A few years ago, Dr. Richard T. Bosshardt waded into a minefield. He had been a Fellow of the American College of Surgeons (ACS) for over thirty years when he expressed his opinion that the ACS’s diversity, equity, and inclusion initiatives were threatening their dedication to excellence.
Whatever your position is with regard to DEI/antiracism, if you believe that censorship to silence dissenting opinions among professionals in an organization such as the American College of Surgeons, please read and sign my petition at https://www.change.org/ACS-petition-reinstate-Bosshardt, then pass it on to anyone you know. Thank you! R. Bosshardt
Thank you, Dr. Cifu and Sensible Medicine for modeling how to hold space for differing opinions. The wide-spread censorship that is happening in this supposed democracy is very concerning to say the least. (The supposed Voltaire quote is attributed to Evelyn Beatrice Hall. https://quoteinvestigator.com/2015/06/01/defend-say/?amp=1)
I have a question for Dr. Bosshardt. I am curious if he has any close friends who are Black or Brown from the US and if he has asked them what their experiences have been in seeing a doctor, going to the emergency room, in medical school... I am also curious about this book and if he (and others) would consider reading it.
B Moon- I do have friends and medical colleagues who are black and brown, understanding that those terms are subject to interpretation) and have had those experiences. They agree with me that labeling our country from its founding until today as systemically racist is wrong and ignores the reality of progress in race relations throughout human history, until now. I have never disputed the existence of racism and I do not expect we will ever totally eradicate it. Until recently, we have made continuous progress in providing equality of opportunity to all. This is different than equity, which seeks to make outcomes for everyone equal. I believe that is not only impossible, it is not desirable and efforts to do this, e.g. socialism, communism, authoritarianism, have resulted in untold human misery and death. And, yes, I will read that book. I have already ordered it. Rick
The whole "gender" over SEX bs must end. It's been going on for longer than DEI and some feminists have been sounding the alarm for decades, but no one wants has wanted to even listen until the DEI stuff arrived on the scene... which is too late, because doctors already caused the shift to anti-science, by accepting the pseudoscience of "sex changes" in mammals. It's bs and it needs to end.
People have lost their ability to think clearly! I do not understand where the DEI B.S. is coming from. It must be a continuation of the tropes we’ve been dealing with since the 70s. Racism is big business just ask Jesse Jackson and Al Sharpton. People won’t be happy until whites are the minority it seems or until this country is torn apart, whichever comes first. I understand where some are coming from but you do everyone a disservice when you dumb down entrance requirements, curriculum and the like. Forcing things to change too fast can be just as bad as no change at all.
Thanks, Richard. I am a "member" of Do No Harm. I retired in 2022 at the age of 74 after more than 40 years in academic medicine as a pediatric pulmonologist. When the DEI craze arrived, I was appalled that my Department, my medical school, and so many of my colleagues willingly went all in. Pediatrics has attracted generous, liberal (in the best sense of the word) and idealistic individuals for the last generation. The idea that we all had implicit bias and racism was suffused in our daily work is and was absurd. Children's Hospitals have provided a single class of care for all infants and children for decades. No separate wards for the rich and famous unlike some esteemed adult hospitals. Further the invocation of a paper by Supreme Court Justice Ketanji Jackson that sick infants might have better outcomes if cared for by members of their own race was ridiculous on its face. Too many of our colleagues keep their blinders. On the silence of pediatricians while young children were masked and so many children and adolescents were kept out of school should reverberate with condemnation for a group of physicians who knew better.
This was in Dr. Bosshardt's original comment in the ACS Bulletin in 3/2019:
"My medical school class of 1978 was 80% male with a smattering of black, Hispanic, and oriental students. Today’s classes, such as that of my daughter, University of Miami class of 2017, are 50% female and way more ethnically diverse. That is wonderful but in an era where one of the greatest concerns is a shortage of physicians, I know that female physicians are unlikely to devote the same number of man hours/years to medical practice over a career that I am my male peers did. While this may sound like unbridled male chauvinism, I submit this as a simple fact. Every one of my daughter’s female colleagues seeks a “balance” between their career in medicine and having a family and children. Despite all of the ideals of feminism and gender equality, it remains a biological fact that women are the child bearers and nurturers of the next generation. We disallow for this at our peril as a society."
He claims to not understand what "disrespectful language" he used, yet posted about "oriental" students and essentially claimed that women seeking work-life balance makes men better choices to be doctors. Trying to head off claims of chauvinism doesn't make it any less chauvinistic.
