By Mike Markham
Duke University Health System fired Dr. Kendall Conger, an emergency room physician in its Raleigh, North Carolina hospital, for questioning Duke’s 2021 “pledge” against racism in medicine.
Conger stated his views in a May 2023 Martin Center article, “Duke Health’s Antiracist ‘Pledge’ is Not Guided by Science.”
Conger, a respected member of the medical community, did not object to standing against racism or treating people with decency and respect, primary tenets of the pledge. Conger questioned whether racism in medicine was as significant a problem as Duke claimed it to be and whether there was legitimate scientific evidence to support that belief.
In 2020, for example, Duke Health had gone so far as to declare racism “a public health crisis.”
Going Public a No-No
After years of being ignored and receiving information from Duke that was long on ideology and short on science and clinical data, Conger exceeded his employer’s tolerance.
In December 2023, Conger’s supervisor told him that the reason the institution was typically reluctant to engage him on its stances was his tendency to discuss those matters outside of the workplace. Conger was understandably puzzled that a prominent institution would take issue with challengers after it released its statement publicly and strongly defended it.
Conger immediately sent a letter to several of his colleagues informing them of the message he had received from his supervisor.
Duke Health notified Conger of his termination a few weeks later. Under the terms of his employment, Duke was not required to provide a reason. Duke, however, stated in a letter to Conger, “We believe your behavior is negatively impacting the emergency physician team, which could jeopardize the care of patients. Given this, we are choosing not to renew your contract for employment.”
Accused of Harming Patients
While failing to offer any specifics, Duke Health appeared to suggest Conger’s commitment to treating patients as individuals and rejecting the dynamics of collectivism could put patients in harm’s way, as could his observation of the lack of scientific evidence for Duke’s ominous claims about racism in medicine.
In his article, Conger said Duke is “guided by science” but its 2021 “antiracist pledge,” while well-meaning, was an unnecessary response to a popular political movement.
Duke employees had been briefed on the pledge before it was released publicly and were invited to contact their superiors with any questions or concerns. Conger’s trouble began when he decided to take his employer up on that offer.
Up the Chain of Command
Conger reached out to Duke Raleigh Hospital President Dr. Barbara Griffith and met with her in person. Also present at that meeting was a representative from the human resources department. Conger’s specific question was “Why is equity a better goal than equality?” Griffith did not respond to Conger’s follow-up emails related to that meeting.
Conger wanted to be sure he wasn’t being personally roped into a political position held by his employer. Duke never offered any scientific or clinical justification for the idea that racism is a significant problem in medicine.
That concerned Conger, who wanted to perform his job free from the shadow of politics or well-meaning but false social narratives. Conger specifically asked Duke brass why they believed it was beneficial to view patients as members of ethnic groups more than as individuals requiring care.
As a respected physician, Conger was particularly concerned about any ideas being presented as absolutes without accompanying clinical data or scientific proof. A Duke-employed doctor for 12 years, Conger had everyday professional experiences in the intense field of emergency medicine that were at odds with Duke’s claims about racism.
‘Implicit’ Bias Claimed
Duke’s antiracism pledge states, “We recognize our own implicit biases.” Ironically, by definition, one cannot recognize his or her own implicit biases as that phrase is traditionally defined. Before his notice of termination, Conger did at one point receive an email from a Duke official who said, “I concede that I cannot find a [clinical] trial that proves implicit bias is the cause of worse health outcomes for African Americans. Believe me. I have looked.”
Conger was astounded that the Duke official admitted to searching for supporting data after the institution created and publicly released its pledge.
The Duke official who corresponded with Conger mentioned “ample causal inference data in the social sciences.” Conger believes a medical institution should rely on evidence-based clinical data. Social science data are known to be easily manipulable and are generally viewed as inappropriate and insufficient for forming conclusions or driving actions in the field of medicine.
White Males Singled Out
Conger also recalls being shown an illustration during a Duke-sponsored function, that depicted white males as agents of oppression and exploitation while ominously labeling members of other demographics as “targets.” Again, no scientific or clinical data were offered to justify or explain why a major health care provider espoused such darkly generalized views of people.
While Conger is left to plan his next professional move, Duke Health—an arm of a Tier 1 research university and so-called Southern Ivy—has yet to explain its ominous claim that racism is “a public health crisis.”
Mike Markham (Mike@mikemarkham.com) is a program coordinator with Color Us United. An earlier version of this article was published by the James G. Martin Center. Reprinted with permission.
