First do no harm

National Review, Oct 13, 1997 by Gail Herjot

Until recently, Patrick Chaviss claim to fame was that he was admitted to the University of California at Davis Medical School as an affirmative-action student in 1973 the year Allan Bakke was rejected. Because of Chaviss outspoken advocacy of racial preferences, the media sometimes referred to him as "the student admitted in Bakkes place although, strictly speaking, he was one of several possibilities.

Chavis went on to become an obstetrician/gynecologist in Compton, California, a mostly minority suburb of Los Angeles. Chavis also became a much-celebrated symbol of racial preferences. When the New York Times Magazine published Nicholas Lemanns ten-page paean to affirmative action in 1995, Dr. Chaviss picture graced the cover. Inside was a full-page photograph of him cradling a newborn.

During the Proposition 209 campaign, his name was difficult to escape. Sen. Edward Kennedy (D., Mass.) called him a "perfect example of the enormous dividends affirmative action has paid. Tom Hayden and Connie Rice argued that by practicing medicine in Compton, Dr. Chavis had contributed more to society than Dr. Bakke had: "Bakkes scores were higher, but who made the most of his medical-school education? From whom did California taxpayers benefit more?

Then came the fall from grace. Two months ago, citing his "inability to perform some of the most basic duties required of a physician, Judge Samuel Reyes ordered Dr. Chaviss license suspended. His "gross negligence and "incompetence had led to the death of one patient and near-fatal injuries to others. Allowing Chavis to continue practicing medicine, the judge wrote, would "endanger the public health, safety, and welfare.

It turns out that Chavis no stranger to disciplinary actions even before his suspension was in the liposuction business. He learned the procedure at a four-day seminar at the Liposuction Institute of Beverly Hills; he never bothered with the programs second half. For $2,580, Dr. Chavis would send a limousine to whisk you away to his office; he would have you back home before dinner, thinner and lovelier.

Thats how it was supposed to work. Yolanda Mukhalian had a very different experience. Hours after her surgery, she was vomiting, incontinent, and unable to stand without assistance. Blood poured down her legs. Instead of getting her to the hospital, however, or even checking her vital signs, Dr. Chavis took her to his home. There she lay for 40 hours, with shockingly little supervision, her blood soaking the towels and sheets. During her last 24 hours there, neither Chavis nor his nurse even looked in on her.

Afterward, Miss Mukhalian repeatedly sought Dr. Chaviss help for bleeding, pain, and delirium. He prescribed heat packs and massage, again without examining her. When she finally went to a hospital, she was found to be suffering from serious infection. She had lost 70 per cent of her blood. The medical board filed ten separate charges of gross negligence against Chavis on account of her treatment.

But she at least survived, as did another liposuction patient who had a similar experience. Tammaria Cotton was less fortunate. She died despite desperate attempts by emergency-room doctors to revive her.

This tragedy obviously doesnt prove that most doctors who received preferences are incompetent, just as the original story didnt prove they are all saints. Its a counter-anecdote neutralizing the original storys rhetorical effect. As such, its use is fair: live by the anecdote, die by the anecdote.

More importantly, the story is a reminder that medicine is too serious to be driven by ideology or political pork, with qualifications overridden when some group doesnt get its "fair share of slots. Bakkes college GPA was 3.46; his scores on the verbal, quantitative, science, and general-information portions of the Medical College Admission Test were in the 96th, 94th, 97th, and 72nd percentiles, respectively. The average student admitted through the diversity program had a GPA of 2.88 and MCATs in the 46th, 24th, 35th, and 33rd percentiles. Entering credentials matter.

A study published in the Journal of the American Medical Association in 1994 reports that failure rates for the National Board of Medical Examiners Part I exam which measures minimum competence in the scientific core of modern medicine, including basic anatomy, pharmacology, and pathology were 51.1 per cent for African-American medical students, compared to 12.3 per cent for their white counterparts. Preferences were almost wholly to blame for this gap, which mostly disappears when MCAT scores and undergraduate GPAs are taken into account.

While they undermine the quality of medical practice, racial preferences dont much improve inner-city access to medicine. The average minority medical student is only somewhat more likely than other students to open a practice in the inner city. If the University of California were really interested in that goal, a loan-forgiveness program for doctors who practice in under-served areas, regardless of skin color, would be vastly more effective than racial preferences.