Affirmative action is an umbrella that covers many activities -- from aggressive recruiting to filling quotas, from the awarding of contracts to higher education admissions. This means that opponents can call up unpopular images of the most aggressive examples of affirmative action (such as hiring set-asides) to attack the entire idea of affirmative action.

In the higher education arena, opponents subtly "play the race card." They focus on affirmative action related to the admission of racial/ethnic minorities although women, athletes, and children of alumni and large donors also receive special consideration.

An initial (and critical) question is: What is society's compelling interest in assuring racial and ethnic diversity in medicine? The rationale for racial and ethnic diversity in medicine is robust, including at least five components. * It is a matter of simple equity and justice that minorities have equal opportunities to be a part of such a key profession in our society.

We now have data that minority physicians improve access to care. They are much more likely to serve minority patients, poorer patients, and sicker patients.

A broad research agenda is essential for scientific progress against the diseases that plague and kill all Americans. Though there is less data to support this assertion, in my experience people research the problems they see and feel. in running faculty development programs, minority physicians are much more likely to be interested in research problems that are relevant to poor and minority patients.

Medicine is now a trillion dollar-a-year corporate enterprise. For a variety of reasons that are now well accepted in corporate America, it is essential that some of those managers be minority.

"Cultural competence" is an essential skill in serving the diverse patient population,s that characterize America now. This requires diverse teams of students who can teach each other cultural competence and diverse health care delivery teams to practice it.