The Evidence Against Evidence-Based Medicine: "The curriculum [to become a doctor] now must have social justice as a 'core tenet of medical ethics,' teach about 'unconscious racism,' and include 30 core competencies for caring for LGBTpatients."(MEDICINE & HEALTH)

• Author: Orient, Jane M.
• Position: MEDICINE & HEALTH

With all of the talk about "evidence-based medicine," you might think that doctors were becoming much more focused on rigorous science but, like the names attached to bills in Congress--such as the Patient Protection and Affordable Care Act, which outlaws affordable insurance--the language used in the movement to transform America and American medicine fundamentally usually means the opposite of what it suggests.

Are older doctors uneducated in science, and do they base their treatments on opinion, intuition, or outdated dogma, while younger doctors use objective observations and analysis? Consider the kind of medical student our prestigious medical schools are seeking now. In former years, premeds were notorious nerds, usually science majors, constantly studying to make grades in hard subjects. High scores on the Medical College Admissions Test (MCAT) required ability for quantitative thinking and a foundation of factual scientific knowledge.

Since 2015, the new MCAT includes "situational judgment tests." The president of the entity that makes the test, Darrell Kirch of the Association of American Medical Colleges, intends to redefine what makes a good doctor. "I believe it is critical to our future to transform health care. I am not talking about tweaking it. I am talking about true transformation."

Ezekiel Emanuel, chair of the Department of Medical Ethics and Health Policy at the University of Pennsylvania, asks in the Journal of the American Medical Association, "Does medicine overemphasize IQ?" A high IQ is no guarantee that a physician can "lead a multi-disciplinary health team or effectively help patients change their behavior in ways that tangibly improve their health outcomes."

Instead, reformers advocate eliminating "the irrelevant premed requirements of organic chemistry, physics, and calculus, while requiring training in psychology and leadership." A model negotiating session might be included in the interview process. Of course, the physician must be able to "sensitively discuss end-of-life care preferences." Emanuel has promoted the view that people have lived long enough at age 75.

The curriculum now must have social justice as a "core tenet of medical ethics," teach about "unconscious racism," and include 30 core competencies for caring for LGBT patients. Certain propositions are assumed to be true, and evidence that contradicts them is flushed down the memory hole, while supporting data is accepted without question. For...