Then, in this article, he writes "This is not an easy task in a society rife with disparities from a multiplicity of causes and in a field where our measures of excellence are flawed."
Why do people who rail against DEI assume that these initiatives will lead less "excellence?" Medicine is a field rife with subjective measures - at my medical school, white students disproportionately received honors over all minorities. I'm sure some fun people would come out of the woodwork and say "see, this is evidence of medicine relaxing its standards to allow in the blacks and hispanics!" but do we really think that the Asians, who racists love holding up as the "model minority," have 6x worse grades than white students because of any objective excellence? Dr. Bosshardt writes that he understands that our measures of excellence are flawed, but then completely ignores that.
This article perfectly exemplifies the victim complex of people like Dr. Bosshardt, who feel as if progressivism attacks them for being white. Being asked to be mindful in a diverse society is not an attack. Rather than doubling down and being defensive against these initiatives, some true self-reflection would be useful.
With respect, there is so much wrong with your comment, I hardly know where to begin and just do not have the time to educate you. That you take issue with my use of the term "oriental" is telling and I apologize for offending your sensibilities with my microaggression. That you critique me for stating simple facts in an objective manner makes it unlikely we will have a fruitful discussion. Even so, I hope you will agree that silencing speech we disagree with is illiberal and unAmerican, and has no place in a professional organization such as the ACS. You did not mention this, the most important point of my article in your comment.
Rick
PS- I have no victim complex as you put it. As to being attacked for begin white, if you deny this happens, your are truly naive. Please do some research and educate yourself as I have.
I chose Emergency Medicine in part for work-life balance. I have been able to flex up and flex down in order to spend more time with my children when they were little. I have been able to split shifts with other working mothers in order to be home more or attend a special event at school. I do work less than the men in my group.
I'm a female and a feminist. I have no kids, because I'm not a fool. Second Wave feminist advocated for women to make CHOICES between motherhood and careers.
Silly Third Wave "feminism" pretended that women were superhumans and could "have it all", this is so wrong headed.
If I were in an ideal HR (not in a the current setting obviously) I would be most certainly be asking if the interviewee is capable of giving a full schedule just like all the other employees, and if they plan on taking leaves.
I am an advocate for FEMALE CHOICE. Not female "have it all" and do everything half arsed.
Joseph, you do not address the heavy-handed cancellation engineered by the ACS. What is wrong with an open and honest debate. I find nothing "chauvinistic" about his matter-of-fact assessment of the career contributions of female physicians. Surely, he could have treated this idea in greater detail while acknowledging some of the virtues that women can bring to the workplace.
The fact that they would not show you what your supposed "mistakes" were and that you had no right to appeal, should be enough to show that they are not interested in anything but pushing their own agenda and excellence is not part of it. As a nurse of 45 years, it has been a source of pride that the patient is always treated to the best of our abilities, regardless of their race, their gender or whether they are an inmate or a highly regarded person in society. I know there are those who may not do so but that has not been my overall experience over the years. Seems like there is much more today about dividing people instead of uniting us.
Here is where I stand: " I have a dream, that someday my little girl will be judged by the content of her character and not the color of her skin." (MLK) The least heard quote amongst the advocates of equity.
The ACS has banded other members for discussions that challenged their mission and goals. Some of these discussions called for ACS to stand up to reimbursement cuts, poorly written surprise medical bill laws and the progressive consolidation of healthcare. Some of us left the ACS because they were more interested in making money through their annual Clinical Congress or other CME products than protecting the rights of surgeons. ACS does not care if it’s members are unhappy with its leadership decisions. They have their agenda and anyone interfering with that was and is silenced. Members who disagree need to voluntarily vote with their dues. I left before the DEI discussions took off and have concerns about where merit fits into all the discussions.
Eileen-first of all, Hello! Secondly, I recall reading your posts on the forums when all that you mentioned was taking place. Thank you for being a consistent advocate for 'sensible medicine' before it was cool.
Well I feel your pain. My professional organization, the American Academy of Pediatrics, is entrenched with DEI. What’s scarier is how the trans ideology took over. Lots of active damage being done
The answer is very simple. Just apply the same standards to everyone regardless of race, creed, gender, etc. etc. etc........Those who want special consideration to be given to any group or category are the racists, sexists, etc. It never seems to occur to those who want special privileges for one group that this will inevitably result in discrimination against some other groups. There is ample evidence of this with discrimination against Jewish students in the past and Asian students today.
