My isolation within the American College of Surgeons began over a year ago, on April 17, 2022. This was the day that Tyler Hughes, general secretary of the ACS and editor-in-chief of its online forum, informed me that I had been banned for life. I had inquired why I could not access the Communities, the online discussion forum of the ACS, for nearly two weeks. Neither could I access the members directory or my own private messages. Hughes made it clear that this was to be a permanent ban.
Why was I banned? For questioning the ACS’s rush to embrace critical race theory.
For nearly 30 years, I had been a proud fellow of the ACS, the oldest organization representing surgeons—it was founded in 1913—and the largest, with 84,000 member fellows. Its mission statement: “To heal all with skill and fidelity.” Fellowship indicates that surgeons practice at the highest level of the profession and allows them to place the honorific “FACS” after their “MD,” something I was proud to do. Beyond being a fellow and paying my dues, however, I was never active in the ACS. My busy practice, involvement in local medical societies, and family life precluded additional commitments.
This changed in 2020, in the wake of the George Floyd killing. In the chaotic, hyper-racialized, and politicized aftermath of that event, nearly every major organization in the United States rushed to signal its acceptance of the belief that the country, its institutions, and even its legal system were systemically racist and in need of radical transformation. This took the form of embracing critical race theory (CRT) under the guise of diversity, equity, and inclusion (DEI) initiatives.
The ACS joined this pell-mell rush and within weeks of the Floyd killing had assembled a Task Force on Racism to combat structural racism in the organization. The reality of structural racism was never questioned, nor did the task force provide any evidence for its existence. Rather, the task force assumed racism to exist on the basis of disparities in the representation of blacks in the ACS and allegations of racial disparities in surgical outcomes. The task force’s recommendations were to adopt “antiracism,” an activist social movement that claims that one cannot simply not be racist; one must be actively engaged in antiracism, a term coined by Ibram X. Kendi, author of How to Be an Antiracist. The ACS installed a new Department of Diversity to counter racism, with its own executive director and clinical director, the latter a new position on the Board of Regents. The board also instituted DEI initiatives such as training in implicit bias, microaggressions, and ally/active-bystander response, all of which are integral to CRT. (Even so, the board denied that any of these measures constituted CRT.) in June 2021, the ACS hosted a retreat for leaders of all the surgical societies in the U.S. and invited Kendi as keynote speaker.
Along with several other fellows, I viewed these changes with alarm. To us, it seemed that the ACS was prioritizing DEI at the expense of excellence and meritocracy. We believed that sacrificing these principles for an ideology would inevitably lead to an erosion in quality of care. And the claims that white surgeons were racist and that racism infused our specialty were repugnant to us.
I took issue with these changes in a post on the ACS Communities online forum. This led to the longest-running comment thread with the highest engagement in the history of the forum. Those who agreed with me outnumbered those who didn’t by two to one. The ACS leadership invited me to discuss my concerns over a Zoom call. The call included Hughes, one of the Regents, the new Clinical Director of Diversity, and a female, black surgical colleague of mine who has supported me. All participants aired their views, and the discussion was entirely civil. After the call, however, the ACS changed the rules for the Communities to ban any discussion of DEI on clinical forums, and I was soon deplatformed permanently.
The reasons given for my ban were my “continuous disrespectful language and placement of non-clinical posts in the General Surgery community,” according to Hughes. I disputed both claims and asked multiple times for examples of either offense. The ACS leadership ignored this request. I asked for a hearing. The leadership informed me that my ban was not being handled through the ACS’s Central Judicial Committee (as ACS bylaws require), so this was not a disciplinary matter that justified a hearing. My isolation within the ACS was complete.
Why should anyone care about this? What does it matter that a professional organization has silenced a single surgeon for objecting to its embrace of DEI? It matters because the stifling of open, civil discussion and debate is a litmus test for the health of our liberal democracy. It matters because medicine should be free of partisanship and the promotion of ideology over science and facts. And it matters because group identity and race essentialism should not supersede excellence and meritocracy.
To date, the ACS has failed to present peer-reviewed evidence of its claims of structural racism within the organization. Moreover, studies purporting to show that blacks do worse under the care of white doctors are fatally flawed and intended to score political points at the expense of science. Is your surgeon unconsciously racist? As a black patient, can you expect the best care from a white surgeon? Are blacks being held back from becoming ACS surgeons due to racist policies and practices? These are important questions. They need to be discussed, debated, and investigated through well-constructed, peer-reviewed studies.
To say, without evidence, that the ACS and white surgeons generally are racists who treat their black patients with substandard care, and then silence those who dissent is despicable and antithetical to the tradition of scientific inquiry in medicine. I am not a racist, and I know of no surgeon who is. I submit that any claim to the contrary is wrong.