Rebranding Diversity, Equity, and Inclusion in the American College of Surgeons

The feckless character of the ACS leadership is now on full display as it attempts to hide its DEI department and initiatives behind a new label.

(My latest op ed was published in City Journal two weeks ago regarding the attempt by the ACS to disguise its DEI programs under the new label, “inclusive excellence.” A lengthier version is below.)

Three years ago, the leadership of the ACS embraced Ibram X. Kendi’s antiracism to deal with the alleged structural racism in the ACS, among its surgeons, and in the very practice of surgery. Because of the controversial nature of antiracism, with its claim that the answer to racism is reverse racism,  it adopted the more acceptable term “diversity, equity, and inclusion” (DEI), which is nothing more than a dog whistle for antiracism.

In its rush to fully embrace DEI, the ACS established an entirely new Department of Diversity with its own clinical director and executive director and began to aggressively push DEI initiatives such as implicit bias training, mandatory sessions on things like microaggressions, and other measures designed to ferret out white oppression of blacks throughout the profession of surgery.   

DEI has relentlessly pushed the narrative that the United States is an irrevocably racist nation whose history and culture is one of systemic oppression of non-white minorities by privileged whites. The proof of this is under-representation of blacks in selected areas. The magic number is 13%. Any number below this is proof of racial discrimination. The application of this criterion, however, is selective. Well under 13% of college professors, physicians, and engineers are black branding these professions as discriminatory whereas occupations where blacks predominate, e.g. the NBA and NFL, are exempt.

Two things have resulted in the widening retreat of DEI in our culture. One is the Supreme Court decision reversing fifty years of affirmative action as unconstitutional. The other is the growing realization that DEI departments, programs, and initiatives do not improve performance or foster more inclusive workplaces, but rather the opposite.  Now, more than four years after capturing nearly every organization, institution, corporation, and even the federal government and the military, the ideology of diversity, equity, and inclusion (DEI) is in retreat nearly everywhere.

Despite this, the DEI ideologues are not giving up. To circumvent the counterproductive and toxic nature of DEI by that name and also avoid running afoul of legislative restrictions to flagrantly discriminatory practices, many organizations are re-branding DEI using other descriptives.

A case in point is the American College of Surgeons’ attempt to deal with the increasingly toxic reputation of DEI by rebranding it. Gone is DEI. The new label is “Inclusive Excellence.” Search the ACS website for the Office of Diversity and you will be redirected to the Office of Inclusive Excellence. The ACS’s DEI Toolkit, which was introduced in December 2023, is now renamed, ‘ACS Inclusive Excellence Resource and Implementation Toolkit.’

The “new” Inclusive Excellence” toolkit continues to promote the discredited Implicit Association Test as a measure of implicit bias. It still claims, without proof, that emphasis on diversity to achieve proportionate representation of identity groups somehow makes organizations better. It maintains the underlying premise of DEI- that disparities of representation are an indicator of discrimination. According to DEI, unless racial representation within the ACS perfectly aligns with the percentages of those racial groups in society, it is de facto a structurally racist organization. I suspect that a proper canvassing of the membership of the ACS would reject this premise outright.

The most repellent aspect of DEI has been retained unchanged. This is racial concordance which claims that patients receive better care and obtain better outcomes if their surgeon is of the same race. The toolkit still references a thoroughly discredited study purporting to show that black babies have better survival if their doctor is black. This claim is repugnant to all physicians who do their utmost to treat every patient to the best of their ability.

Scrubbing the ACS website of term DEI will be a lengthy, ultimately futile effort because it is so pervasive. It is window dressing in any event and reflects a desperate attempt by the leadership of the ACS to virtue signal its return to a focus on excellence while retaining all of the most illiberal premises of DEI and allowing its attention to be diverted from the worrisome decline in quality of medical and surgical education, as demonstrated here and here.

If the ACS is serious about restoring the primacy of excellence in surgery, it should abandon DEI by any name and reject the racialization of surgery. It should focus on restoring the quality of surgical training programs and surgical residents-in-training by promoting quality metrics based solely on merit and competence. Anything less is a disservice to the patients who trust us to provide excellent care without regard for anything but the need of the patient before us. This is true Hippocratic medicine.

Instead, the ACS leadership wastes resources and resorts to subterfuges like rebranding and continues to censor dissenting voices.

Richard T. Bosshardt, MD, FACS, Senior Fellow at Do No Harm, Founding Fellow at FAIR in Medicine

My book, The Making of a Plastic Surgeon: Two Years in the Crucible Learning the Art and Science will give you a behind-the-scenes peek at the most fascinating and misunderstood of all medical specialties. It is available on Amazon as an eBook and in paperback.