From Race-Based to Race-Conscious Care
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September 27, 2024
What if the way we teach medicine is actually harming the very people it’s meant to heal? Despite AMA policies acknowledging that race is a social construct, medical education often clings to outdated ideas that link race to biology, leading to dangerous diagnostic biases. This problem starts in the classroom, but spreads into clinical training, where false assumptions and flawed tools contribute to misdiagnoses and health disparities, especially for Black, Indigenous, and People of Color (BIPOC) patients.
It’s time for a new approach—one that moves beyond race-based medicine and embraces race-conscious care to create a more equitable health care system. Unlike race-based medicine, race-conscious care acknowledges that race is not a biological determinant but a social category that affects health through lived experiences, access to resources, and exposure to systemic biases. This approach centers on understanding how racism, rather than race itself, impacts health outcomes and guides clinicians to consider social and structural factors in diagnosis and treatment.
In July 2023, a new project was launched at the University of Wisconsin School of Medicine and Public Health aimed at addressing a critical issue in medical education: the persistent use of race-based assumptions in clinical practice. With a focus on dismantling race-based diagnostic practices, this initiative set out to educate internal medicine residents about the importance of race-conscious care, promoting a more equitable and just health care system.
Leading the work is Dr. Andrea Schnell, a clinical associate professor of general internal medicine. The project, funded by the Building Trust Through Diversity, Health Care Equity, Inclusion and Diagnostic Excellence in Internal Medicine Training grant program, features a two-part workshop series designed for second- and third-year internal medicine residents. The workshops explore the negative impacts of race-based medicine and provide tools for more accurate, race-conscious diagnostic decision-making.
Reflecting on her experience teaching this curriculum, Dr. Schnell shared: “What I’ve enjoyed most is teaching foundational skills, such as diagnostic reasoning and understanding the limitations of clinical tools—skills that are broadly applicable in clinical medicine. We specifically apply these skills to race-based medicine, and it’s been both rewarding and fun to engage with the residents on these topics.”
The first workshop, “Lunch, Listen, and Learn,” brings residents together with community leaders and experts from the University of Wisconsin’s Health Department of Diversity, Equity, and Inclusion. Here, participants learn about the specific racial health disparities affecting their community and the grassroots efforts addressing these issues. The second workshop, “Diagnostic Excellence: Moving from Race-Based to Race-Conscious Care,” takes a more hands-on approach, using case-based learning to critically examine race-based clinical algorithms and diagnostic biases. Cooper has also led four community roundtable discussions, where residents engaged directly with community members to explore ways to build trust and address racial disparities.
Feedback from the workshop’s attendees has been overwhelmingly positive. One resident described the session as “eye-opening.” They said, “It was very revealing to see how some of our most widely used medical models are based on inaccurate and often harmful assumptions about race…I will definitely be thinking about these topics going forward.”
By challenging race-based medical practices and fostering a more inclusive approach to care, this project is paving the way for systemic change in medical education. As it expands to reach more health care professionals, the potential for creating a more equitable health care system grows, demonstrating that meaningful change begins with a commitment to education and community engagement.
