Is There Any Place for Race in Medicine?

What prescription would you recommend?” my attending physician asked me.

We had just admitted a patient to the large teaching hospital where I was a medical student. He had been in hypertensive crisis with type-2 diabetes and would soon need a medication he could take at home. This was the first Black patient I had helped evaluate with this condition, and I knew we could not recommend the standard medications, the ones prescribed to all of the patients I had seen up to that point in my medical training.

His prescription would have to differ because a series of decades-old studies, “adjusted” for race (“Black” vs. “non-Black”), found that Black research participants had a suboptimal response to the standard, first-line treatment.

Physicians often still assess—and treat—Black patients differently.

I knew this common wisdom well from graduate school training in epidemiology, where decisions like these were about numbers and statistics. As expected, the team prescribed this Black patient a calcium channel blocker rather than a standard ACE (angiotensin converting enzyme) inhibitor or an ARB (angiotensin receptor blocker) that non-Black patients received.

It was only later that I learned that this recommendation was based on studies that had looked specifically at the responses of African-Americans. But we had been treating an immigrant from West Africa at a Canadian hospital. Which meant that we were making a prescription decision not based on data from people of his particular genetic background or lived experience but on his skin color alone. And that felt like a flimsy clinical benchmark. But it was 2011, and I was still a medical student, so I went along with the established, “best practice” recommendation.

Today, despite decades of work