make statements in support of equity-based redesign. When the majority is silent, it allows a handful of bigots to have outsized impact. We are heartened to see groups like the American Medical Association making such statements of solidarity. Please ask others to join in. {Send this sample email to your professional societies}.
The work of implementing equity-based redesign often falls to historically marginalized groups to execute and to Black women in particular. We cannot leave our colleagues to face the backlash of this important work alone. We must join in solidarity to demand more, not less, equity-based care delivery and to reinforce that bigotry and white supremacy have no place in medicine.