Don't I get credit for using the word "sexist" in the second sentence. Interesting that your obsession with shades of meaning of nearly equivalent terms is much like that of the people you claim to criticize with their "pronouns" and other such nonsense. I am beginning to wonder whether you may be that dreaded controlled opposition designed to deflect those of us that are truly concerned with individual rights and freedom.
This focus on DEI & seeing everything through the lens of skin color and "equity" - in practice, in many institutions like schools- has decided attendance isn't important, grades are not important, rigorous math in 8th grade is not important, discipline is not important, etc.
The logical conclusion is that excellence is not important...in fact, the dogma has explicitly said that excellence is "white supremacy culture".
Institutions like healthcare (and more), adopting this dogma/ ideology is terrifying.
Since DIE has been enshrined by CMS, Joint Commission, and many state health agencies on down, it's now an administrative burden whose appetite cannot be squelched. Healthcare gospel, like "safe and effective", and a business can't quite bite the hand of it's biggest payor ...
CA legislation points:
Hospital Statutory Requirements CA Assembly Bill 1204: Annual Equity Reports
-Posted on the hospital website including the words “Equity Report”
-First report due September 30 2025
-Disparities by age, sex, race, ethnicity, language, disability status, sexual orientation, gender identity, payor, socioeconomic status.
-Data would contribute to well informed health policy, public health response, would improve overall health of individuals and communities in the state.
No mention of cost/benefit of the abovementioned...the benefits of juicy contracts, consultants, lobbyists, and salaries.
Whatever your position is with regard to DEI/antiracism, if you believe that censorship to silence dissenting opinions among professionals in an organization such as the American College of Surgeons, please read and sign my petition at https://www.change.org/ACS-petition-reinstate-Bosshardt, then pass it on to anyone you know. Thank you! R. Bosshardt
Thank you, Dr. Cifu and Sensible Medicine for modeling how to hold space for differing opinions. The wide-spread censorship that is happening in this supposed democracy is very concerning to say the least. (The supposed Voltaire quote is attributed to Evelyn Beatrice Hall. https://quoteinvestigator.com/2015/06/01/defend-say/?amp=1)
I have a question for Dr. Bosshardt. I am curious if he has any close friends who are Black or Brown from the US and if he has asked them what their experiences have been in seeing a doctor, going to the emergency room, in medical school... I am also curious about this book and if he (and others) would consider reading it.
https://www.scientificamerican.com/article/a-black-physician-takes-on-racism-in-medicine/
B Moon- I do have friends and medical colleagues who are black and brown, understanding that those terms are subject to interpretation) and have had those experiences. They agree with me that labeling our country from its founding until today as systemically racist is wrong and ignores the reality of progress in race relations throughout human history, until now. I have never disputed the existence of racism and I do not expect we will ever totally eradicate it. Until recently, we have made continuous progress in providing equality of opportunity to all. This is different than equity, which seeks to make outcomes for everyone equal. I believe that is not only impossible, it is not desirable and efforts to do this, e.g. socialism, communism, authoritarianism, have resulted in untold human misery and death. And, yes, I will read that book. I have already ordered it. Rick
Thank you for you thoughtful and principled stand.
I just learned that the link for the ACS Task Force on Racism recommendations does not work. You can access that link here: https://bulletin.facs.org/2021/01/task-force-reports-on-how-the-acs-can-confront-racism-in-surgery/
Thanks Richard for taking a stand against DEI and all that it connotes.
I thought we were doctors practicing the art of medicine?
Those who have corporatized medicine and ushered politics to the bedside should be ashamed of themselves.
Step 1.
Scientists and "health" professionals need to stop using euphemisms.
Humans have two SEXES.
Mammals have two SEXES.
It's determined absence/presence of the SRY gene and is immutable.
Every single person who says "gender" instead of SEX has been participating in the lies.
The whole "gender" over SEX bs must end. It's been going on for longer than DEI and some feminists have been sounding the alarm for decades, but no one wants has wanted to even listen until the DEI stuff arrived on the scene... which is too late, because doctors already caused the shift to anti-science, by accepting the pseudoscience of "sex changes" in mammals. It's bs and it needs to end.
People have lost their ability to think clearly! I do not understand where the DEI B.S. is coming from. It must be a continuation of the tropes we’ve been dealing with since the 70s. Racism is big business just ask Jesse Jackson and Al Sharpton. People won’t be happy until whites are the minority it seems or until this country is torn apart, whichever comes first. I understand where some are coming from but you do everyone a disservice when you dumb down entrance requirements, curriculum and the like. Forcing things to change too fast can be just as bad as no change at all.
