Don’t Buy the American College of Surgeons’ DEI Rebrand

Soon after George Floyd’s death in May 2020, the leadership of the American College of Surgeons assembled a Regental Task Force on Racial Issues to “address the issue of structural racism in the American College of Surgeons (ACS) and within the profession of surgery.” Now, with DEI out of favor, it’s scrambling to rebrand again—but no one should fall for it.

What was the justification for the grave allegation that surgery is “structurally racist?” ACS contended that minorities are underrepresented in the governance of the organization and in surgery more broadly, and that the only possible explanation for these disparities is systemic racism. No other cause was considered.

The leadership of ACS went further, suggesting that black patients would have better outcomes if their surgeons were black. This idea, known as racial concordance, is not only based on low-quality evidence but is also corrosive to trust between surgeons and patients of different racial and ethnic backgrounds.

The ACS leadership began transforming a venerable, respected professional association into a promoter of racialist ideology by adopting the antiracism approach of Ibram X. Kendi. It formed a new regental office of diversity and started training its staff and surgeons on how to implement this ideology.

That effort included the publication of a “DEI Toolkit” in December 2023. The toolkit explicitly promoted the discredited Implicit Association Test and racial concordance. In support of racial concordance, it cited a study that has since been debunked by Manhattan Institute scholars. A rigorous, systematic review by Do No Harm has also discredited racial concordance.

Now, faced with Kendi’s fall from grace, the shuttering of Boston University’s Center for Antiracist Research, and growing disillusionment with the DEI movement, the ACS leadership had three choices: divest itself of its DEI-related initiatives, continue to promote them uncritically, or find a compromise allowing the ACS to claim that it was distancing itself from DEI even while continuing to pursue it. Unsurprisingly, ACS chose the third option.

The first step was to rebrand DEI under a new name. The ACS chose “inclusive excellence.” Look beyond the revised labeling, and you find the unchanged tenets of DEI: proportionate racial representation as a goal, lowering standards to avoid disparate outcomes, and racialization of all aspects of surgery, including an adherence to racial concordance.

The subterfuge included scrubbing references to DEI wherever possible. Both the DEI (aka Inclusive Excellence) Toolkit and the report and recommendations by the ACS Task Force on Racism are currently unavailable on the organization’s website.

A quick perusal of course offerings at the upcoming ACS Clinical Congress this October makes clear that the organization has not meaningfully retreated from DEI. Attendees can participate in courses like DC04, “Inclusive Excellence Certificate Course”; ME308, “Inclusive Excellence: Changing Composition of the Surgical Workforce”; and ME312, “The Impact of Social Determinants of Health on the Surgical Oncology Patient.”

The practice of surgery faces many challenges. Those include declining quality of surgical training and a shortage of surgeons that is projected to worsen. The focus on race and racial disparities distracts from necessary efforts to address these and other real problems.

The ACS leadership needs to acknowledge its mistake in embracing critical race theory in the guise of antiracism and DEI. It should apologize to its member surgeons and their patients for promoting the odious concept of racial concordance. And it should eliminate all DEI initiatives. Only then can the ACS restore the trust it has squandered and return to its primary mission: “To Heal All with Skill and Trust.”

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