Failure To Promote Diversity Leads To Litigation

On July 2, 2021, the Accreditation Council for Graduate Medical Education (ACGME) placed the graduate medical education programs at the Tulane University School of Medicine on probation.

The dean stated that the ACGME outlined two areas of concern: "oversight of our programs" and "improving our learning and working environments, including enhancing equity, diversity, and inclusion."

The national accreditor visited Tulane following allegations of racism and retaliation made by an administrator against the school.

Dr. Dennar, a black woman, was suspended from her position as the director of the internal medicine-pediatrics residency program in Feb. 2021. She alleged the School of Medicine retaliated against her for filing a federal racial and gender discrimination lawsuit against the school in Oct. 2020. She claimed her residency program was "disproportionately composed of women of color."

Tulane denied the allegations and alleged that she was suspended because of a review following a warning from the ACGME. However, Dr. Dennar contended that other programs had received warnings, but that she was targeted for review. She retained her position as a medical director of another program.

The dean offered to reinstate Dr. Dennar but conditioned it on her receiving coaching, support, and ongoing oversight. She declined the offer. Her lawsuit is ongoing.

According to the chief public policy officer of the ACGME, when taking action against a school the council first issues a warning, followed by probationary accreditation, which could lead to a school losing its accreditation if the issue is not corrected by the next review cycle. While on probation, a program cannot expand its programs or apply for new ones.

He said in the case of Tulane, "there are very widespread concerns about racism and [graduate medical education]." He added that the council can expedite site visits when "a violation of our requirements puts in jeopardy either the safety or the education of the residents," such as in the case of retaliation.

The dean of the School of Medicine outlined a plan for responding to the probation that included a task force to evaluate the handling of reports of mistreatment and unprofessionalism as well as decreasing the clinical workload of residence. Unequal workloads have led to discrimination complaints.

The school will also hire a law firm to evaluate the "operation, oversight, and supervision of graduate medical education" and a consulting group to help the school "better understanding individual experiences related to equity, diversity, and inclusion." Philip Kiefer "Tulane School of Medicine placed on probation by accreditor amid allegations of racism, lack of diversity" thelensnola.org (Jul. 06, 2021).

 

Commentary and Checklist

The ACGME review process gives healthcare and healthcare-related organizations an opportunity to correct issues that can result in litigation.

The healthcare organization heeded the assessment of the accrediting association that Tulane’s School of Medicine had “very widespread concerns about racism and graduate medical education”, which observations about issues can put a healthcare organization at risk of discrimination lawsuits. 

How can healthcare employers promote a culture that embraces diversity and inclusion and celebrates the contributions of every individual to the organization?

  • Hire and promote individuals of differing genders, races, nationalities, religions, and backgrounds.
  • Implement a diversity sensitive recruitment process to encourage more diverse hires.
  • Provide hiring and employment documents in multiple languages when possible.
  • Provide managers with sensitivity training in addition to training them annually on your anti-discrimination and anti-harassment policies.
  • Make sure that all individuals are listened to equally in team meetings and given equal responsibility, regardless of background.
  • Pay all individuals fairly without discrimination.
  • Monitor interactions among employees for signs of harassment.
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