Medical Elitism in America

Since the dawn of modern medicine, only those with power and privilege were able to enter a field as “prestigious” as medicine. Despite traditional medicine and healing being historically practiced by women, the emergence of modern medicine was the emergence of medical elitism and transformed into an opportunity for white men to become the highest authority on health. During the rise of modern medicine in the United States, the only people with the power and privilege to enter the medical field were white men. Women who wanted to enter the medical field could do so as midwives, but the physicians and surgeons were men. Women and people of color did not start having a true presence in the medical field until the late 1970’s when multiple anti-discrimination laws were passed, however, even in 1985, only 16% of practicing physicians were female, and in 2021, still only 36% are female compared to a whopping 64% of physicians being male. Because men were the ultimate authority on medicine from the 17th century onwards, practically every medical text until the late 20th century was written by white men who used other white men as the primary health model.

This absence of women and BIPOC from the healthcare industry has caused huge disparities when it comes to healthcare. Due to this absence of diversity—not only in practitioners but also in textbooks and treatment methods— there are many diseases that present differently in different sexes and ethnicities that are often misdiagnosed or go unnoticed because of the lack of information regarding how they affect different groups. There is still an extreme lack of diversity in present day clinical studies, which is likely due to the well deserved mistrust that many BIPOC have of the healthcare industry because of numerous human rights violations, experiments, incidents of medical malpractice, and discrimination against them by the western medical system (the most well known example being the Tuskegee experiments).

An effective way to combat the gross inequalities that permeate the medical system would be to have more women and BIPOC practitioners, however the systems currently in place are still incredibly restrictive. In order to become a practicing physician, one must undergo 4 years of undergraduate education and 4 years of medical school before even earning an income. At public 4-year institutions, the average in-state tuition and required fees total $9,308 per year; out-of-state tuition and fees average $26,427. At private 4-year institutions, the average tuition and fees at a nonprofit college total $35,801 annually; at for-profit institutions, tuition and fees average $15,156 annually.

After finishing undergraduate studies “an applicant to 15 medical schools can easily spend over $10,000 in the application process.” The average cost of 4 years of medical school in America in 2019-2020 was $250,222 at public institutions and $330,180 at private colleges, according to a fall 2020 report issued by the Association of American Medical Colleges. These are not costs that the average American citizen can handle without loans (or even with loans). The inability to bear those costs is already a huge deterrent for many, and those with the ability to spend copious amounts of money on schooling are still majority white men (or the children of those white men). Even if one is able to bear the cost of undergrad and medical school with scholarships or loans, the intense rigor and pace of medical school can be equated to military hazing that turns eager medical students into technocratic zombies more concerned over the monetary gains they can make back rather than the treatment of patients. This system provides a functional barrier between the medical field and potential doctors who could bring actual diversity and consideration for the patients they treat. While conservatives will vehemently deny it, the white patriarchy still heavily permeates every single facet of our lives, including our bodies and our health. It uses capitalism as a way to control and exploit women and BIPOC while continuously benefiting the people in power.

While we have certainly made progress in diversifying the medical industry since the early 17th century, inequality still dominates the health industry and prevents millions of people from receiving the proper health care they deserve. This system operates on so many levels to industrialize and privatize the healthcare system for profit while neglecting the health of its people. A capitalist medical system only further breeds the exploitation of those without privilege, and it won’t be sustainable for much longer as the cracks in the system continue to spread with the increase of disease, pandemics, and climate refugees. We can only hope that these clear cracks in the system continue to wake people up to the deeply flawed system in place and somehow systemic change will be brought about before it’s too late.