That DEI happened should not be surprised. The minute doctors started enabling FAKE SEX surgeries, 50 years ago, the ground was laid.
All lies lead to more lies.
Thanks, Richard. I am a "member" of Do No Harm. I retired in 2022 at the age of 74 after more than 40 years in academic medicine as a pediatric pulmonologist. When the DEI craze arrived, I was appalled that my Department, my medical school, and so many of my colleagues willingly went all in. Pediatrics has attracted generous, liberal (in the best sense of the word) and idealistic individuals for the last generation. The idea that we all had implicit bias and racism was suffused in our daily work is and was absurd. Children's Hospitals have provided a single class of care for all infants and children for decades. No separate wards for the rich and famous unlike some esteemed adult hospitals. Further the invocation of a paper by Supreme Court Justice Ketanji Jackson that sick infants might have better outcomes if cared for by members of their own race was ridiculous on its face. Too many of our colleagues keep their blinders. On the silence of pediatricians while young children were masked and so many children and adolescents were kept out of school should reverberate with condemnation for a group of physicians who knew better.
GBM, Thanks for the kind words. Please share this article with other physicians. Also, if you would be so kind, sign and pass on my petition:
https://www.change.org/ACS-petition-reinstate-Bosshardt
Regards,
Rick
This was in Dr. Bosshardt's original comment in the ACS Bulletin in 3/2019:
"My medical school class of 1978 was 80% male with a smattering of black, Hispanic, and oriental students. Today’s classes, such as that of my daughter, University of Miami class of 2017, are 50% female and way more ethnically diverse. That is wonderful but in an era where one of the greatest concerns is a shortage of physicians, I know that female physicians are unlikely to devote the same number of man hours/years to medical practice over a career that I am my male peers did. While this may sound like unbridled male chauvinism, I submit this as a simple fact. Every one of my daughter’s female colleagues seeks a “balance” between their career in medicine and having a family and children. Despite all of the ideals of feminism and gender equality, it remains a biological fact that women are the child bearers and nurturers of the next generation. We disallow for this at our peril as a society."
He claims to not understand what "disrespectful language" he used, yet posted about "oriental" students and essentially claimed that women seeking work-life balance makes men better choices to be doctors. Trying to head off claims of chauvinism doesn't make it any less chauvinistic.
Then, in this article, he writes "This is not an easy task in a society rife with disparities from a multiplicity of causes and in a field where our measures of excellence are flawed."
Why do people who rail against DEI assume that these initiatives will lead less "excellence?" Medicine is a field rife with subjective measures - at my medical school, white students disproportionately received honors over all minorities. I'm sure some fun people would come out of the woodwork and say "see, this is evidence of medicine relaxing its standards to allow in the blacks and hispanics!" but do we really think that the Asians, who racists love holding up as the "model minority," have 6x worse grades than white students because of any objective excellence? Dr. Bosshardt writes that he understands that our measures of excellence are flawed, but then completely ignores that.
This article perfectly exemplifies the victim complex of people like Dr. Bosshardt, who feel as if progressivism attacks them for being white. Being asked to be mindful in a diverse society is not an attack. Rather than doubling down and being defensive against these initiatives, some true self-reflection would be useful.
Joseph,
With respect, there is so much wrong with your comment, I hardly know where to begin and just do not have the time to educate you. That you take issue with my use of the term "oriental" is telling and I apologize for offending your sensibilities with my microaggression. That you critique me for stating simple facts in an objective manner makes it unlikely we will have a fruitful discussion. Even so, I hope you will agree that silencing speech we disagree with is illiberal and unAmerican, and has no place in a professional organization such as the ACS. You did not mention this, the most important point of my article in your comment.
Rick
PS- I have no victim complex as you put it. As to being attacked for begin white, if you deny this happens, your are truly naive. Please do some research and educate yourself as I have.
I chose Emergency Medicine in part for work-life balance. I have been able to flex up and flex down in order to spend more time with my children when they were little. I have been able to split shifts with other working mothers in order to be home more or attend a special event at school. I do work less than the men in my group.
I'm a female and a feminist. I have no kids, because I'm not a fool. Second Wave feminist advocated for women to make CHOICES between motherhood and careers.
Silly Third Wave "feminism" pretended that women were superhumans and could "have it all", this is so wrong headed.
If I were in an ideal HR (not in a the current setting obviously) I would be most certainly be asking if the interviewee is capable of giving a full schedule just like all the other employees, and if they plan on taking leaves.
