Is Change Possible?

Why It Matters

Removing race from clinical algorithms prevents misdiagnosis and unequal treatment, directly improving health outcomes for Black patients while highlighting the need for broader systemic reforms.

Key Takeaways

• Race-based clinical algorithms harm Black patients and lack scientific basis
• NYC’s CIRCA coalition removed race from nine major hospital algorithms
• Pediatric guidelines once denied catheters to Black girls, risking infections
• De‑implementation improves transplant wait times without disadvantaging White patients
• Sustainable change requires diverse stakeholder input and equitable resource distribution

Summary

The video examines how race has been embedded in medical diagnostics and treatment, arguing that it is a social construct rather than a biological reality. Rachel Gotbaum interviews Dr. Michelle Morse of NYC Health Dept and Dr. Joseph Wright of the American Academy of Pediatrics to explore why race‑based medicine persists and how it can be dismantled.

The physicians recount personal experiences of hearing “piss‑poor protoplasm” used to explain illness in patients of color and describe the backlash when they challenged the inclusion of Black race in eGFR calculations. They cite a pediatric guideline that exempted Black girls from catheterized urine tests, and detail the NYC Coalition to End Racism in Clinical Algorithms (CIRCA) which has removed race from nine algorithms, including kidney and lung function estimates.

Notable moments include the silent shock after a 2017 grand rounds on eGFR, the proactive recalculation of kidney‑transplant wait times that gave Black patients years back without harming White patients, and the acknowledgment that bias in over 300 AAP clinical guidance documents fuels disparate care. Dr. Wright emphasizes that outcomes, not intent, matter, and calls for interdisciplinary teams in guideline development.

The discussion underscores that eliminating race from algorithms is only a first step; true equity demands universal health coverage, payment reforms aligned with de‑implementation, and open dialogue across institutions. By reshaping education, policy, and resource allocation, the medical community can prevent systemic harm and improve outcomes for millions of patients.

Original Description

Source:

https://www.podbean.com/eau/pb-uaevd-1aecf5e

The use of race in medicine is harming patients. What is being done to move away from these practices and to change a culture of medicine based on the false premise that race is biological?

A full transcript of this episode is available at https://www.nejm.org/doi/full/10.1056/NEJMp2601981.