Howard, Mehary Cry Foul Over Newspaper’s Questionable Study

The study, conducted by The Hartford Courant and published the last week in June, called into question the academic quality of the two historically Black medical schools, the competence of their graduates and the future of the medical students who currently attend them.

“Classmates that I have spoken with are outraged,” says Dr. David Travillion, a 2002 graduate of Meharry Medical College in Nashville, and a resident at the University of Texas Health Science Center in San Antonio. Travillion heard about the newspaper’s findings while listening to an interview with one of the study’s authors on National Public ­Radio.

“The report made me feel self-conscious at first,” he says. “I expected to be confronted by colleagues. … I think it will bring unwarranted scrutiny on Meharry graduates.”

Both Howard, Meharry and a number of other organizations in the medical profession questioned the newspaper’s methodology and, therefore, its findings. Among them were Dr. Jordan Cohen of the Association of American Medical Colleges; Dr. L. Natalie Carroll, president of the National Medical Association; and Dr. Roxane Spitzer, CEO of Meharry’s teaching hospital, Nashville General.

“We are reviewing the methodology employed by The Hartford Courant,” a statement on Howard University’s Web site, posted July 7, said. “We also question the failure of The Hartford Courant to appropriately distinguish the type and manner of discipline involved in these cases and the reasons for the discipline. There is no way to determine, based upon the article, whether the discipline was in the form of an admonition, censure, suspension or revocation of license.”

Carroll of the National Medical Association, the leading organization of African American physicians, said in a July 1 letter to the newspaper’s editor:

“We at the National Medical Association are extremely disturbed by the article’s unsubstantiated findings and the sweepingly negative implications upon the medical community at large, and specifically upon two premier medical colleges that have educated a large number of the nation’s physicians of color.”

Prior to the newspaper’s publication of the articles, Meharry President John Maupin said he asked one of the reporters of the study if the school could have access to the data in order to properly review them. The reporter said he would share some of it but not all, according to Maupin.

“Without being provided with the data in full, in the same format as it was obtained by the newspaper, we felt denied the opportunity to make an informed response,” Maupin said in a July 18 interview.

Regarding the methodology, Maupin said:

“First, we still don’t know what methodology the paper used. …The paper did not provide the complete analysis of the data, explaining their precise methodology. In fact, the most basic question concerning this group of physicians, ‘When did they graduate from medical school’? was never addressed in the article.

“Second, the paper looked at all disciplinary actions taken as a result of any infraction. …Without knowing the specifics of the infractions, it is impossible to judge how a physician’s medical school experience may have ultimately contributed to it. … Finally … there are any number of factors one must thoroughly review if trying to determine the causal relationship associated with disciplinary action against a physician. It is erroneous and just simply faulty to make a direct relationship between disciplinary actions and the quality of medical school education alone.”

The implications of the study’s findings were not lost on The Hartford Courant‘s editorial staff. The newspaper ran the lead article with the stark title, “Med Schools: Four That Flunk.” After analyzing three separate databases, the study author’s concluded that Meharry and Howard, along with the Autonomous University of Guadalajara in Mexico and Manila Central University in the Philippines, were the only “elite” medical schools in the United States that were in the bottom 5 percent of all three databases. The Courant defined “elite” as “larger, well-­established schools.” Graduates of these well-established schools made up 90 percent of the doctors in the three databases that the newspaper analyzed, according to the Courant. The databases, which included the consumer advocacy organization Public Citizen’s “Questionable Doctors” and two “physician profiles” maintained by California and Ohio, listed doctors who had been disciplined by federal and state regulators.

Jack Dolan, one of the two reporters of the Courant study said the newspaper struck a balance in its coverage by writing “the stories with an eye toward the remarkable challenges Howard and Meharry have faced over the decades.” As part of the two-day series, the newspaper reported a separate story on the historically Black medical schools entitled, “Black Medical Schools Struggle to Compete,” which ran June 30. The article discussed some of the factors, besides academics, that could have landed the schools at the bottom of the study. Among the other factors discussed were racism, inadequate funding, increased competition for good African American students, serving underserved students, and graduates serving underserved communities.

In a statement released to Black Issues, Howard officials pointed out that a significant number of their graduates serve disadvantaged communities:

“We expect our graduates to provide an exceptional level of service to the nation. And they do. In the most recent review, nearly 40 percent of Howard-trained physicians had returned to practice in America’s inner cities, where many patients are economically disadvantaged and medically underserved. In treating this segment of the population, physicians often provide medical services to patients suffering from more advanced stages of disease before help is sought and, consequently, requiring more complex treatment,” said the statement.

As well, Maupin is proud of the fact that Meharry admits some students from “disadvantaged backgrounds,” and that many of its graduates tend to practice in traditionally underserved medical professions and underserved areas. Instead of suggesting that those were culprits in the newspaper’s finding, Maupin instead wonders whether cultural or racial factors cause Black physicians to be disciplined more than others.

“We know that pockets of racism still exist in this country and do thread their way throughout society,” he says. “Therefore, we do believe that racism and ignorance of cultural differences probably do play a role in some, if not many, of the disciplinary actions taken.”

Along those lines, some have accused the newspaper of being racist.

“I know why they think that, and I don’t blame them,” Dolan says. “All I can say is that when I did the initial computer query, I wasn’t expecting to see Howard and Meharry. The results were a genuine surprise.”

The results also presented a dilemma for the newspaper, according to Dolan.

“Challenging governments and powerful industry organizations is our job, and we don’t shrink from it. But this time we found ourselves with evidence that basically noble, traditionally under-resourced institutions, were producing doctors who go on to endanger their patients at higher rates than other schools. That presented a dilemma. Ignoring our findings would have meant withholding important information from the public. … The flip side is that writing these stories was bound to bring some grief on people — graduates who have never been disciplined, for example —  who don’t deserve it.”

Howard and Meharry are two of the four historically Black medical schools in the United States. The two schools graduated the most African American physicians in 2002, according to Black Issues‘ Top 100 graduate report (see Black Issues, July 3).