I am an advocate for FEMALE CHOICE. Not female "have it all" and do everything half arsed.
Joseph, you do not address the heavy-handed cancellation engineered by the ACS. What is wrong with an open and honest debate. I find nothing "chauvinistic" about his matter-of-fact assessment of the career contributions of female physicians. Surely, he could have treated this idea in greater detail while acknowledging some of the virtues that women can bring to the workplace.
The fact that they would not show you what your supposed "mistakes" were and that you had no right to appeal, should be enough to show that they are not interested in anything but pushing their own agenda and excellence is not part of it. As a nurse of 45 years, it has been a source of pride that the patient is always treated to the best of our abilities, regardless of their race, their gender or whether they are an inmate or a highly regarded person in society. I know there are those who may not do so but that has not been my overall experience over the years. Seems like there is much more today about dividing people instead of uniting us.
Here is where I stand: " I have a dream, that someday my little girl will be judged by the content of her character and not the color of her skin." (MLK) The least heard quote amongst the advocates of equity.
The ACS has banded other members for discussions that challenged their mission and goals. Some of these discussions called for ACS to stand up to reimbursement cuts, poorly written surprise medical bill laws and the progressive consolidation of healthcare. Some of us left the ACS because they were more interested in making money through their annual Clinical Congress or other CME products than protecting the rights of surgeons. ACS does not care if it’s members are unhappy with its leadership decisions. They have their agenda and anyone interfering with that was and is silenced. Members who disagree need to voluntarily vote with their dues. I left before the DEI discussions took off and have concerns about where merit fits into all the discussions.
Eileen-first of all, Hello! Secondly, I recall reading your posts on the forums when all that you mentioned was taking place. Thank you for being a consistent advocate for 'sensible medicine' before it was cool.
Well I feel your pain. My professional organization, the American Academy of Pediatrics, is entrenched with DEI. What’s scarier is how the trans ideology took over. Lots of active damage being done
The DEI was successful because for 50 years they've been pushing the lie of "gender" onto us and few fought back beyond a handful of feminists.
Now that DEI has arrived in full force, people are finally noticing the bs.
It's so exhausting seeing how long it takes society to see the lies.
The answer is very simple. Just apply the same standards to everyone regardless of race, creed, gender, etc. etc. etc........Those who want special consideration to be given to any group or category are the racists, sexists, etc. It never seems to occur to those who want special privileges for one group that this will inevitably result in discrimination against some other groups. There is ample evidence of this with discrimination against Jewish students in the past and Asian students today.
As long as you use the silly word "gender" instead of the actual scientific word which is SEX, you yourself are enabling all this.
Mammals have two sexes, determined by absence/presence of a SRY gene, and it's immutable.
People have been telling these lies for 50 years and it's got to stop.
Oh please. Did you really miss the whole point of the comment?
YOU asked for standards, yet YOU fail to apply standards to your own language. No wonder we're in the mess we're in.
Don't I get credit for using the word "sexist" in the second sentence. Interesting that your obsession with shades of meaning of nearly equivalent terms is much like that of the people you claim to criticize with their "pronouns" and other such nonsense. I am beginning to wonder whether you may be that dreaded controlled opposition designed to deflect those of us that are truly concerned with individual rights and freedom.
This focus on DEI & seeing everything through the lens of skin color and "equity" - in practice, in many institutions like schools- has decided attendance isn't important, grades are not important, rigorous math in 8th grade is not important, discipline is not important, etc.
The logical conclusion is that excellence is not important...in fact, the dogma has explicitly said that excellence is "white supremacy culture".
Institutions like healthcare (and more), adopting this dogma/ ideology is terrifying.
Since DIE has been enshrined by CMS, Joint Commission, and many state health agencies on down, it's now an administrative burden whose appetite cannot be squelched. Healthcare gospel, like "safe and effective", and a business can't quite bite the hand of it's biggest payor ...
CA legislation points:
Hospital Statutory Requirements CA Assembly Bill 1204: Annual Equity Reports
-Posted on the hospital website including the words “Equity Report”
-First report due September 30 2025
-Disparities by age, sex, race, ethnicity, language, disability status, sexual orientation, gender identity, payor, socioeconomic status.
-Data would contribute to well informed health policy, public health response, would improve overall health of individuals and communities in the state.
No mention of cost/benefit of the abovementioned...the benefits of juicy contracts, consultants, lobbyists, and salaries.